The fight against polio is not over. We must continue efforts to eradicate it

Viruses are microscopic living organisms that, by their very nature, can be incredibly difficult to control and even harder to eliminate for good. SARS-CoV-2 raised awareness worldwide of the extra challenges of managing and controlling a completely novel pathogen. But many challenges hold true even for longstanding and intractable infections like polio. Despite nearly reaching a worldwide goal of eradicating polio, the global public health community remains several years away from that achievement.

On this World Polio Day, I am fully confident that we will reach that laudable objective sooner rather than later if we all continue to play our part in the fight. We’ve come very close, but there are still a few big hurdles to overcome before we fully rid the world of this devastating disease.

Polio used to be omnipresent. It infects people through the mouth and digestive tract and is highly contagious. At one point in history it had made its way to nearly every corner of the world. Many of us remember grandparents who limped or suffered worse outcomes from their infections before vaccinations became available. Even in 1988, at the creation of the Global Polio Eradication Initiative (GPEI), 350,000 children were still paralyzed each year across 125 different countries.

Today, thanks to massive awareness and vaccination campaigns, in most developed countries, we no longer see polio. GPEI and health care workers across the globe have eradicated two out of three wild virus types, with the remaining one only endemically circulating in just two countries where political unrest has hampered vaccination campaigns (Afghanistan and Pakistan). The World Health Organization (WHO) has also recommended that live, attenuated oral polio vaccines be followed up with two shots of inactivated polio vaccines to reduce the rare occurrence of vaccine-derived polio outbreaks (called cVDPV) that can occur.

But in recent years, the total case numbers have grown slightly, due to wars, socio-economic and public health crises that have inhibited optimal access to all necessary vaccines. Many public health leaders fear the gains made so far against the disease could be precarious still, especially if vaccination is not maintained and increased in most at-risk areas.

In 2018, the world saw only 33 world polio virus cases and just 105 cVDPV cases. We saw increases of more than 100 wild polio cases in 2019-2020 and a rise in cVDPV in 2020 to more than 1,000 cases, a number which the public health community was able bring back down to 75 in 2021, so far. To provide some perspective, the US Centers for Disease Control and Prevention (CDC) has estimated that if current vaccination programmes worldwide were stopped, within a decade a polio resurgence could paralyze 200,000 children a year.

The kinks in the path to eradication came in part from pauses in routine vaccination programmes when the COVID-19 pandemic hit. In 2020, nearly 70% of countries surveyed by the WHO reported that routine immunization programmes (including those that cover polio) saw disruption due to the pandemic.

A year later, almost 40% of countries still reported ongoing disruption of their vaccination programmes. This includes some developing countries where vaccination levels for polio and other childhood diseases were still at precarious levels before 2020. I believe these countries will continue to close the gap and catch up in the months ahead.

Vaccines are critical to reaching eradication, and they will be important contributors to maintaining eradication once it is achieved. The GPEI has set its eradication goal at the year 2026, but even when we achieve it, public health experts will continue to advocate for ongoing vaccination with inactivated polio vaccines for years or even decades thereafter.

While this may sound counter-intuitive, it will be a critical part of truly beating polio. If there is even one child with an infection, an outbreak can occur. We must be vigilant in the long term by ensuring perfect coverage with vaccines as is humanly possible, not only to close in on the virus but also to remove it from life on earth forever.

Sanofi remains committed to our part by supplying inactivated polio vaccines (IPV) and pediatric combination vaccines. We must collectively help the world catch up and maintain high rates of vaccination with all available polio vaccines if we are to continue to strive for full and long term eradication.