Cameroon:“Africa can use the polio example to get rid of vaccine preventable diseases”- Prof Rose Leke

The ARCC just recently certified Cameroon and 46 other African countries as wild polio free, how did all of this…

The ARCC just recently certified Cameroon and 46 other African countries as wild polio free, how did all of this come about?

The ARCC- the African Regional community commission is the only body that can certify the region free from the wild polio virus and so that was done on August 25. In working, the ARCC has had the duty to put in place national certification committees, National Polio Expert Committees and National Task Force, committees in countries that work with the programs in the country and then collaborate with all the partners in the polio eradication initiative to make sure that surveillance is well done in the country, routine immunization is improved at all times because we need that for population immunity. When a country gets to where it has been three years any sign of polio virus, and surveillance is very good, and routine immunization is at its best, we now have that country present their documentation and if accepted, then they will get a polio free status documentation presented to the ARCC.

All the countries have gone through that process and the last four; countries South Sudan, Nigeria Cameroon and Centre African Republic were the last African countries to go through this process in June which was quite challenging, because these are areas with conflicts, inaccessibility but we were able to give them the polio free status in June; that is why all the 47 countries have had their polio free status. It has been four years since the last polio virus was noticed in the region, it was time for the certification commission to say that the African region has interrupted the transmission of wild polio virus and the commission now signs the certificate that was handed to the regional director who responded and of course present also was the Director General of WHO, and then all the partners, WHO, Centers for Disease Control, Rotary International, Unicef, Bill and Melinda Gates,  Dangote etc. And so, each of these partners had a turn to say something and of course Garvey which gets the vaccines. All of them had something to say because it is really a massive achievement   for public health and for us in this region though there is still quite a lot to do.

After gaining this wild polio free status does it means that vaccination will stop, Is there no risk for wild poliovirus to resurface again?

 The work does not stop here as Dangote said that, we celebrate today and tomorrow we start working,  because we have to be sure…Pakistan and Afghanistan are they two countries that have the wild poliovirus circulating there. If anybody from these two countries visits us here, and the population immunity is low, the virus will come in and stay with us and if surveillance is not good, we will not even know that the virus is there and it would have spread around before we even notice. So, it is important that surveillance be kept at its best and that routine Immunization really improved on in all countries in the region. Talking about that also, we are talking about the transmission of the wild poliovirus because right now, we have the outbreaks of the circulating vaccine derived poliovirus(cvdpvd2) and so …when there is low population immunity, children that are not vaccinated, this now mutates and attacks these children and causes this paralysis. So we have to really heighten up surveillance the same with routine immunization which is very important for the region, until we will be rid of wild polio virus and cvdpvd2 all over the world and it is from there that we can stop with the vaccination, but for now is it very imperative that we keep on with the vaccination, no complacency at all.

What lesson Africa have from this success which can be replicated to achieve other public health goals?

This shows that Africa can use this as an example to be able to get rid of other vaccine-preventable diseases. The polio program has a great infrastructure that was put in place and that would really benefit other programs. It is a very structured program right from the headquarters down to countries and districts and so on, if other programs could work like that, we will really improve on a lot on these diseases that we have.

Also, the laboratory network for polio is excellent, those are polio legacy, those surveillance officers who were trained for polio, at least two million volunteers that are working like vaccination officers are the ones who worked very hard now for covid-19 …so they are doing surveillance for COVID-19 and also for polio. If you remember in Nigeria there was one case of Ebola and you know what Ebola would have done to Nigeria,  it is the polio structure that got that one case and dealt with it in a way that it disappeared and that was all. There was no other spread of Ebola in Nigeria because of the polio structure. The emergency operating centre that was put in Abuja…and that is where we have all these ideas of emergency operating centres, it really started out with polio and working in Nigeria and has spread out around other areas. So, there is a lot that this structure that was put for polio can do in countries and people can use it; use the knowledge, use the expertise, use the structure to better the health of the population.

To be a bit specific, can we apply the polio immunization scheme and achieve the same success in the fight against the COVID-19?

Routine immunization means …all these vaccines that u are given for routine, it is not only polio. There is polio and all other diseases, that is why we encourage mothers to go because when they are vaccinating, they are not only vaccinating for polio, they start with diphtheria, tetanus and whooping cough, together with the polio vaccines. The campaigns are usually polio but routine immunization is most of these antigens so mothers should go and they will be getting polio (vaccines) and other antigens that will be helping them to prevent diseases in the children.

Back to the Circulating Vaccine derived polio virus (cvdpvd), the risk is magnified by interruptions in vaccinations due to the COVID-19, leaving communities vulnerable. How does the region go about this?

Campaigns were already set for cvdpvd2s; the programs had gotten the money, even here in Cameroon.  These campaigns were stopped because of covid-19, the headquarter just asked to stop the campaigns and be able to work on COVID-19 , but since things are getting better now, the (WHO)headquarters has asked us to start with the campaign if the conditions are favorable. So, those campaigns should be starting soon because they are important against these countries. In some countries like Burkina Faso where campaigns have really gone at a level, we have seen a reduction in the number of these outbreaks. The WHO is also working on getting another molecule which could be better for this cvdpvd2. It is at the research level and hopefully it will be put out soon.