NAIROBI, KENYA—Somalia is suffering an “explosive” outbreak of polio and now has more cases than the rest of the world combined, a WHO official said Friday.
Vaccine-wielding health workers face a daunting challenge. Those areas of Somalia where seven out of 10 children aren’t fully immunized are difficult to access because Al Qaeda-linked militants control them.
Polio is considered mostly eliminated around the world except for the three countries — Afghanistan, Nigeria and Pakistan — where it is endemic.
India marked a major success in February 2012 by being removed from the World Health Organization’s list of countries plagued by the highly infectious disease.
RELATED:$5.5B plan to end polio by 2018
Figures released Friday show Somalia now has 105 cases, and another 10 cases have been confirmed across the border in a Kenyan refugee camp filled with Somalis. Globally there have been 181 cases of polio this year, including those in Somalia and Kenya.
Since the Somalia outbreak began in May, vaccination campaigns have reached four million people, but health officials have limited access to about 600,000 children who live in areas controlled by the militant Islamist group Al Shabab.
“It’s very worrying because it’s an explosive outbreak. and of course polio is a disease that is slated for eradication,” said Oliver Rosenbauer, a spokesman for the Global Polio Eradication Initiative at the World Health Organization in Geneva.
“In fact we’re seeing more cases in this (Somali) area this year than in the three endemic countries worldwide.”
In a bit of good news, Rosenbauer said polio numbers are down in the three remaining endemic countries.
“The only way to get rid of this risk is to eradicate in the endemic countries, and there the news is actually paradoxically very good,” he said.
Somalia was removed from the list of endemic polio countries in 2001. This year’s outbreak is the second since then.
It began one month after Bill Gates helped unveil a six-year plan at the Global Vaccine Summit to eradicate polio. That effort will cost $5.5 billion, three-quarters of which has already been pledged, including $1.8 billion from the Bill and Melinda Gates Foundation.
The outbreak in Somalia does not set back the six-year plan, said Rosenbauer, because unpredictable and intermittent outbreaks were programmed into the timeline.
Somalia and the Horn of Africa were also identified as vulnerable spots, said Ellyn Ogden, worldwide polio eradication co-ordinator with the U.S. Agency for International Development.
“We know where you have large pockets of unvaccinated kids, it’s always a possibility (that outbreaks may occur),” said Ogden, who has been travelling back and forth to Kenya since the outbreak began. “So, you know, it’s not great but it’s not exactly a big surprise for us.”
Ogden is optimistic, however, that the outbreak will be brought under control. The response from neighbouring countries has been good, with surveillance efforts heightened at border crossings. Families in the affected areas are also eager for vaccinations, which is always a good sign.
“Usually when you have high demand, if you provide services in a fairly safe place, people will come and seek it out,” she said.
But finding those safe spaces will be challenging to say the least.
In a sign of how difficult it is for medical providers to operate in Somalia, the aid group Doctors Without Borders announced this week it was pulling out of the country after 22 years because of attacks on its staff members. MSF, as the group is also known, was not taking part in the polio vaccination campaign.
Somalia shares one significant trait with the three endemic countries: pockets of severe violence where populations can be hostile to health-care workers. In February, gunmen in Nigeria believed to belong to the radical Islamist sect Boko Haram shot and killed at least nine women taking part in a polio vaccination drive.
Polio, for the moment, has been defeated in two areas of Pakistan. But in one region where the disease persists — the dangerous North and South Waziristan region near the Afghan border — local authorities have banned immunization campaigns since mid-2012.
Vaccination programs, especially those with international links, have come under suspicion since a Pakistani doctor ran a fake vaccination program to help the CIA track down Osama bin Laden.
“So no immunizations are taking place, and sure that’s a challenge and that has to be addressed,” said Rosenbauer.
Southern Afghanistan hasn’t recorded any polio cases since November, a story of success after years of failure there. Afghanistan saw 37 polio cases last year but only four so far this year.
Polio cases are also down in Nigeria, about the same as in Pakistan.
With files from Jennifer Yang