No new cases of polio, but Indonesia still in danger – Opinion

Recent reports of a neighboring polio epidemic in Papua New Guinea (PNG) have raised concerns about the risk of spread of poliovirus in Indonesia. Health authorities have taken measures to prevent travelers from importing the virus, including from Papua and Papua West, bordering Papua New Guinea – even though Indonesia has been polio-free since then. 2014.

As vaccine coverage rates remain stubbornly low in some countries, it is unlikely that we will reach the goal of a polio-free world by 2018 over the next few weeks.

According to the World Health Organization, poor immunization coverage of 50-60% in PNG reportedly contributed to the country's polio outbreak in September, which recorded 14 confirmed cases. The outbreak came just two months before more than 20 leaders from the Asia-Pacific region gathered in Port Moresby for the 2018 Asia-Pacific Economic Cooperation (APEC) Summit, November 17-18. Rapid steps have been taken to combat outbreak areas.

The polio epidemic in Papua New Guinea has been a concern in Indonesia. Seven children with acute flaccid myelitis – whose symptoms include sudden weakness of arms or legs – have been discovered in several parts of Papua, including two in Merauke. The Ministry of Health followed the disease closely and later confirmed that the symptomatic paralysis of the children was not caused by polio.

Another preventive measure is to integrate a polio vaccination program into the current measles and rubella immunization program in Papua. This program is part of the ongoing mbad vaccination campaign in 28 provinces outside of Java, targeting about 32 million children from 9 months to just under 15 years old. However, the program has reached only 63% of targeted children in Papua, which is significantly lower than the required 95% minimum to establish collective immunity.

The PNG poliovirus outbreak of origin and wild poliovirus transmissions in Afghanistan, Nigeria, and Pakistan show that eradicating polio remains an unfinished business for the world.

The Global Polio Eradication Initiative, a public-private partnership that published the 2013-2018 Strategic Plan for Polio Eradication and the final phase of polio eradication. polio, is an ongoing effort to increase the polio vaccination rate. The plan includes routine immunization to achieve sufficient population immunity to prevent poliovirus transmission.

Experts warn that until polio is eradicated globally, all countries remain at risk of contracting the disease. "Polio is a very infectious disease and we have seen many times that it spreads or re-emerges easily in areas of low immunization coverage. A new upsurge in polio this year in Papua New Guinea highlights this risk, "said the director of polio eradication of the WHO, Michel Zaffran, at the Jakarta Post.

For the disease to be completely eradicated in the world, Zaffran added, countries need to maintain high immunization coverage everywhere, as well as close surveillance of the disease.

WHO paid tribute to Indonesia's routine immunization program; Indonesia last experienced cases of poliomyelitis in 2006. However, there is a need for further immunization, particularly in the context of National Polio Week. Good, well-funded polio eradication programs and skilled health professionals have contributed to the success of the country.

"These are good pro-active measures taken by the Indonesian government. We appreciate the commitment of the Indonesian Government to maintain the [its] Polio-free country and child protection status, "said Vinod Kumar Bura, an epidemiologist and WHO-approved doctor in Indonesia.

Bura added that the introduction of inactivated polio vaccine (IPV) into Indonesia's routine immunization schedule underscored the country's commitment to the global phase of polio, which required the phased removal of oral polio vaccine.

All countries now use at least one dose of IPV in their routine immunization program. In Indonesia, IPV was introduced in all provinces in 2016. Contain three serotypes of poliovirus IPV can strengthen children's immune systems for better protection against polio. However, the injectable vaccine costs more than the oral type, but will become the only polio vaccine available after stopping the use of all OPVs.

Roland Sutter, coordinator of research and product development of the Global Polio Eradication Initiative, said that with the support of stakeholders, including the public-private partnership of Gavi Alliance on Immunization, IPV had been introduced in all countries.

"For the poorest countries, but also for those who are eligible for Gavi support, including in Indonesia, IPV is provided free of charge," said Sutter, also a member of the department's polio eradication department. l & # 39; WHO.

Innovative procurement mechanisms and new vaccine formulations are two other major advances that a global coalition of partners aims to reduce the cost of the vaccine and ensure a supply of IPV for all countries.

World Polio Day, to be held on October 24, should serve as a wake-up call for the government and the people of Indonesia to fall prey to polio-free status. Given the high potential for re-emergence of the disease, especially when immunization coverage is low, more urgent efforts are needed to maintain our polio-free status, especially to ensure high immunity of the population through surveillance of polio. quality.

Populations need to participate fully in immunization programs, but there is a need to increase public awareness of the benefits of the vaccine and the serious consequences of poliomyelitis for the health and the national economy. Parents should be more willing to listen to experts who tell them that the vaccine is safe and effective and that it does not contradict religious beliefs – one of the factors of resistance to vaccination.

Once a polio-free world is created, polio will become the second most eradicated disease in Indonesia after smallpox – and this is no small feat.