Somalia is suffering an “explosive” outbreak of polio and now has more cases than the rest of the world combined, an official said on Friday.
Vaccine-wielding health workers face a daunting challenge: accessing areas of Somalia controlled by militants, where 7 out of 10 children are fully immunized.
Polio is mostly considered eliminated globally except mainly in three countries where it is considered endemic: Afghanistan, Nigeria and Pakistan. India marked a major success in February last year by being removed from the WHO’s list of countries plagued by the disease.
Somalia now has 105 cases, figures released on Friday show, and another 10 cases have been confirmed across the border in a Kenyan refugee camp filled with Somalians. Globally there have been 181 cases of polio this year, including those in Somalia and Kenya.
Vaccination campaigns in Somalia have reached 4 million people since the outbreak began in May, but those health officials have limited access to about 600,000 children who live in areas of Somalia controlled by the armed Islamist group al-Shabaab.
“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 WHO in Geneva.
Somalia was removed from the list of endemic polio countries in 2001, and this year’s outbreak is the second since then.
It began one month after Microsoft founder Bill Gates helped unveil a six-year plan to eradicate polio at the Global Vaccine Summit. That effort will cost US$5.5 billion, three-quarters of which has already been pledged, including US$1.8 billion from the Bill and Melinda Gates Foundation.
The outbreak in Somalia does not set back the six-year plan, Rosenbauer said, because unpredictable and intermittent outbreaks were programmed into the timeline.
In al-Shabaab-controlled south-central Somalia, disease surveillance is functioning, but health officials are likely not to able to detect all polio cases.
Mohamud Yasin, a retired doctor who has treated polio throughout his career, said: “It’s indeed worrying because this comes at a time when the country is still hugely affected by the raging fighting, which prevents volunteers from accessing people in need of vaccines. It may take time before we can confidently say we have universal coverage of the immunization.”
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 believed to belong to a radical Islamic sect known as Boko Haram shot and killed at least nine women taking part in a polio vaccination drive in northern Nigeria.