Brazzaville, 2 September 2004 -- Several rounds of nationwide mass immunization are planned for Nigeria and neighboring Niger Republic in 2004 to interrupt the remaining chains of indigenous wild poliovirus transmission in those countries.

According to an Information Document to be discussed at the fifty-fourth session of the WHO Regional Committee for Africa which will take place from 30 September to 3 September in Brazzaville, Republic of Congo, the only two remaining polio endemic countries in 2003, Nigeria and Niger, had re-infected eight countries in the region and paralysed nearly 500 children.

"The very impressive progress in polio eradication in the African region between 1996 and 2002 that resulted in only two of the 46 countries in the region remaining polio endemic suffered a set back in late 2003 and 2004. By 2003 wild poliovirus from the Nigeria and Niger, reinfected eight West and Central African countries paralyzing close to 500 children. By end of June 2004, Africa had reported five times as many polio cases compared to the same period in 2003," says the document.

In response to the further spread of polio in polio free countries at risk for importations due to geographical proximity or other commercial links with Niger and Nigeria , there will be two rounds of Supplemental Immunization Activities (SIAs) before the end of this year to boost population immunity. It adds: "The resurgence in wild poliovirus transmission (in the African region) is attributed to a failure to vaccinate at least 90% of all susceptible children in the most endemic areas in Nigeria and Niger. Persistent gaps in the quality of SIAs in these areas as well as the suspension of all immunization activities in Kano State (Nigeria), which is the epicentre of this transmission, have contributed to the current massive increase in wild poliovirus transmission". …/1 Niger and Nigeria account for 353 or 92% of the 383 confirmed polio cases in the African Region between 1 January and 7 July this year. In 2003, genetic sequencing confirmed that wild poliovirus from the Niger-Nigeria reservoir had re-infected eight West and Central countries - Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Cote d'Ivoire, Ghana and Togo. This year, six West, Central and Southern African countries -- Benin, Botswana, Burkina Faso, Central African Republic, Chad, Cote d'Ivoire, Mali and Guinea were re-infected.

The document notes that although the African Regional Certification Commission reviewed documentation of eight countries that had fulfilled the criteria for certification, the commission's work was being "substantially complicated" by importation of wild poliovirus to countries such as Botswana which are of considerable distance from the Niger-Nigeria epicentre of transmission.

It also adds that the Global Polio Eradication Initiative faces a funding gap of about US$100 million for activities in 2004 - 2005; almost half of the amount is required in Africa.

Among other proposals, the document suggests that all countries in the region develop preparedness plans to ensure rapid response to wild poliovirus importation. "Importations will remain a risk until polio is eradicated everywhere, and they should be treated as an urgent public health threat", it says.

The information document concludes: "The tremendous progress and experience in Africa since the launch of the "Kick Polio out of Africa Campaign" clearly demonstrates that a polio-free Africa is achievable. Africa's emergency response to the spread of poliovirus in West and Central Africa will preserve this progress and the considerable investment to eradicate this crippling disease from the continent".

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