In March 2024 the WHO Eastern Mediterranean Region announced that Sudan’s Federal Ministry of Health (FMOH) is to launch a polio vaccination campaign in April 2024 in response to a “new emergence of variant poliovirus type 2” that was reported in January 2024. The emergence was detected in six wastewater samples collected between September 2023 and January 2024 in the Port Sudan locality, Red Sea State.
The FMOH has been supported by WHO to complete field investigations and a risk assessment to understand the extent of virus circulation. The campaign preparations have begun in Red Sea, Kassala, Gedaref, River Nile, Northern, White Nile, Blue Nile, and Sennar States. WHO reports that the other states will have a “differentiated approach” as appropriate.
Learning from previous outbreaks
This detection has been reported 14 months after Sudan declared an “unrelated” outbreak of variant poliovirus type 2, detected in a 4-year-old child in West Darfur in October 2022. In response to that outbreak the FMOH worked with UNICEF and WHO to deliver and distribute 10.3 million doses of oral polio vaccine in a March 2023 campaign. Around 8.7 million children under the age of 5 were reached.
Since then, no vaccination campaign has taken place “due to the ongoing conflict”. However, surveillance for poliovirus in children has been “strengthened”. This is conducted by searching for acute flaccid paralysis (AFP), the “most common indicator” of polio infection, and wastewater surveillance.
Dr Dalya Eltayeb, Director-General of Primary Health Care in the FMOH, commented that “since the escalation of the conflict”, the FMOH has worked “closely” with WHO and UNICEF to “develop and implement the Polio National Emergency Action Plan”.
“The new detection has only redoubled our commitment to safeguarding our children’s future. In collaboration with partners, we are mobilising an outbreak response campaign to ensure that every child under 5 years in accessible areas receives the polio vaccine, and special plans will follow for hard-to-reach areas.”
Although no child has been paralysed in the new emergence, this detection “puts children across the country at high risk”. Furthermore, the “breakdown in health services” such as routine vaccination “significantly increases” the risk of outbreaks and spread of communicable diseases. Dr Mohammad Taufiq Mashal, Polio and Immunisation Team Lead for WHO Sudan, recognised the remarkable efforts of public health officers.
“Despite extremely challenging conditions, our health workers have managed to sustain surveillance for poliovirus, which has allowed us to detect and respond to this new poliovirus strain in a timely manner.”
Dr Tedla Damte, Chief of Health and Nutrition at UNICEF Sudan, suggested that “the ongoing war is undoing the enormous gains” that have been made on childhood vaccinations.
“Millions of displaced children on the move cannot be protected against life-threatening diseases, like polio, yet these can be prevented through vaccination. Health systems are overstretched, subsequently impacting the delivery of health services including vaccinations.”
Dr Damte emphasised that “UNICEF remains committed to supporting vaccination campaigns to protect children, no matter what”.
The importance of rigorous, sustained surveillance in health systems is an issue that will be explored by some of our experts at the Congress in Washington this April so do join us to participate in the discussion or subscribe here for more updates.
