In Kwango Province, Democratic Republic of the Congo (DRC), 5-year-olds Makiese, left, and Madinu brandish red cards after receiving their polio vaccinations in 2023.
Immunization

Polio Eradication Is Within Reach: Here's What It Will Take to Get There

We're in the last mile in the fight to eradicate polio, but progress is fragile. As long as the disease is a threat anywhere, it remains a threat everywhere. A look at how UNICEF and partners are working to reach every child with lifesaving polio vaccines.

There is no cure for polio, only prevention

Since the introduction of the first polio vaccine in the 1950s, fully vaccinated children have been protected from the dangerous viral illness that attacks the nervous system, causing paralysis and sometimes death. 

Today, polio is on the brink of eradication, but conflict, climate disasters, displacement and vaccine misinformation are hindering efforts to reach some of the world's most marginalized children with lifesaving vaccines.

On Nov. 7, 2023, UNICEF Representative in Afghanistan Fran Equiza gives a polio vaccine to a young boy, who has just returned to Afghanistan from Pakistan with his family.
On Nov. 7, 2023, UNICEF Representative in Afghanistan Fran Equiza gives a polio vaccine to a young boy who has just returned to Afghanistan from Pakistan with his family. © UNICEF/UNI475171/Karimi

In 1988, a public-private partnership was formed to reach every child in every country with the polio vaccine. Led by national governments and supported by six core partners —  UNICEF, the World Health Organization (WHO), Rotary International, the U.S. Centers for Disease Control and Prevention (CDC), the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance — the Global Polio Eradication Initiative (GPEI) vaccinates over 400 million children each year, maintaining 99 percent eradication in global polio. 

After almost four decades of close collaboration, more than 3 billion children have been vaccinated. The wild poliovirus has been wiped out in much of the world — today, it's confined to a few districts in Afghanistan and Pakistan

On Feb. 29, 2024, polio vaccinator Hafsat Mikauli 30, marks a girl’s finger with a whiteboard marker to indicate she has received the polio vaccine in Makurdi Gagi,  Sokoto South LGA, Sokoto Sate, Nigeria.
On Feb. 29, 2024, polio vaccinator Hafsat Mikauli 30, marks a girl’s finger with a whiteboard marker to indicate she has received the polio vaccine in Makurdi Gagi,  Sokoto South LGA, Sokoto Sate, Nigeria. © UNICEF/UNI536036/Boman

Smallpox was eradicated in 1980 — polio could be next

Thanks to the commitment of community health workers (CHWs), government leadership and GPEI partners, polio is poised to become the second disease to be declared eradicated, after smallpox. UNICEF and partners and will not rest until every child is protected.

In February 2024, a young girl shows her finger, marked to indicate she has received a polio vaccination near her home in Aden, Yemen, as part of a critical polio campaign, launched with support from UNICEF.
In February 2024, a young girl shows her finger, marked to indicate she has received a polio vaccination near her home in Aden, Yemen, as part of a critical polio campaign, launched with support from UNICEF. © UNICEF/UNI529051/Alfilastini

What does reaching the final mile look like?

The poliovirus is transmitted from person to person or, less frequently, through contaminated food or water. To eliminate polio, every child in every household must receive multiple doses of the vaccine. Millions of “zero dose” children, those who have not received a single dose of the polio vaccine series, remain vulnerable.

On April 14, 2023 in Lahore, Punjab province, Pakistan, two vaccinators and a social mobilizer travel by boat to conduct an integrated outreach activity to vaccinate children in an urban slum where the population lacks access to a nearby health facility.
On April 14, 2023 in Lahore, Punjab province, Pakistan, two vaccinators and a social mobilizer travel by boat to conduct an integrated outreach activity to vaccinate children in an area where the population lacks access to a nearby health facility. © UNICEF/U.S. CDC/UNI416565/Saiyna Bashir

In significantly under-immunized populations, a strain of polio related to the weakened live strain found in the oral vaccine can arise. The lower the population's immunity, the longer variants can survive, replicate and exchange genetic material to become more dangerous strains. Most of the recent cases have been recorded in eastern Democratic Republic of the Congo, northern Nigeria, south central Somalia and northern Yemen.

A fully immunized population will be protected against both wild and vaccine poliovirus strains. 

On Nov. 7, 2023, two boys sit in the back of a truck at Afghanistan's Torkham border with Pakistan in eastern Nangarhar province.
On Nov. 7, 2023, two boys sit in the back of a truck at Afghanistan's Torkham border with Pakistan in eastern Nangarhar province. Since September 2023, thousands of Afghans living in Pakistan have returned to Afghanistan through the Torkham crossing in Nangarhar province and the Spin Boldak crossing in Kandahar province. Around 60 percent of returning Afghans are children. © UNICEF/UNI475431/Karimi

Battling misinformation by building trust

One of the greatest impediments to polio immunization is widespread mistrust of vaccines. Trained CHWs, the majority of whom are women, are the front line in reaching every child with lifesaving vaccines. In addition to administering vaccines to children ages 0 to 59 months, they dispel misconceptions and fears around vaccine efficacy.

On March 5, 2023, health care worker Hafsat Isah, center, speaks to nursing mothers who brought their children for vaccination in Kofan Rini PHC, Sokoto State, Nigeria, in
Health care worker Hafsat Isah, center, speaks to nursing mothers who brought their children for vaccination in Kofan Rini PHC, Sokoto State, Nigeria, on March 5, 2023. © UNICEF/UNI536743/Boman

Many female health workers are mothers themselves; they build trust by sharing their experience vaccinating their own children. Women vaccinators can also enter households that may prohibit unrelated males from entering due to religious or cultural norms.

On April 18, 2023 in Peshawar, Khyber Pakhtunkhwa province, Pakistan, Lady Health Worker (LHW) Shamim Hussain, center, speaks with a man and a child on a bicycle while a group of children look on.
On April 18, 2023 in Peshawar, Khyber Pakhtunkhwa province, Pakistan, Lady Health Worker (LHW) Shamim Hussain chats with a man and a child on a bicycle. © UNICEF/U.S. CDC/UNI412745/Saiyna Bashir

Engaged leaders boost vaccine acceptance and embrace sustainable health systems

UNICEF and partners engage with governments and community leaders to enlist them as immunization advocates. Visible leadership participation in campaign launches and household visits reassures communities of vaccine safety.

In Mogadishu, Somalia on March 4, 2024, a community leader, center, spoke with representatives from UNICEF, the Ministry of Health, Banadir Regional Administration (BRA) and WHO, who visited polio campaigns and went house-to-house in Dheriyaale Singaale IDP camp in the Hodan District, with health mobilizers to ensure children received the lifesaving polio vaccine.
In Mogadishu, Somalia on March 4, 2024, a community leader, center, spoke with representatives from UNICEF, the Ministry of Health, Banadir Regional Administration (BRA) and WHO, who visited polio campaigns and went house-to-house in Dheriyaale Singaale IDP camp in the Hodan District, with health mobilizers to ensure children received the lifesaving polio vaccine. © UNICEF/UNI541063/Hill

From donkeys to drones — vaccines stay cold every step of the way, no matter how far the journey

Ensuring every child under 5 receives multiple rounds of vaccines requires supply chain management and procurement and distribution capability that only UNICEF offers. UNICEF leverages its unrivaled supply chain and cold storage capability to procure and distribute more than 1 billion doses annually.

A drone carrying polio vaccines from Matawale Health Center lands at Magomero Health Center in Zomba, southern Malawi on July 14, 2023.
A drone carrying polio vaccines from Matawale Health Center lands at Magomero Health Center in Zomba, southern Malawi on July 14, 2023. © UNICEF/UNI518089/Chikondi

Once vaccines are procured and designated for specific clinics and communities, health workers use any conveyance necessary to cover the terrain between vulnerable children and vaccine administration.

With diligence and determination, they reach the most remote areas and large populations of people traveling within countries and across borders.

On Nov. 7, 2023, vaccinator Sayed Nasrullah Atayee, carrying a cold box full of vaccines, sets out by motorcycle from Layaba Basic Health Clinic in Layaba village, Fayzabad district, Badakhshan Province, Afghanistan.
On Nov. 7, 2023, vaccinator Sayed Nasrullah Atayee, carrying a cold box full of vaccines, sets out by motorcycle from Layaba Basic Health Clinic in Layaba village, Fayzabad district, Badakhshan Province, Afghanistan. © UNICEF/UNI484148/Haya Burhan

The legacy of GPEI and polio’s eradication

Beyond the elimination of the poliovirus, in many areas, GPEI has developed an infrastructure that strengthens local health systems and provides a blueprint for other disease outbreaks and public health crises. Without vaccination campaigns, the under-5 mortality target for SDG 3: Ensuring good health and well-being for all at all ages cannot be met.

Many public health systems now have a highly skilled workforce that can break down cultural barriers and build trust in immunization and routine health activities. Resources previously spent on polio activities can be invested in other critical health and nutrition interventions for children.

A UNICEF-supported vaccination team crosses the Ulindi bridge over the Ulindi River in South Kivu province, DR Congo, to vaccinate children against polio on August 14, 2023.
A UNICEF-supported vaccination team crosses a bridge over the Ulindi River in South Kivu province, Democratic Republic of the Congo, to vaccinate children against polio on August 14, 2023. © UNICEF/UNI430901/Mirindi Johnson

Help UNICEF deliver lifesaving vaccines to protect children from polio. 

 

TOP PHOTO: In Kwango Province, Democratic Republic of the Congo (DRC), 5-year-olds Makiese, left, and Madinu brandish red cards after receiving their polio vaccinations. In August 2023, the Ministry of Health, with support from UNICEF and partners, launched the "Red Card Against Polio" campaign using the popularity of soccer to garner widespread community support for childhood vaccination, with the aim to "Kick polio out of DRC" and protect children from other vaccine-preventable diseases. © UNICEF/UNI551212/Mukama

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