Global polio eradication; can we replicate the smallpox success story?

Abstract

Although the Global Polio Eradication Initiative has been largely successful in elimination of polio from various parts of the world, sporadic local outbreaks in non‐endemic areas continue to pose a threat to global polio eradication efforts. In the two endemic countries, Pakistan and Afghanistan, a staggering 176 cases of wild poliovirus 1 (WPV1) were reported in 2019. In 2020 alone, 959 cases of Circulating Vaccine Derived Poliovirus 2 were reported globally from 27 countries. After staying polio‐free for years, cases of WPV were detected in Malawi and Mozambique in 2022. The roots of the reported strains matched with the WPV strain from Pakistan. The emergence of WPV cases in Malawi and Mozambique underscores the fact that WPV still has the chance to spread beyond the Afghanistan‐Pakistan region and sustained efforts are required for its complete eradication. In the case of smallpox, surveillance‐containment was the key to eradication as many countries had already eradicated smallpox and the bigger concern was to track and contain any new cases emerging. Smallpox eradication followed a comprehensive plan which included elements like quality control and standardisation of vaccination protocols. Governments all over the world should prioritise immunisation drives, surveillance, and awareness campaigns to achieve the dream of a polio‐free world.

Identification of key residues in MERS-CoV and SARS-CoV-2 main proteases for resistance against clinically applied inhibitors nirmatrelvir and ensitrelvir

“…Mouse Hepatitis Virus (MHV, Betacoronavirus lineage A) is a rodent pathogen and was used for resistance studies in Paxlovid licensing due to its harmlessness to humans ( 76 , 77 ). Lastly, poliovirus (Picornaviridae) is still causing sporadic local outbreaks, mostly through reverted, live attenuated vaccine strains and in unvaccinated populations ( 78 , 79 ).…”

Threat of resurgence or hope for global eradication of poliovirus?

“…A 4-year-old child was confirmed to have WPV1 in Malawi on 17 February 2022 [33][34][35]. A few months later in April 2022, a 12-year-old was found to be infected with WPV1 in neighboring Mozambique [34,36]. Both incidents of paralytic poliomyelitis occurred after 30 years of no reported cases in the two countries.…”

Current Challenges in Polio Eradication in Pakistan: A Call to Action

“…Leveraging the knowledge and support of international organizations such as the World Health Organization and UNICEF, Pakistan should adopt effective strategies and build upon global success stories. 10 To accelerate polio eradication in Pakistan, we need a multifaceted approach: (1) engage community and religious leaders to dispel polio vaccine myths and underline its critical role in child health. (2) Invest in health care infrastructure, especially in rural areas, for universal immunization access.…”

“…Leveraging the knowledge and support of international organizations such as the World Health Organization and UNICEF, Pakistan should adopt effective strategies and build upon global success stories. 10…”