afrol News, 1 February - Egypt and Niger have now been declared polio-free, leaving Nigeria the only country in Africa where the age-old disease still is endemic. The Ministries of Health in Cairo and Niamey today celebrated the announcement together with the World Health Organisation (WHO).

According to a press statement released by WHO today, this is the first time in three years that the number of polio-endemic countries has fallen, leaving Nigeria, India, Pakistan and Afghanistan as the world's sole remaining countries yet to have stopped indigenous polio transmission.

In Cairo, the news of a polio-free Egypt was celebrated as a historic event. "Polio has been endemic in our country for all of recorded history," said Egyptian Minister of Health, Hatem Mostafa El-Gabaly. "The best tools of our age finally defeated this enemy who has been with us from pharaonic times," he added.

The process of eradicating polio in Egypt has been much slower than in other countries of the North African and Middle East region. According to WHO, the main challenge to polio eradication in Egypt was the "highly efficient polio transmission in the crowded cities" of the densely populated Nile Valley.

In Niger, the national government and UN agencies found other challenges. Vaccinators in Niger faced a sparse population, some of it nomadic, scattered over a vast country with a long and heavily-travelled border with Nigeria, the world's largest reservoir of poliovirus.

According to WHO, multiple immunisation campaigns in Niger had been "painstakingly planned" over the last few years to ensure children were being vaccinated even in the remotest and border areas. In 2005, the last nine polio cases reported in Niger had all been the result of importations over the border with Nigeria, health workers found. Therefore, WHO found it could declare Niger free of endemic polio.

Now, the remaining problem regarding polio eradication in Africa is heavily populated Nigeria, which has exported polio cases to other African countries during the last few years. Only during the past six months, five African countries have reported circulation of imported poliovirus from Nigeria; Angola, Chad, Ethiopia, Niger and Somalia.

Focus is now on vaccination in northern Nigeria with the use of next-generation polio vaccines. To fully exploit these new tools, "government commitment in Nigeria must remain high at all levels to ensure that all children are vaccinated," said Jonathan Majiyagbe of Kano, Nigeria and past President of Rotary International.

Ninety percent of polio cases in Nigeria are concentrated in just eight of the country's 37 states, mostly in the north along the border with Niger. Cultural and religious resistance had hindered past immunisation campaigns in northern Nigeria, thus leading to a new spread of the polio virus. These hinders are now overcome and WHO and its partners are working together with local governments to wipe out the disease from Nigeria as well.

Outside Africa, polio still is endemic in India, Pakistan and Afghanistan, while there have been recent polio importation cases in Indonesia, Nepal and Yemen. With the eradication of polio in Egypt and Niger, WHO today celebrates a major victory in its global polio eradication campaign. The campaign was launched in 1988, when the paralysing disease still was endemic in 125 countries worldwide.

WHO now hopes that polio may be wiped out from the face of earth by mid-2007. "The finish line is in sight," the UN agency's polio campaign leader David Heymann told journalists yesterday. The main challenge remained in Nigeria, the WHO official indicated, while the situation with imported polio in Yemen and Somalia also was seen as complicated.

By staff writers

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