Keeping Iraq polio free: immunization campaign targets 5.8 million children

Baghdad: A 5-day nationwide polio immunization campaign targeting 5.8 million children under 5 years of age began in Iraq. The campaign launched with events in Baghdad, organized by the Ministry of Health, and in Erbil organized by the Kurdistan regional Ministry of Health. Representatives of WHO and UNICEF attended both events with Rotary International attending the launch in Erbil. It is over a year since the last case of polio was reported in Iraq, and the new campaign aims to vaccinate every child under 5 throughout the country.

Iraq is one of the countries at highest risk for polio in the Region due to vulnerable populations living in multiple governorates. These include internally displaced persons, refugees, communities dwelling in slums and vast portions of the country where insecurity hinders health outreach activities. Vaccination teams will exert extra effort to reach children within these populations during the April campaign, with approximately 24 000 health workers set to conduct house-to-house visits.

“Action to contain and stop polio in Iraq has been strategic, concentrated and swift due to the strong commitment of the Government,” said Dr Jaffar Hussain, WHO Representative to Iraq. “Keeping Iraq polio free has been a major priority for WHO and its partners over the past 12 months, and we are doing everything we can to maintain this great achievement,” he said.

In the last year, a total of 13 subnational and national polio immunization campaigns have been conducted across the country to counter gaps in routine immunization services. Violence and insecurity in many parts of Iraq, damage to health facilities, and a shortage of health workers continue to create hurdles in reaching every child under 5 with oral polio vaccine (OPV).

“Population movement and shortfalls in routine immunization pose significant challenges for the polio eradication programme,” Dr Hussain said. “However, with the committed leadership of the Ministry of Health, support from donors, and through strong collaboration amongst our partners, we have been able to consistently reach over 90% of all children for the last 9 campaigns since April 2014,” he said.

Dr Hussain cautioned that certain high-risk governorates such as Baghdad, Karbala, Muthana and Babylon do not have uniformly high vaccination rates at the district level and thus require particular attention during the campaign.

WHO, UNICEF and nongovernmental health partners have provided a range of support functions to the Federal and Kurdistan Ministries of Health to combat polio within Iraq’s borders. While WHO provides technical support and training in communicable disease surveillance, case detection, and stool sampling and testing for acute flaccid paralysis – a major indicator for polio, UNICEF has been instrumental in the procurement of OPV and cold-chain equipment, and in helping to raise community awareness of the debilitating disease.

“The absence of wild poliovirus in Iraq for over a year, despite the complex humanitarian crisis, is testament to the efforts put into the emergency response from the respective Ministries of Health. UNICEF, along with WHO, remains committed to providing strong technical support and welcomes the visit of Rotary for this campaign, as one of the spearheading partners in the Global Polio Eradication Initiative,” remarked Philippe Heffinck, UNICEF Iraq Representative.

Thanking Rotary International for their unflinching support to the Global Polio Eradication Initiative (GPEI) through its history, WHO and UNICEF country representatives have appealed for continued support to the polio emergency response in Iraq. To ensure prevention of new importation-associated polio outbreaks and to save children from vaccine preventable diseases, additional campaigns must be held over the coming year. However, the Iraq Ministry of Health estimates a funding gap of US$ 45.5 million for campaigns planned in 2015 and 2016. Given the high political commitment of the Government to polio eradication and the Expanded Programme on Immunization, WHO and UNICEF have appealed to the wider international community to come forward and support efforts to ensure vaccine delivery to all children and women of Iraq to prevent significant mortality and morbidity.

The UNICEF Iraq Country Representative emphasized that funding shortages in Iraq are putting all children at risk. “The scope and scale of the crisis, and the unimaginable hardships that Iraqi children have suffered stretch our ability to respond. If the immediate and longer term funding gaps are not met, millions of children will not receive the life saving interventions, including polio and routine immunization, that they need.”

WHO and UNICEF continue to support both Ministries of Health in increasing vaccination coverage in Iraq. Through the GPEI, the organizations are currently supporting immunization campaigns in three countries in the Region.