Zim remains at risk of a deadly polio outbreak
ZIMBABWE last reported a case of indigenous wild poliovirus in 1986 and has been certified polio free since 2005. Following the detection of wild poliovirus 1 in Mozambique and Malawi in 2022, Zimbabwe undertook in 2023 multi-country supplementary immunisation activities with bivalent oral polio vaccine and conducted four rounds of supplementary immunisation activities.
After declaring a public health emergency in October 2023, Zimbabwe has to date detected 21 circulating vaccine derived polio virus type two cases from environmental samples in Harare.
The samples were from the four polio environmental surveillance sites in Harare.
Polio outbreak response activities commenced with plans to conduct two supplementary immunisation activities using novel oral poliomyelitis (polio) vaccine type 2.
Round one of campaigns was completed in February 2024 and reached approximately 4,6 million (108%) children.
Similarly, round two campaign was completed on March 22, 2024, reaching approximately 4,8 million (115%) children.
During the reporting period, no new environmental samples confirmed polio virus type 2 from environmental sites were reported.
A total of 13 new acute flaccid paralysis cases were reported between March 15 and 29, 2024.
Cumulative cases are at 80 with a non-polio acute flaccid paralysis rate at 1,6% children aged 0-14 years.
Zimbabwe, like many other countries, remains at risk of a polio outbreak either for wild polio or vaccine derived, until global eradication.
It is important to maintain high immunity within the population and increase efforts for routine polio vaccination coverage and ensuring strengthened disease surveillance for early detection of cases is accorded high priority.
In response activities, special considerations are needed for special populations.
These include vaccine hesitant religious groups with high concentration in Manicaland (Buhera, Mutasa and Mutare districts), populations in refugee camps (Tongogara in Manicaland and Waterfalls transit camp in Harare), populations along borders, cross-border traders, artisanal miners and populations in emerging peri-urban settlements in Harare.
Funding overview and partnerships To respond to the outbreak, the United Nations Children’s Fund (Unicef ) Zimbabwe received US$4,1 million.
Thanks to the generous support of German Development ministry (BMZ) and Bill and Melinda Gates Foundation (BMGF).
The funding from BMZ is supporting surge staff capacity for six months between January and June 2024 and the BMGF funding supported the two rounds of novel oral polio vaccine type 2 vaccination campaigns.
Unicef’s response: Co-ordination and planning
Unicef provided technical and financial support to the Health and Child Care ministry in various activities such as planning and coordination, training, monitoring and supervision, vaccine accountability management, cold chain and logistics, social mobilisation, cross-border co-ordination.
The support considered the supplementary immunisation activities data, which helped to identify areas of improvement and guided provinces in implementing high-risk operational plans for round two.
In the coming weeks, Unicef will support the Health and Child Care ministry with a national expanded programme on immunisation review meeting (April 8 to 12, 2024) to capture lessons learned and best practices including for round two novel oral polio vaccine type 2 campaign.
The review looked at Lot Quality Assurance Sampling, administration data, independent monitors, and other data sets to assess the performance of the campaign and a detailed analysis of the routine expanded programme on immunisation for future programming purposes.
Human resources and surge support
Unicef has supported the Health and Child Care ministry with additional surge staff to support the outbreak response through the recruitment of four local and three international staff to support co-ordination, social behaviour change activities and vaccine management.
Vaccine management and logistics
Unicef has been supporting the Health and Child Care ministry in organising a daily review of vaccine accountability monitoring, to ensure adequate availability of vaccines.
More specifically, the team followed up on the distribution and verification of vaccines, vaccine accountability monitoring tools and other supplies in the field including validation for the implementation and preparedness of the campaign.
Vial repatriation is in progress at subnational level — capturing all used and partially used vials.
The unopened vials from both rounds one and two are being collected.