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DRC: The untold success story of polio

10 Sep 2014

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Repeated, coordinated immunization campaigns have helped eradicate polio in the Democratic Republic of the Congo. The country has been polio-free since late 2011. Credit: WHO/ E. Kabambi
The Democratic Republic of the Congo — Central Africa’s largest country — has been polio-free for almost three years.

The Democratic Republic of the Congo (DRC)—Central Africa’s largest country—has been polio-free since the end of 2011. The last case was recorded in December of that year, when Congolese and World Health Organization (WHO) specialists responded to a small outbreak in Lusangi health zone, in Maniema Province, eastern DRC.

According to international standards, a country must record no new cases of polio for six months to be declared free of the disease. DRC has now been polio-free for almost three years.

“The challenges were many, but we needed to succeed, not only for DRC but also for the region,” said WHO Representative Joseph Cabore. “Being polio-free means that all of us have invested in this great achievement, but we need to remain vigilant.”

For many years, DRC was among the most affected countries. In 2010, 100 polio cases were tallied across the vast country; at the end of 2011, the country had 93 cases.

Synchronized vaccinations key

According to health experts, a combination of activities, combined with luck, led to this success.

Synchronized vaccination campaigns—otherwise known as national immunization days—have played a key role. Polio is a virus that travels easily, but one of the most effective ways to eliminate it is to vaccinate large numbers of people at the same time, across several provinces.

National immunization days are held at least twice a year. In 2011, the vaccination was synchronized with neighbouring Angola and Congo.

Breaking down mistrust and misinformation

Community outreach before the arrival of vaccination teams helped to reduce skepticism about the benefits of vaccination. In the past, deep-seated religious and cultural beliefs, such as vaccination being a “plot” to control peoples, or claims that their religion banned Western medicine meant that many households were reluctant to vaccinate their children.

Congolese health officials and staff from WHO and the UN Children’s Fund (UNICEF) worked with community leaders to pass on messages to break down the barrier. They were joined by an army of community workers, local radio stations and religious and political leaders, all spreading the message that immunizations were safe and potentially life saving.

According to PolioInfo, a UNICEF-affiliated information site tracking polio, the number of groups resisting vaccination reduced across the country from 61 to 20 between April and December 2011. In the capital, Kinshasa, seven out of eight previously resistant groups now support vaccination.

Overcoming violence and displacement

Efforts to eradicate polio have been complicated by the conflict and insecurity that plagues large parts of the country. In eastern DRC, an estimated 2.6 million people are living away from their homes. Despite the insecurity, WHO insists that it is necessary to vaccinate returnees, refugees and displaced people.“Insecurity and violence constitute a major obstacle,” said a senior Health Ministry official.  “But as long as we are not putting the lives of children at risk, we will vaccinate. When there are no bullets flying, it is the terrain that we have to fight with. By land, air and sea, our teams have used all possible means to reach the communities.”

Donor contributions have also been instrumental. In addition to UNICEF and WHO’s budgets, partners such as the Bill and Melinda Gates Foundation, the US Centres for Disease Control and Prevention, Rotary International and a handful of Governments have been faithful financial backers of health efforts in DRC, contributing millions of dollars to eradicate polio and other diseases.

Beating the cliché

Unfortunately, when it comes to DRC, success stories such as eradicating polio do not receive much attention. The country has been plagued by the continuing presence of Lord’s Resistance Army fighters in Province Orientale, and a high-profile security crisis brought on by a now-defunct armed group called M23.

The country is also coping with a spiraling internally displaced persons crisis in Katanga and, more recently, with an influx of refugees fleeing violence in the Central African Republic.

The challenge for the Congolese health system, and the international humanitarian community, is to make sure that polio does not return, and to extend this successful approach to other diseases. However, the Congolese health system suffers from an insufficient number of trained doctors, and even the most basic medical equipment is often in short supply.

“We need to learn from the lessons of polio to tackle other diseases that we want to see eradicated,” WHO’s Cabore said.