Tajikistan moves quickly to prevent a polio outbreak

WHO/Nargis Saparova

The first round of a polio immunization campaign started on February 24, 2014 in GBAO province, Tajikistan.

In a first round of a campaign for poliomyelitis (polio) immunization, health workers and volunteers vaccinated 18 900 children aged 0–5 years in the Gorno-Badakhshan Autonomous Oblast (GBAO) of Tajikistan. It reached 94.6% of the targeted population and was conducted on 24–28 February 2014; the second round starts on 1 April.

Need for stepped-up measures

The 2010 polio outbreak in Tajikistan raised concerns about the quality of routine immunization services and the reliability of reported coverage in the country. A serosurvey conducted by WHO and the United States Centers for Disease Control and Prevention (CDC) in 2010 demonstrated immunity gaps in the population.

Following the 2013 recommendation of the WHO European Regional Certification Commission for Poliomyelitis Eradication (RCC) to close immunity gaps and considering Tajikistan’s proximity to a polio-endemic country (Afghanistan), the Ministry of Health and Social Protection decided to conduct nationwide supplementary immunization activities with oral polio vaccine, targeting all children aged 0–5.

Two rounds of national immunization days were initially planned for March and April 2014. Detection of wild poliovirus in the Badakhshan province of Afghanistan, which shares a long border with GBAO, and financial constraints, however, prompted the Ministry immediately to start vaccination activities in GBAO.

Roll-out across the country

Over 2.4 million doses of oral polio vaccine, donated by the KfW Development Bank of Germany, were delivered to Tajikistan in the first quarter of 2014 to conduct the national immunization days. Other committed partners include the Ministry of Health and Social Protection, WHO and the United Nations Children’s Fund (UNICEF). The Ministry appeals to all partners for additional support to implement the national immunization days across the whole country.

Funds (US$ 170 000) are needed to ensure access to oral polio vaccine for all children living in remote and geographically isolated areas. This is the key to the success of the campaign. Public health work is needed at subnational levels to achieve universal coverage in the country and prevent transmission of poliovirus in the event of importation.

Polio-free Europe

In June 2002, all 53 countries in the WHO European Region were certified polio free. The 2010 outbreak, which began with an imported case in Tajikistan and spread to neighbouring countries, threatened this status, but the rapid international response, with widespread control efforts, quickly interrupted transmission, allowing the Region to remain polio free.

Sustained routine immunization and disease surveillance, along with supplementary immunization activities to close immunity gaps in any part of the European Region, are essential to ensure that that everyone is protected and that any importation of polio will be quickly detected.