Polio teams roll out targeted polio campaign to halt ongoing outbreak

A vaccinator marks door of a home to show that the children in the house were vaccinated. Photo: WHO SomaliaMogadishu, 25 June 2019 - Health authorities rolled out a polio campaign yesterday in Puntland and Somaliland to vaccinate more than 940 000 children under 5 years of age to stop an ongoing outbreak of a strain of poliovirus.

The campaign runs from 24 to 27 June 2019, with support from the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF). It targets all children in 12 districts in Somaliland and 9 districts in Puntland.

By the numbers:

• 945 480 children to be vaccinated
• 3160 vaccinators knocking on doors
• 677 team supervisors taking part
• 1558 social mobilizers sharing messages on vaccination and children’s health
• 15 children have been infected with the polioviruses so far, since outbreaks began

Somaliland, Puntland and other states in Somalia are currently experiencing outbreaks of 2 strains of poliovirus. Each strain requires a different vaccine. Children need several doses of each vaccine to boost immunity. Even though these viruses are not wild poliovirus, both these circulating strains can infect and paralyse children with low immunity. The last case of wild poliovirus in Somalia was in August 2014.

A vaccinator provides 2 doses of the oral polio vaccine to a young boy“It’s vital that parents ensure their children receive this vaccine because it builds immunity against a specific strain of poliovirus circulating in the country. I call upon all caregivers in the areas being covered in this campaign to please ensure children are at home and accept the oral polio vaccine when it is offered. Oral polio vaccines are stored and administered safely, and can save children from paralysis and permanent disability,” said Dr Mamunur Rahman Malik, WHO Representative for Somalia.

“The only way to protect children from all polioviruses is to ensure they receive multiple doses of polio vaccine, through campaigns and health facilities where possible,” said Werner Schultink, UNICEF Somalia Representative. “Caregivers need to ensure children receive this vaccine when it is available.”

Somalia’s polio programme has conducted 14 immunization campaigns, including 5 nationwide campaigns, since December 2017 to stop further spread of the outbreaks. Despite these efforts, not all Somalia’s children are being vaccinated, which has resulted in the polioviruses spreading across the country and spilling over to Ethiopia. To address this, polio teams from Somalia and Ethiopia conducted a joint planning workshop in Hargeisa last week, and are coordinating immunization activities along their shared border and in high-risk areas in each country during this round in order to prevent cross-border transmission and spillover.

Concurrent to the polio campaign, polio health workers have also been working to vaccinate more than 650 000 people aged one year and above against cholera in high-risk districts of Somalia.

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About GPEI

The Global Polio Eradication Initiative, is a public-private partnership led by national governments and spearheaded by the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC), and the United Nations Children’s Fund (UNICEF) working towards a future where no child will ever again be paralysed by polio.

For additional information, contact:

Dr Kamil Mohamed
Polio/Expanded Programme on Immunization (EPI) Team Lead
WHO Somalia
Email: هذا البريد محمى من المتطفلين. تحتاج إلى تشغيل الجافا سكريبت لمشاهدته.
Mobile: +252 613 041 057/+962 7 9643 1246

Dr Yasmine Challoub
Polio Team Lead
UNICEF Somalia
Email: هذا البريد محمى من المتطفلين. تحتاج إلى تشغيل الجافا سكريبت لمشاهدته.
Mobile: +252682418691/ +254719192825

Jamal Abdi Sarman
Communications Officer
UNICEF Somalia
Email: هذا البريد محمى من المتطفلين. تحتاج إلى تشغيل الجافا سكريبت لمشاهدته.
Mobile +252 634107531

Namita Mediratta
Polio Communications Consultant
WHO Somalia
Email: هذا البريد محمى من المتطفلين. تحتاج إلى تشغيل الجافا سكريبت لمشاهدته.
Mobile: +254 722 762 145

A woman receives oral cholera vaccination in Kahda district, Banadir region, Mogadishu. Photo: Maryan Abdi Sheikh 23 June 2019 – Combating cholera is a challenge for Somalia. Due to protracted crisis destroying the water and sanitation infrastructure and dilapidated health systems, coupled with regular flooding, several states are recurrently being hit by cholera epidemics. Despite these grave challenges, the Ministry of Health of Somalia, WHO and other partners face issues head on to identify sustainable solutions.

Unlike in 2017, the country continues to report cholera cases sporadically. The country faced one of the largest cholera outbreaks in 2017 with over 78 000 cases, including 1159 deaths. In 2019, the country has so far reported 1041 cases of suspected cholera, including one related death from about 25 districts of the States, which are located in the basins of the Jubba and Shabelle rivers.

Owing to the improved capacity of the health system to detect, treat and prevent cholera in the country, the number of cases have decreased in recent times but the disease continues to claim lives and cause suffering.

Practical and solid steps are needed to save the people of Somalia from the recurrent threats of cholera.

One of the largest oral cholera vaccination campaigns in a fragile setting in Africa gets under way

Somali health authorities and WHO are conducting Africa’s largest immunization campaigns using oral cholera vaccines (OCV) with the support of the United Nations Children’s Fund, Gavi, the Vaccine Alliance, and the Global Task Force for Cholera Control.

The campaign, which runs from 22 to 28 June 2019 in high-risk areas of Somalia, will vaccinate more than 650 000 children aged one year and above to eliminate the risk of the disease among vulnerable populations and to prevent recurring cholera outbreaks in the country.

“No one should die of cholera in the 21st century, especially when we have an affordable and easily administrable cure. It remains our collective responsibility to save lives and end cholera from Somalia. We remain committed to keep the country free from future cholera outbreaks,” said Dr Mamunur Rehman Malik, WHO Representative for Somalia.        

Before the campaign was launched, social mobilization teams were successfully trained in Balad and other targeted districts. Ministry of Health staff facilitated the training sessions. Polio workers and UNICEF's 'communication for development' teams briefed front-line health workers on vaccination techniques, record keeping and also how to search for those who missed vaccination.

Social mobilization team training in Balad. Photo by: Ali Hassan

The Health Minister of Federal Government of Somalia HE Dr Fauziya Abikar Nur commented on the cholera situation in Somalia, highlighting challenges and efforts, saying, “Cholera remains one of our major public health threats. We now have the means and solutions to prevent outbreaks in Somalia. We continue to work with WHO and our other partners to save lives and prevent cholera on a long-term sustainable basis.”

On the first day of the campaign, a total of 111 010 people were vaccinated, which includes 52 518 people aged 1 to 15. The current pre-emptive campaign using OCV is expected to play a major role in eliminating the risk of occurrence of cholera among vulnerable populations. As part of the country-led strategy to prevent cholera outbreaks in Somalia, health authorities and WHO are using the OCV in combination with other proven interventions such as improving access to safe water and sanitation and improving hygiene as a long-term sustainable solution to eliminate the risk of recurrent cholera outbreaks.

Related link

Cholera situation reports

For additional information, kindly contact:

Dr Mutaawe Lubogo
Epidemiologist
WHO Somalia
+252 612 857 531/+256 701 733 699

Ms Fouzia Bano
Communications Consultant
WHO Somalia 
هذا البريد محمى من المتطفلين. تحتاج إلى تشغيل الجافا سكريبت لمشاهدته.
+252 619 235 880

Mogadishu, 22 June 2019 – Somalia has just launched one of Africa’s largest immunization campaigns using oral cholera vaccines (OCV). The campaign, which runs from 22 to 28 June 2019 in high-risk areas of Somalia, will vaccinate more than 650 000 people aged one year and above to eliminate the risk of the disease among vulnerable populations and to prevent recurring cholera outbreaks in the country.

Somali health authorities and the World Health Organization (WHO) are conducting the campaign with the support of the United Nations Children’s Fund, Gavi, the Vaccine Alliance, and the Global Task Force for Cholera Control.

“No one should die of cholera in the 21st century, especially when we have an affordable and easily administrable cure. It remains our collective responsibility to save lives and end cholera in Somalia. We remain committed to keeping the country free from future cholera outbreaks,” said Dr Mamunur Rehman Malik, WHO Representative in Somalia.

During the 2 rounds of the campaign, vaccinators will go house to house in the 6 districts of Heliwa, Kahda and Harmajajab in Banadir, Balad and Afgoye in the South West State, and Kismayo in Lower Juba offering oral cholera vaccine.

Vaccination teams that include 126 supervisors at national, regional and district level and 112 vaccinators will aim to vaccinate around 150 people a day. A total of 217 community mobilizers have been deployed to conduct house-to-house visits and inform communities about campaign dates and benefits of the vaccines prior to beginning of the campaign.

The Minister of Health of Somalia HE Dr Fauziya Abikar Nur commented on the cholera situation in Somalia, highlighting challenges and efforts, saying, “Cholera remains one of our major public health threats. We now have the means and solutions to end cholera in Somalia. We continue to work with WHO and our other partners to save lives and prevent cholera on a long-term sustainable basis.” 

Since the current cholera outbreak began in January 2019, Somalia has reported 1041 cases of suspected cholera, including one related death, in 25 districts of the States located in the basins of the Jubba and Shabelle rivers.

In 2017, the country faced one of the largest outbreaks in its history, with 78 784 cases, including 1159 deaths.

A year later, in 2018, Somalia saw a reduction in the number of reported cases of cholera and related deaths, largely due to improved disease surveillance and case management, with the reported number of cases at 6448, including 45 deaths. The case–fatality rate, a measure of the severity of the disease, defined as the proportion of confirmed deaths of a specified disease or condition, for Somalia dropped from 1.47% in 2017 to 0.69% in 2018. Currently, in 2019, the overall case–fatality rate from cholera in Somalia is 0.09%.

The use of OCV in combination with other proven interventions such as improving access to safe water and sanitation and improving hygiene will help to eliminate the risk of recurrent cholera outbreaks faced by the country.

Related link

Acute watery diarrhoea/cholera situation reports

For additional information, kindly contact:

Dr Mutaawe Lubogo
Epidemiologist
WHO Somalia
+252 612 857 531/+256 701 733 699

Ms Fouzia Bano
Communications Consultant
WHO Somalia 
هذا البريد محمى من المتطفلين. تحتاج إلى تشغيل الجافا سكريبت لمشاهدته.
+252 619 235 880

7 May 2019 –  From the moment we’re born, we’re all at risk of contracting diseases. So the question is, are we aware enough? Are we responsible enough? Are we immune enough? Not long ago infections like influenza, tetanus, chickenpox and measles were prolonged, painful illnesses, which often resulted in death. Immunization saves millions of lives every year and is widely recognized as one of the world’s most successful and cost-effective public health interventions.

The Expanded Programmme on Immunization (EPI) started in Somalia in 1978 with the support of WHO and UNICEF. Due to the prolonged conflict and instability Somalia’s health system, including immunization services, is very weak, fragmented and severely under-funded. Control of vaccine-preventable diseases remains a huge challenge in Somalia, due to the low routine immunization coverage and the continued inability to reach children in security-compromised areas, hard-to-reach areas, nomadic children and competing health priorities for parents other than immunization of children. Low routine immunization coverage and a history of serious outbreaks that have hit Somalia in the past are a strong reminder of the risks posed by large cohort of un-immunized children. Vaccine-preventable diseases are prevalent in Somalia and child mortality is 137 per 1000 live births.

Somalia has been providing the traditional 6 antigens in routine immunization and with the support of GAVI - the Vaccine Alliance and immunization partners like UNICEF and WHO. The country has introduced pentavalent vaccine in 2013 and inactivated polio virus vaccine in 2015 and plans to introduce measles-containing-vaccine second-dose (MCV2) in 2020. With the continuous support of GAVI, Centers for Disease Control and Prevention, Atlanta, Bill & Melinda Gates Foundation and Rotary International and other important donors immunization coverage has improved in recent years; however, Somalia has still not attained the desired levels of coverage.

To improve immunization coverage more efforts needs to be in place for integrated approach along with other programmes like nutrition, malaria, water and sanitation and communication programmes to complement the reach of immunization and improve coverage of all eligible children with equity.

Somalia faced a deadly measles outbreak in 2017; out of the 31 000 people affected, 83% were children under the age of 10. WHO Somalia’s Emergency Response team, Somali national authorities, and partners targeted 4.7 million children in the nationwide measles campaign. During this intervention, around 4.5 million children were vaccinated. As a result of the nationwide immunization campaign conducted, as of April 2019, Somalia witnessed a decline in the trend of cases reported this year. This steady progress can be attributed to partners’ commitment to strengthen routine immunization and to reach out to unvaccinated children to boost their immunity. However, Somalia’s children are still not out of danger – measles outbreaks are likely to spread in security-compromised inaccessible areas.

Somalia’s last outbreak of wild poliovirus, which occurred from 2013 to 2014, affected 194 children. Since then, as a result of mass and more focused immunization campaigns, and robust surveillance for polio symptoms to guide immunization activities, the country has been free of wild poliovirus. However, due to the challenges faced in reaching hard-to-reach areas, the country is currently experiencing 2 outbreaks of rare strains of the poliovirus, which have affected 13 children so far. The last nationwide polio campaign, conducted in March, vaccinated more than 2.7 million children under 5. More than 84 000 children were vaccinated for the first time.

Marked during the last week of April, World Immunization Week aims to promote the use of vaccines to protect people of all ages against disease. WHO wants to assure parents and communities in Somalia that vaccines are safe, effective, and can lead to lifetime immunity from diseases.

While celebrating World Immunization Week with the theme “Protected Together: Vaccines Work”, Dr Mamunur Rahman Malik, WHO Representative for Somalia, called for scaling up the routine immunization programme in Somalia through working together with partners, communities and grass-root level organization. In  2018, Somali authorities, WHO and partners vaccinated more than 400 000 children against measles as part of routine immunization programme. Yet, about 170 000 children were missed or did not receive the first dose of measles vaccine last year. “Our priority is to reach out to all these children who misses the routine vaccine doses or remain unvaccinated owing to access or any other barrier.  Leaving no child behind, we can ensure every child’s right to lead a healthy and productive life- if all who need to vaccinated are vaccinated in a timely way,” he stated.

In the last decade, Somali health authorities and WHO worked with Gavi and other key partners to strengthen routine immunization. This protected 2.4m children against 8 vaccine-preventable childhood diseases.

Somalia has shown remarkable progress in achieving good immunization coverage for some diseases that is realistically feasible to achieve in a fragile state, lot of works still need to be continued and scaled up to fill the immunization gaps through enhancing partnerships with other local stakeholders which is the key theme of this year’s World Immunization Week. Responding to outbreaks of measles or polio is a priority but can be prevented through achieving high coverage in routine immunization programme and also by reaching out to the children who do not receive any vaccine during the first year of their life.

Despite the gains made by vaccination over the years, there are still unvaccinated and under-vaccinated children in Somalia today. As a consequence, millions of children are being put at risk against vaccine-preventable diseases.  As part of this year’s campaign, grass-root level vaccinators who spearhead all barriers to reach every child in inaccessible areas of the country were honoured as immunization heroes. Their roles in keeping children healthy and securing a safer future has been acknowledged throughout the country.