Poliomyelitis in Africa: Progress, Challenges, and Road to Eradication

Isma Butt, DPT, DLHA Volunteer and Freelance Medical Writer. Medically reviewed by: Dr. K. Craig. Mb.BS, MPH

Image showing a group of seated African children with polio holding on to their crutches. Credits WHO

 

Highlights:

• Africa has seen a 93% reduction in variant type 1 poliovirus cases since 2023 due to large-scale vaccination campaigns.

• Nearly 54 million children were vaccinated in coordinated campaigns across multiple African countries in early 2025.

• Challenges like insecurity, vaccine hesitancy, and hard-to-reach populations still hinder the full eradication of polio.

• New vaccines and digital tools improve surveillance, response, and vaccination coverage.

• Strong coordination between African governments, the WHO, the Global Polio Eradication Initiative, and communities is key to reaching every child and achieving a polio-free Africa.

 

Introduction 

Poliomyelitis, commonly known as polio, is an infectious viral disease that has affected numerous families in Africa over the years. This infectious virus has the potential to cause paralysis, disability, and even death, particularly in children less than five years old. However, with incredible work in the field of public health and tremendous vaccination campaigns, Africa is on the verge of eliminating this disease today.

It is important to understand the current situation of polio, the obstacles encountered, and what should be done to eliminate it among people in Africa. This article will take you through the effects of polio, the recent eradication achievements in Africa, the challenges that remain, and the efforts that all stakeholders can make to end the fight. Knowing this will also help you protect yourself, your family and your community.

 

What is poliomyelitis?

Poliomyelitis is a contagious illness caused by a special type of germ called poliovirus (enterovirus) which multiplies in the intestine, from where it can get into the nervous system and cause paralysis, or even death

An image showing the poliovirus. Credit

 

Variants of wild poliovirus:

There are three distinct serotypes (variants) of wild polio virus (WPV), types 1, 2 and 3, and infection or immunisation with one serotype does not induce immunity against the other two serotypes.

Of the three wild poliovirus serotypes only WPV1 remains. WPV2 was declared eradicated in September 2015, with the last case detected in India in 1999. WPV3 was last detected in November 2012 in Nigeria and was declared eradicated in October 2019.

Image showing three different variants of poliovirus. Click on image to enlarge

 

Mode of transmission (How you catch polio):

1. Faecal-oral route: This is the primary route of polio transmission. The virus spreads from the faeces (poop) of an infected person to the mouth of another person, which can happen when hands are not properly washed after using the toilet, or through food or water contaminated by the faeces. (see fig. 1): 

Fig. 1: Image demonstrating the faecal-oral route of virus transmission. Click on image to enlarge.

 

2. Oral-oral Route: This mode of transmission is rare and happens when an infected individual coughs, talks, or sneezes, and releases tiny saliva droplets. These droplets then land on the mouth or nose of a nearby person or on objects people touch (utensils, food, etc.) and then place their hands into their mouth. This happens when individuals are in close contact because droplets do not travel very far. Therefore, the transmission can be either through direct contact with saliva or through air droplets near an infected person (see. fig 2). Once inside the body, the virus multiplies in the intestine and can enter the nervous system.

Fig. 2: Image showing the direct droplet (Oral-oral) route of virus transmission. Click on image to enlarge.

 

Types of polio

About 70% of polio infections in children do not show symptoms. Infected individuals without apparent illness pass the virus through their nose, throat secretions, and poop over days or weeks and can infect others.

1. Abortive poliomyelitis: This is the mildest form and occurs in 25% of cases. It makes you feel sick but does not cause permanent damage. The symptoms feel more like a mild flu which is usually short-lived. Symptoms include:

• Fever
• Sore throat
• Headache

2. Non-paralytic poliomyelitis: It occurs in 1% to 5% polio infections in children. This type also causes flu-like symptoms but they are more severe and last longer. It can lead to:

• Muscle pain
• Weakness and stiffness in the neck, back, arms, and legs.
• Other possible symptoms can include headache, vomiting, fever, and fatigue.

Hospital care can be needed, but paralysis does not occur.

3. Paralytic poliomyelitis: This is the rarest and the most severe form of polio seen in less than 1% population. The virus attacks and destroys the nerve cells that control muscles.  It leads to permanent paralysis of some muscle groups, e.g., breathing muscles, leg muscles, and death if left untreated.

Photo of a child paralysed by Polio. Credit WHO. Click on image to enlarge.

 

Who is more at risk and why?

The highest risk is borne by unvaccinated children younger than five years, because their immune system is not fully developed and they have a higher probability of contact with contaminated environments. This is why it is important to vaccinate children.

Related: Poliomyelitis: What Africans Need to Know

 

A Glimpse into Polio's History in Africa 

Polio outbreaks were common in African countries for many years. These epidemics left thousands of children paralysed or dead. In addition to the physical burden, polio also caused fear and stigma to the families. 

But, this began to change in the late 20th century with the introduction of polio vaccines. Mass immunisation, awareness, and the support of foreign partners also helped to decrease the spread of the virus. Since 1988 the number of polio cases in the world has decreased by more than 99 per cent, with major progress being achieved in Africa.

These efforts have helped in the prevention of the spread of the virus and the protection of millions of children. The accomplishment shows the strength of teamwork and how it can lead to a healthier future for all.

 

The Current Situation: Hope and Progress

Despite the progress, the battle against polio in Africa is not yet over. The continent continues to struggle with issues that ensure the virus remains active in some areas.

WHO Africa regional reports highlight that as of 2025:

• More than 54 million children had been vaccinated in mass campaigns in African countries.

• Countries like Madagascar have even declared the end of recent outbreaks and this reflects that polio can be eliminated through efficient and concerted efforts.

• There has been a 93% decrease in the cases of variant type 1 poliovirus compared to the cases of 2023.

• In countries such as Kenya, Ethiopia, Somalia, Benin, and Malawi, vaccination campaigns have reached millions of children, protecting them from infection.

• Because of the ongoing conflicts, inaccessible locations, and misinformation, the Lake Chad Basin, some parts of the Horn of Africa still encounter polio cases.

These figures are testament to significant progress as well as the effort yet to be done.

Related:

Ghana Launches Nationwide Polio Vaccination Campaign

Kenya Launches Polio Vaccination Campaign

 

Major Challenges to Polio Eradication

Africa has many major challenges to overcome before it can achieve a polio-free future. Here are some of them:

• Insecurity and Conflicts: Children are not being vaccinated because insecurity in regions such as the Lake Chad Basin makes it unsafe to vaccinate children, and many are at risk of getting the disease.

• Vaccine Hesitancy: Distrust, misinformation, and lack of vaccine-related education decrease vaccination coverage in certain communities.

• Population Movements: Cross-border travel and migration spread the virus and made tracking and immunisation harder.

• Remote and Hard-to-Reach Areas: Nomadic people and villages are inaccessible most of the time.

• Surveillance Gaps: To detect the virus early, there must be good laboratory and field surveillance, which in some cases is not available.

All these factors may lead to the problem of delaying the eradication of polio, but once known, they can be used to design superior solutions.

 

How Africa Is Fighting Back Against Polio: Vaccination and Surveillance

I. The Africa Regional Polio Eradication Plan: A Clear Path

The Africa Regional Polio Eradication Action Plan (2024-2025) sets clear goals:

• End wild poliovirus type 1 outbreaks by the end of 2024.
• Stop all circulating poliovirus type 2 by the end of 2025.
• Prevent the spread of outbreaks to new countries by the end of 2026.

To meet these goals, the plan focuses on:

• Increasing outbreak response with three to five vaccination rounds based on risk.
• Improving detection with more surveillance and laboratory support.
• Increasing integration by linking polio work with other routine health services.
• Advocating urgency among governments and partners to keep resources flowing.

This comprehensive approach is crucial for sustainable success.

II. Vaccination Programmes

There's no doubt vaccination remains the most effective weapon against polio. Two types of vaccines are in common use in African countries (see fig. 3): 

1. Oral Polio Vaccine (OPV): It is given by mouth, easy to use in mass campaigns, and effective at stopping transmission.

2. Inactivated Polio Vaccine (IPV): This injectable vaccine provides excellent individual protection, particularly important in routine immunisation.

Fig. 3: Side-by-side image of Oral and Inactivated Polio Vaccines. Click on image to enlarge. Credit. GPEI

 

The typical vaccination schedule includes (see Table 1):

• OPV at birth, IPV given to babies at 6 weeks, 10 weeks, and 14 weeks of age
• A booster dose of IPV at 18 months

In countries like South Africa, this schedule is common.

Tabe 1: Typical vaccination schedule for polio in some African countries. Click on image to enlarge. 

 

Other countries may use slightly different schedules, for example:

• A 4-dose IPV schedule at 2, 4, 6 months, and 4 years of age
• The vaccine may be combined with other shots, like DTPa-hepB-IPV-Hib (which protects against other diseases too).

A young African girl is receiving the life-saving oral polio vaccine. Credits. WHO

Related: Childhood vaccines and routine immunization In Nigeria

III. Other strategies driving progress include:

• National immunisation days: Africa conducts campaigns where many children receive vaccines in coordinated regional immunisation programs. More than 161 million children living in the Lake Chad Basin, the Sahel, East, and West Africa were vaccinated in synchronised campaigns during the first half of 2025.

• Advance Tracking System: Innovations like Geographic Information Systems (GIS) can be used to map low-coverage areas and plan targeted campaigns.

• Environmental Surveillance: The screening of sewage water to detect the presence of poliovirus provides a quicker means of detecting hidden virus circulation.

• Multi-Round Campaigns: Conduct three to five rounds of vaccination in affected areas to stop transmission effectively.

• Community Involvement: Health workers, community volunteers and religious leaders are key for social mobilisation. They play an important role in the process of educating families and ensuring the safe delivery of vaccines.

 

New Tools and Strategies Moving Forward

Recent advances are helping in keeping the poliovirus in check better than ever:

• New Vaccines: Scientists have developed new oral vaccines that reduce the risks of vaccine-derived outbreaks.

• Digital Tracking: Mobile technology supports faster, more efficient campaign delivery.

• Health System Integration: Polio vaccination efforts are combined with other health services like measles immunisation, thereby increasing acceptability.

• Laboratory Strengthening: Enhanced sequencing and laboratory capabilities speed up outbreak investigations and response.

These tools make programs more effective and assist in overcoming traditional barriers.

 

What You Can Do to Help End Polio

Ending polio is a contribution that each individual can make: 

• Get your Children Vaccinated: Make sure your children are given their complete polio vaccine doses on time as on the immunisation schedule and during every campaign. Even if your child appears healthy, vaccination will ensure that he/she is safe in the future.

• Stay Informed: Understand the safety and importance of vaccines; do not spread rumours and false information.

• Support Campaigns: This involves participation in community vaccination days and encouraging others to do the same.

• Empowering others: helps neighbours and families to get their children vaccinated. Community support is very influential.

• Report Symptoms: Alert health workers if you see someone with sudden limb weakness or paralysis. Quick reactions stop outbreaks.

Community support is a key piece of this issue.

 

Governments and Partners Leading the Way

Vaccination and surveillance programs are led by African governments, assisted by The Global Polio Eradication Initiative with six partners – the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC), the United Nations Children's Fund (UNICEF), Gates Foundation and Gavi, the vaccine Alliance. They raise funds, train health workers, develop and educate health workers, and coordinate cross-border strategies.

Technical and financial support is offered by international partners, which is important to reach out to all the children and respond swiftly to outbreaks.

 

Impact of Polio Eradication in Africa

Eradicating polio is beneficial beyond preventing paralysis:

• Health: strong vaccination systems enhance the overall health of the children and reduce other infectious diseases.

• Economic: healthy children lead to better development of the family and the community at large, cutting down healthcare expenses due to disability.

• Social: With a polio-free Africa, even more children will grow up in full mobility and independence, making the society stronger.

The lessons learnt during the polio fight also enhance the way African countries tackle other infectious diseases and vaccination campaigns.

 

Conclusion

Africa has made incredible achievements in the fight against polio. Millions of children are safer today than ever before. Yet, the final steps require persistent effort. Continued vaccination, surveillance, community engagement, proper sanitation, good hygiene practices, and strong leadership will wipe out polio for good.

Together, we can protect our children from this paralysing disease. Let us all commit to vaccinating every child, supporting local campaigns, and spreading awareness. A polio-free Africa is not just a dream; it is within our grasp.

 

Sources:

1. World Health Organisation (WHO) Africa Regional Office: Highlights of the Polio Response, January–March 2025. [internet. n.d]. Cited August 18, 2025. Available from here.

2. Global Polio Eradication Initiative (GPEI), Africa Regional Polio Eradication Action Plan 2024-2025. [Internet. n.d]. PDF. Cited August 18, 2025. Available from here.

3. Global Polio Eradication Initiative (GPEI). A critical moment for global public health: Polio eradication at the 2025 World Health Assembly. [internet. n.d]. Cited August 18, 2025. Available from here.

4. Boston Children's Hospital. Poliomyelitis Types. [internet.n.d]. Cited August 18, 2025. Available from here.

 

 

Published: September 3, 2025

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