The world conquered a disease in Gaza

There had not been a single confirmed case of polio in Gaza for twenty-five years. However, a baby became partially paralyzed last month after contracting the disease following ten months of Israel’s war in the Gaza Strip, which has destroyed the health care system and created unsafe and unhygienic conditions for Palestinians.

In order to facilitate a widespread vaccination campaign in Gaza, UN Secretary-General António Guterres called for an immediate humanitarian ceasefire as the virus spread throughout the besieged enclave. Subsequently, Israel consented to several humanitarian pauses spanning three days in the northern, central, and southern regions of the Gaza Strip. The vaccination campaign has so far reached over 161,000 children under the age of ten, according to the World Health Organization (WHO), which said this on Monday.

To be sure, polio poses no threat to public health in Gaza just yet; there is still much work to be done. WHO needs to reach 640,000 children under the age of ten, or 90% of them, in order to reach its goal. Every child should receive two rounds of vaccinations, with the second round beginning four weeks following the administration of the first doses.

This makes the immunization campaign difficult to carry out, particularly if the fighting rages on without humanitarian breaks and results in more infrastructure destruction and displaced people. It will be “very difficult for humanitarian actors to move around and be able to provide vaccines for not only polio but for other diseases” if Israel keeps issuing evacuation orders and carrying out attacks on Gaza’s infrastructure, for example, according to Julia Bleckner, senior health researcher at Human Rights Watch.

For Palestinians in Gaza, the disease—which is all but extinct—presents a major risk. Experts caution that a more widespread outbreak is possible, could have an impact on the region, and might even spread outside, despite health officials’ inability to predict whether the number of polio cases will stay contained.

In Gaza, how did polio resurface?

Polio is a highly contagious disease that attacks the nervous system and can quickly cause complete and permanent paralysis. It primarily affects children under the age of five. Most nations have been successful in eliminating the disease because, although there is no known cure, it can be prevented with vaccinations. In actuality, confirmed cases of polio have dropped by 99 percent worldwide since the Global Polio Eradication Initiative was established in 1988.

Polio was thought to have been eliminated in Gaza for many years. Nonetheless, in July, polio virus was found in wastewater samples from Khan Younis and Deir al Balah, which are located in central and southern Gaza. Guterres declared last month that “[The poliovirus] would have a disastrous effect left unchecked, not only for Palestinian children in Gaza, but also in neighboring countries and the region.”.

What are known as vaccine-derived strains of the virus are probably the cause of the polio outbreak in Gaza. A live, but weakened, strain of the poliovirus is administered to individuals as part of one type of the vaccine. Consequently, recipients of that vaccine may excrete some of that weakened virus, typically in wastewater. After a sufficient amount of time, the virus can revert to its pathogenic strain and continue to spread throughout the community.

The conditions Palestinians in Gaza have been living in since the war began last October are exactly those of overcrowding and poor sanitation, which makes them particularly susceptible to the virus spreading through contaminated food or water. This is especially true after Israel launched attacks on the infrastructure responsible for providing water and sanitation.

Add to that the fact that the proportion of vaccinated people in Gaza has dropped dramatically as a result of this war. According to the WHO, less than 90% of those living in the strip had received their routine vaccinations in the first three months of this year, compared to 99% prior to October 2023.

According to Bleckner, it is “not a coincidence” that this is the first case of polio in 25 years.

Will there be enough vaccinations in time for Palestinians?

Getting 90 percent of Palestinian children under 10 vaccinated as soon as possible is the top priority for health officials. The campaign is showing encouraging results thus far: the WHO reports that more than 160,000 children were immunized in the first two days of the drive, surpassing the agency’s initial target of 150,000 children.

However, considering the ongoing nature of the war, it is unclear how long-lasting that success will be. Health officials may face challenges in reaching their objectives when humanitarian pauses end. For example, the UN said last week that the nearly constant orders to evacuate issued by Israel have made it more difficult for their aid workers to reach Palestinians in need.

One of the reasons polio has been spreading in some regions of the world is vaccine hesitancy, which health officials may encounter in Gaza. Furthermore, some Palestinians remain skeptical despite the fact that international organizations—rather than Israel—are spearheading the vaccination campaign. Palestinian mothers told Al Jazeera that their people “have lost faith in anything global or Western.”. “.

The issue of safety is also present. “When the majority of health care centers are currently inaccessible and barely functioning, how are parents trying to bring their kids to get vaccinated going to get to health care centers safely?” asked Bleckner. Furthermore, it makes sense that some parents might be concerned that no facility is safe in light of Israel’s attacks on food distribution sites, schools, hospitals, and refugee camps.

Although there hasn’t been much polio transmission globally, Afghanistan and Pakistan are still thought to be endemic for the disease. Every region of the globe is still at risk until the virus is completely eliminated from those nations, according to the Global Polio Eradication Initiative. This is particularly true for low-income nations that lack adequate public health infrastructure. Recent reports of cases of wild poliovirus—that is, cases of poliovirus circulating naturally as opposed to strains derived from vaccines—have come from Malawi and Mozambique.

The success of the current immunization campaign is crucial for the health of Palestinians living in Gaza and the wider region. Though Israel has been immunizing its soldiers since July, it has taken so long to implement that it will demand a remarkable effort. Experts have been alerting Israel and the rest of the world for months about a possible polio outbreak.

“There’s no good reason for any child born in 2024 to contract polio. Since the disease is completely avoidable, even if there is just one confirmed case—and the WHO has noted that several children are currently exhibiting paralysis symptoms—it will already be too late, according to Bleckner. “It’s really a race against time to stop the catastrophic spread of this disease and others because of the truly appalling conditions that people are living in Gaza.”. “.