Kenya meets new goal of eradicating polio, but it risks being undermined by vaccine war

Kenya’s commitment to eradicate polio—a disease that crippled and ultimately killed victims—has so far paid off in millions of lives. But it also fueled controversy over a controversial vaccine policy aimed at curbing the spread of a crippling disease.

On April 7, Kenya’s government vowed to eradicate polio in the country by March, which it did.

That policy, however, has fueled opposition among healthcare workers, some of whom say that polio vaccination has been wrongly branded with the all-too-familiar scarlet letter of “anti-vaxxers.” This campaign comes alongside a looming threat of its own: both the United States and the World Health Organization have warned that their programs will be suspended unless Kenya’s government can protect them from vaccine opponents. The WHO has previously been involved in the creation of a critical, government-wide database to help it track where polio has been transmitted and further push Kenya to do more to stop it.

Kenya has long been a concern among health workers worldwide—many local activists and the country’s minister of health, Cleopa Mailu, have decried the departure of many Western healthcare providers to Israel and other wealthy nations. Many within Kenya point to a recent decision to disband two new primary schools that had been built for low-income parents (who, these activists say, could not afford to obtain national vaccinations) as evidence that the country’s leadership is prioritizing its new campaign.

That move resulted in a lawsuit brought against the government by a family that could have otherwise sent a child to that school. It’s part of a broader debate in Kenya over polio and its latest vaccine mandate, which in January capped a previous program requiring all schoolchildren to receive three doses of a three-shot injection against polio within a two-year period.

Kenya’s finance ministry had in February authorized the financial expenditure of $1.2 million to bankroll the 2018-2019 polio vaccination campaign. According to a Kenyan press report, the ministry of health has set the new vaccination goal at 1.4 million children under five, but estimates that as many as 2.4 million children could be vaccinated in March—the WHO warns that in its absence, the vaccination rate could fall as low as 1 percent.

But for health advocates in Kenya, some of the difficulties associated with campaigning against polio often have little to do with the vaccine itself and more to do with the country’s leadership, many of whom may not fully understand the immunization regime.

Until relatively recently, polio vaccines only required two doses. But in early 2005, after mounting evidence of the disease’s ability to be transmitted through human faeces, WHO Secretary-General Margaret Chan declared that three doses were necessary to ensure that children who receive one dose would be protected against the disease.

This “three doses” definition, however, seems to have created a conflation between chronic polio infection and polio itself.

Two of the three vaccine doses needed to protect against polio are typically administered orally, but the third dose is usually administered through injection. Under this three-dose mandate, many children in impoverished areas may be unaware that their vaccinations can take up to three doses. As a result, many children who receive two doses of the polio vaccine develop antibodies that protect them from the infection, but may not be protected by the third dose.

This leaves many children vulnerable to develop polio, Dr. Johannes Goedhuys, a pediatrician in the affluent Kenyan city of Nairobi, who recently watched his children get vaccinated against polio, told NBC News in November.

“The fact that there is two doses of that vaccine [is] the problem for many parents—they believe that polio is a single-dose disease; that getting rid of polio would be [only] to be done through the three dose of that vaccine,” he said.

Opponents of vaccination also suggest that global officials may view Kenyans as careless with their health—claiming that the vaccine is not as effective as it should be and is nevertheless regularly administered with impunity.

The president of the prominent National Cohesion and Integration Commission told Kenyan television network KTN in October that “people will get polio” if he was not involved in the polio vaccination program.

“If I am no part of this process, then polio-like disease will continue to be a reality in our country,” he said.

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