Iraqi health authorities, in partnership with the World Health Organization (WHO) and UNICEF, launched Nov. 30 a mass polio vaccination campaign targeting more than 1.9 million children under the age of five.
Iraq had completed 1.7 million vaccinations by Dec. 16, Iraqi Minister of Health Hassan al-Tamimi said.
Adham Ismail, a WHO representative, said, “We must continue to do everything in our power to protect children from suffering, and from death due to diseases.”
The campaign, however, seems to have stirred an exceptional controversy, after the Global Polio Eradication Initiative recommended April 3 to suspend polio vaccination campaigns in order to help stop the spread of the novel coronavirus. A recent scientific study published in Science magazine reported that the virus that causes COVID-19 is bringing the global campaign to eradicate polio in grave danger.
The director of the Public Health Department at the Iraqi Ministry of Health, Riyadh al-Halfi, said: “The coronavirus pandemic caused the postponement of the spring vaccination campaign. But after the epidemiological situation in the country improved as a result of the continuous decline in confirmed cases and deaths, and in light of the importance of completing vaccinations to cover areas that need the polio vaccine, the Ministry of Health was required to carry out a noncomprehensive national campaign, targeting in particular areas at risk with poor coverage.”
The Iraqi Health Ministry had admitted on March 30, 2014, the first case of polio in Baghdad, as the first case resurging in 14 years. The last confirmed case was announced in 2000. Meanwhile, press reports in 2019 spoke of a comeback of the disease in Iraq, and the infection of a child with the disease due to a virus from an expired oral vaccination.
Halfi argued that talks about the spread of polio in Iraq is inaccurate, as the country has been free of polio since 2001, except for two cases coming from abroad in 2014. “Since then, Iraq has not recorded any cases of polio.”
“This is evidenced by the fact that Iraq obtained a certificate from the WHO confirming it is free of polio,” he noted. “These campaigns are carried out from time to time to avoid the return of the disease amid the existence of several risk factors that make this possible."
Halfi added that the recent campaign was supposed to be composed of two national campaigns — one in the spring and another one in autumn, but the coronavirus pandemic impeded the spring campaign. “We had to content ourselves with one national campaign, but it does not cover all children. We chose areas that are more at risk than others. About 1.8 million children have been vaccinated. This is the intended goal of the campaign.”
Faleh al-Ziyadi, a member of parliament, said: “The Ministry of Health focuses when implementing the polio vaccination campaign on those under the age of five in sectors, cities, and places with low health coverage in all parts of the country.”
He called for supporting the national government efforts and praised Iraq’s readiness and preparation for any possible re-emergence of polio. “There is a significant interest in health, high coverage rates of vaccinations and accurate epidemiological monitoring and good investigation,” he said.
Ziyadi noted that after the emergence of infections in countries in the Mediterranean region, including Pakistan and Yemen, it has become necessary to implement the vaccination campaign, in collaboration with the WHO and UNESCO.
“More money should be allocated to the Iraqi Ministry of Health to improve children's treatment and preventive services,” he said. “The ministry must focus on mother and child care services, especially after indications of reluctance by families to visit health centers due to the coronavirus pandemic. This also comes in light of an unprecedented increase in the rates of birth defects in most Iraqi hospitals due to environmental pollution.”
Meanwhile, Haider Salman, an official at the Ministry of Health in the Basra Health Department, praised the country's proactive steps to prevent polio from reemerging. He said: "The continuous and multiple vaccination programs by the Health Ministry — which is keen to implement programs to eradicate highly dangerous communicable diseases, including polio — contributed to making polio the least prevalent disease in Iraq, as a result of the vaccination policy according to fixed schedules and solid sources.”
He noted, “Iraqi doctors in general were able to raise awareness among people of the seriousness of polio being the most deadly and disabling disease among children.”
Salman added that the recent campaign included roughly 2 million children. “In 2019, there were two batches — the first in April of around 5.6 million children, then in November of more than 3.1 million children. These schedules are determined in cooperation with the WHO and the Iraqi Public Health Department.”
However, the lack of health services and hospitals in Iraq remains a cause for concern. Rafid Alaa al-Khuzai, a consultant physician, said: “Displacement, the troubled financial and political situation, and rampant corruption will cause the collapse of the preventive medicine system, and thus the emergence of polio cases after a long absence from Iraq.”
In order for the mass vaccination campaign to continue in Iraq, in cooperation with international organizations and with the support of developed countries, Iraq must be more open and more able to win the confidence of the international community. Failing to do so, the country will not be able to overcome any potential health crises.