TThe poliovirus was detected in wastewater samples in Gaza last week, an alarming but not surprising development given the dismantled state of the territory’s health system after nine months of relentless war.
All over Gaza, more than 39,000 people killed, 89,000 injuredand more than It is estimated that there are 10,000 to miss. Most hospitals can no longer function. Although, diarrheal diseases, respiratory infections and hepatitis A, among other things, are raging through Gaza. Nearly everyone in Gaza is facing acute food insecurity and catastrophic hunger. Thousands of children are malnourished, making them even more susceptible to disease.
About 2.3 million people live in the 365 square kilometers (141 square miles) The Gaza Strip, which is further concentrated due to limited access to clean and safe water and deteriorating sanitary conditions.
Since early May, nearly a million people have moved from Rafah to Khan Younis and Deir al-Balah, where the polio samples were detected.
Although no cases of polio have been recorded yet, without immediate action it is only a matter of time before it reaches the thousands of children left unprotected. Children under five are at risk, and especially babies under two, as many have not been vaccinated in the nine months of conflict.
The World Health Organization (WHO) is sending more than 1 million polio vaccines to Gaza, to be administered in the coming weeks to prevent children from contracting the disease. However, without an immediate ceasefire and a massive acceleration of humanitarian aid, including a targeted vaccination campaign aimed at young children, people will continue to die from preventable, treatable diseases and injuries.
We have repeatedly seen polio flourish in places affected by conflict and instability. In 2017, in war-torn Syria, an outbreak of a variant of the polio virus – a mutated form of the wild virus that can spread in underimmunized populations – links 74 children paralyzedIn present-day Somalia, a decade-long civil war has resulted in the longest unbroken chain of variant poliovirus transmission spread worldwide since 2017. In Afghanistan and Pakistan, the last two countries where children are paralyzed by wild polio, humanitarian crises and insecurity have prevented the world from finally eradicating the virus.
Now, children trapped in Gaza face the same threat with nowhere to go. Before the conflict, the vaccination rate was 99%. Now, it has dropped to 86%, which is dangerous because it creates pockets of unvaccinated children, where the virus can circulate. The decimation of the health system, lack of security, destruction of infrastructure, mass displacement of people, and shortages of medical supplies have meant that children have missed many life-saving vaccines.
Only 16 of Gaza’s 36 hospitals are functional – with limited services – and less than half of primary health care facilities are operational. Meanwhile, 70% of all the sewage pumps in Gaza have been destroyed and not a single wastewater treatment plant is functioning. These conditions create the perfect breeding ground for the spread of disease.
In this dire context, health workers are risking their lives to care for people, from working without electricity to testing wastewater samples for deadly diseases. The fact that polio was discovered in Gaza before a large-scale outbreak of paralytic polio is a testament to these incredible efforts, as the disease surveillance system has been severely curtailed due to insecurity.
For more than three decades, the Global Polio Eradication Initiative – consisting of Rotary International; the U.S. Centers for Disease Control and Prevention; WHO; UNICEF; Gavi, the Vaccine Alliance; and the Bill & Melinda Gates Foundation – has supported health authorities around the world in building and maintaining resilient disease surveillance systems that can detect the virus, along with other emerging health threats, regardless of circumstances.
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In Syria in 2017, these systems helped identify and stop the outbreak after a handful of door-to-door vaccination campaigns. Last year, surveillance efforts in Ukraine revealed an outbreak of a variant of the polio virus that left two children paralyzed before a rapid vaccine response was launched stopped the virus.
In the face of great danger and hardship, the international community has a responsibility to leave no one behind and to prioritize health and well-being. This is not unprecedented – from the civil war in El Salvador in the 1980s to the conflict in Sudan’s Darfur region in the early 2000s, ceasefires, known as “days of calm,” have been negotiated to effectively put wars on hold and allow life-saving vaccines to reach communities trapped in inaccessible, conflict-affected areas.
Today, the discovery of polio in Gaza is yet another sobering reminder of the dire circumstances people face. Continued conflict will not only add to the rising death toll in the region, but will also hamper efforts to identify and respond to preventable health threats like polio.
Immediate steps are now being taken to vaccinate every child against polio, but ultimately a ceasefire and free aid are the only ways to protect people and prevent an explosive outbreak.
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Tedros Adhanom Ghebreyesus is Director-General of the World Health Organization
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This article contains a reference to the Bill & Melinda Gates Foundation’s support for polio eradication. Support for The Guardian’s global development journalism comes from the Bill & Melinda Gates Foundation via debewaker.orgRead more about how the Guardian ensures its editorial independence here