Palestinian children pass by stagnant water in the Gaza Strip, which is now facing the threat of a viral break as it contends with war. AFP
Palestinian children pass by stagnant water in the Gaza Strip, which is now facing the threat of a viral break as it contends with war. AFP
Palestinian children pass by stagnant water in the Gaza Strip, which is now facing the threat of a viral break as it contends with war. AFP
Palestinian children pass by stagnant water in the Gaza Strip, which is now facing the threat of a viral break as it contends with war. AFP

Gaza's mass polio vaccination drive vital in averting 'catastrophic' outbreak


  • English
  • Arabic

Live updates: Follow the latest on Israel-Gaza

The World Health Organisation has this week set out plans to administer 1.2 million polio vaccine doses in Gaza in an effort to prevent an outbreak that could exacerbate the current humanitarian crisis.

Two rounds of mass vaccination – targeting hundreds of thousands of children under the age of eight – are to begin this month after the detection of poliovirus in sewage.

Healthcare facilities and sewage systems in Gaza have suffered severe damage after months of bombardment by Israel following the attacks on October 7 last year, raising the dangers of disease spreading.

Here we consider the risks facing Gaza and ask experts whether there is a likelihood of people suffering paralysis as a result of the spread of polio.

What is polio and what has been found in Gaza?

Typically passed on through the faecal-oral route – such as by eating or drinking something contaminated with faeces – poliomyelitis is a viral condition that, in most cases, does not cause symptoms.

A minority of infected people have headaches and other mild effects, but about one in 200 suffers irreversible paralysis. Five to 10 per cent of such paralysis cases result in death when breathing becomes affected.

It was revealed last month that poliovirus had been detected in a number of sewage samples collected from two governorates in Gaza in June. The WHO says it could have been in circulation since last year.

The immunisation drive comes after polio was detected in samples of sewage in Gaza. AFP
The immunisation drive comes after polio was detected in samples of sewage in Gaza. AFP

This viral matter is not wild poliovirus, but instead is circulating vaccine-derived poliovirus (cVDPV), which appears to be spreading within the Gazan population.

With many areas in Gaza severely overcrowded, and with health facilities and sewerage damaged, conditions are ripe for the spread of polio.

cVDPV originates from the oral polio vaccine (OPV), which contains a weakened form of the virus that, in populations where immunisation rates are low, can spread between people.

"When vaccine-derived polio circulates unhindered, after a certain length of time there’s concern it would mutate back to become fully virulent," said Paul Hunter, a professor in medicine at the University of East Anglia in the UK.

"Then you would start to see a big rise in cases of paralytic poliomyelitis."

Vaccine-derived poliovirus can circulate even in developed nations when vaccination rates fall, such as in New York, where it caused the paralysis of a man in 2022.

Huge progress has been made against wild poliovirus, especially since the launch, in 1988, of the Global Polio Eradication Initiative, with cases having dropped by 99 per cent.

Only Pakistan and Afghanistan are still affected by the wild poliovirus, while in Africa, for example, cVDPV is the problem.

What vaccination programme is planned in Gaza?

An UNRWA employee vaccinates a child in Bureij refugee camp, central Gaza, during a previous campaign. AFP
An UNRWA employee vaccinates a child in Bureij refugee camp, central Gaza, during a previous campaign. AFP

The WHO aims to have two vaccination rounds of 600,000 doses for children under eight in Gaza, but has admitted that administering this could be difficult logistically.

The organisation is reportedly securing approvals to enter Gaza to undertake the programme and has called for a ceasefire so it can operate safely.

Prof Hunter, who helped to prepare a report for the WHO on infection control in Gaza during the conflict, said the situation there was "turning into one of the biggest humanitarian catastrophes" of the region in recent times.

Separate to the vaccination in Gaza, in May the Palestinian Ministry of Health announced it was carrying out a round of vaccinations using the OPV for children aged under five in Jerusalem and Bethlehem.

While there is a small risk with the OPV that it could mutate, become virulent again and spread in populations where vaccination rates are not high enough, it is easier to administer than the inactivated polio vaccine (IPV), which is given by injection. Also, the OPV offers stronger protection against the spread of the disease than the IPV does.

In developed nations the polio vaccine used is typically the IPV, which is given as an injection in the arm or leg.

In the US, for example, the IPV has been used since 2000, while the UK moved from the OPV to the IPV four years later.

Should other countries be worried?

Prof John Oxford, emeritus professor of virology at Queen Mary, University of London, said there was a danger that polio could spread outside Gaza.

"It’s very worrisome indeed," he said. "You cannot escape the fact it’s a risk to neighbours and even further afield. It’s a huge dilemma and humanitarian crisis. We don’t want polio coming back anywhere in the world."

Given the risks to Israel, Prof Hunter said the country should allow vaccination efforts to take place for reasons of self-interest, as well as for the sake of the Gazan population.

"If paralytic poliomyelitis started spreading in Gaza, the risk is that it spreads more regionally to Israel and Egypt," he said.

"If it happened in Gaza, it would be absolutely appalling for the Palestinians but it would present a risk for neighbouring countries, including Israel.

"Israel has a responsibility to allow this vaccination to go ahead not only for humanitarian reasons, but to protect its own population."

Separate to the WHO’s planned vaccination of Gazan children, the Israeli military last month announced it would give polio boosters to its soldiers in Gaza.

Dr Hamid Jafari, director of the WHO polio eradication programme, said a fast international response to contain the outbreak could reduce the risk of a wider health crisis.

“There is a clear and present danger and risk of spread internationally of this virus, and the sooner we can respond, the faster we can begin to reduce that risk,” Dr Jafari told The National.

Israel-Gaza war - in pictures

“Our risk assessment tells us there is a very high risk of spread to surrounding countries, particularly Egypt, Lebanon, Syria and Jordan.

“Under-vaccinated pockets are everywhere, including in Israel.

“It's very concerning. Polio is the only ongoing public health emergency of concern under the international health regulation.

“This requires a regional response and what that means is an initial focus on Gaza to stop the outbreak.”

Travel restrictions within the enclave have made it increasingly difficult for health workers to interact with communities in dire need of care.

The polio virus has been detected in sewage in two governates, from several sites in Deir al Balah and in Khan Younis.

The WHO and Unicef are working closely with the Ministry of Health to get the OPV programme up and running.

The initial plan was to start the campaign on August 17 but that has been delayed by another week to August 24.

Maintaining the cold chain storage required for the integrity of vaccine doses is another considerable challenge.

“Most likely polio has been circulating perhaps as long as since September last year,” said Dr Jafari.

“The conditions for polio virus transmission and the force of infection in the present situation in Gaza are extremely high.

“People are getting constantly displaced and they're coming into contact in crowded conditions.

“Gaza had very high immunisation rates and childhood immunisation, but they are falling.

“These conditions are perfect for the virus to circulate very efficiently and risk of spread to other parts of the occupied territories.

“The focus of our response is Gaza, but we are also preparing other countries of the region for a regional response, to increase their surveillance and preparedness.

“The only way to stop this outbreak is a series of mass vaccination campaigns.”

In numbers: China in Dubai

The number of Chinese people living in Dubai: An estimated 200,000

Number of Chinese people in International City: Almost 50,000

Daily visitors to Dragon Mart in 2018/19: 120,000

Daily visitors to Dragon Mart in 2010: 20,000

Percentage increase in visitors in eight years: 500 per cent

Racecard

6pm: Mina Hamriya – Handicap (TB) $75,000 (Dirt) 1,400m

6.35pm: Al Wasl Stakes – Conditions (TB) $60,000 (Turf) 1,200m

7.10pm: UAE Oaks – Group 3 (TB) $150,000 (D) 1,900m

7.45pm: Blue Point Sprint – Group 2 (TB) $180,000 (T) 1,000m

8.20pm: Nad Al Sheba Trophy – Group 3 (TB) $200,000 (T) 2,810m

8.55pm: Mina Rashid – Handicap (TB) $80,000 (T) 1,600m

The%20specs
%3Cp%3E%3Cstrong%3EEngine%3A%20%3C%2Fstrong%3E2.0-litre%204-cyl%20turbo%3Cbr%3E%3Cstrong%3EPower%3A%20%3C%2Fstrong%3E190hp%20at%205%2C600rpm%3Cbr%3E%3Cstrong%3ETorque%3A%20%3C%2Fstrong%3E320Nm%20at%201%2C500-4%2C000rpm%3Cbr%3E%3Cstrong%3ETransmission%3A%20%3C%2Fstrong%3E7-speed%20dual-clutch%20auto%3Cbr%3E%3Cstrong%3EFuel%20consumption%3A%20%3C%2Fstrong%3E10.9L%2F100km%3Cbr%3E%3Cstrong%3EPrice%3A%20%3C%2Fstrong%3EFrom%20Dh119%2C900%3Cbr%3E%3Cstrong%3EOn%20sale%3A%20%3C%2Fstrong%3ENow%3C%2Fp%3E%0A
THE BIO

Born: Mukalla, Yemen, 1979

Education: UAE University, Al Ain

Family: Married with two daughters: Asayel, 7, and Sara, 6

Favourite piece of music: Horse Dance by Naseer Shamma

Favourite book: Science and geology

Favourite place to travel to: Washington DC

Best advice you’ve ever been given: If you have a dream, you have to believe it, then you will see it.

UK-EU trade at a glance

EU fishing vessels guaranteed access to UK waters for 12 years

Co-operation on security initiatives and procurement of defence products

Youth experience scheme to work, study or volunteer in UK and EU countries

Smoother border management with use of e-gates

Cutting red tape on import and export of food

RedCrow Intelligence Company Profile

Started: 2016

Founders: Hussein Nasser Eddin, Laila Akel, Tayeb Akel 

Based: Ramallah, Palestine

Sector: Technology, Security

# of staff: 13

Investment: $745,000

Investors: Palestine’s Ibtikar Fund, Abu Dhabi’s Gothams and angel investors

While you're here
F1 The Movie

Starring: Brad Pitt, Damson Idris, Kerry Condon, Javier Bardem

Director: Joseph Kosinski

Rating: 4/5

Top New Zealand cop on policing the virtual world

New Zealand police began closer scrutiny of social media and online communities after the attacks on two mosques in March, the country's top officer said.

The killing of 51 people in Christchurch and wounding of more than 40 others shocked the world. Brenton Tarrant, a suspected white supremacist, was accused of the killings. His trial is ongoing and he denies the charges.

Mike Bush, commissioner of New Zealand Police, said officers looked closely at how they monitored social media in the wake of the tragedy to see if lessons could be learned.

“We decided that it was fit for purpose but we need to deepen it in terms of community relationships, extending them not only with the traditional community but the virtual one as well," he told The National.

"We want to get ahead of attacks like we suffered in New Zealand so we have to challenge ourselves to be better."

Five films to watch

Castle in the Sky (1986)

Grave of the Fireflies (1988)

Only Yesterday (1991)

Pom Poki (1994)

The Tale of Princess Kaguya (2013)

SPECS
%3Cp%3E%3Cstrong%3EEngine%3A%3C%2Fstrong%3E%202-litre%204-cylinder%20turbo%20and%203.6-litre%20V6%0D%3Cbr%3E%3Cstrong%3ETransmission%3A%20%3C%2Fstrong%3ESeven-speed%20automatic%0D%3Cbr%3E%3Cstrong%3EPower%3A%3C%2Fstrong%3E%20235hp%20and%20310hp%0D%3Cbr%3E%3Cstrong%3ETorque%3A%20%3C%2Fstrong%3E258Nm%20and%20271Nm%0D%3Cbr%3E%3Cstrong%3EPrice%3A%3C%2Fstrong%3E%20From%20Dh185%2C100%0D%3Cbr%3E%3C%2Fp%3E%0A
Barbie
%3Cp%3E%3Cstrong%3EDirector%3A%3C%2Fstrong%3E%20Greta%20Gerwig%3Cbr%3E%3Cstrong%3EStars%3A%3C%2Fstrong%3E%20Margot%20Robbie%2C%20Ryan%20Gosling%2C%20Will%20Ferrell%2C%20America%20Ferrera%3Cbr%3E%3Cstrong%3ERating%3A%3C%2Fstrong%3E%204%2F5%3Cbr%3E%3C%2Fp%3E%0A

Normal People

Sally Rooney, Faber & Faber
 

The specs

Engine: Direct injection 4-cylinder 1.4-litre
Power: 150hp
Torque: 250Nm
Price: From Dh139,000
On sale: Now

COMPANY%20PROFILE
%3Cp%3E%3Cstrong%3EName%3A%20%3C%2Fstrong%3EKinetic%207%3Cbr%3E%3Cstrong%3EStarted%3A%3C%2Fstrong%3E%202018%3Cbr%3E%3Cstrong%3EFounder%3A%3C%2Fstrong%3E%20Rick%20Parish%3Cbr%3E%3Cstrong%3EBased%3A%3C%2Fstrong%3E%20Abu%20Dhabi%2C%20UAE%3Cbr%3E%3Cstrong%3EIndustry%3A%3C%2Fstrong%3E%20Clean%20cooking%3Cbr%3E%3Cstrong%3EFunding%3A%3C%2Fstrong%3E%20%2410%20million%3Cbr%3E%3Cstrong%3EInvestors%3A%3C%2Fstrong%3E%20Self-funded%3C%2Fp%3E%0A
What are NFTs?

Are non-fungible tokens a currency, asset, or a licensing instrument? Arnab Das, global market strategist EMEA at Invesco, says they are mix of all of three.

You can buy, hold and use NFTs just like US dollars and Bitcoins. “They can appreciate in value and even produce cash flows.”

However, while money is fungible, NFTs are not. “One Bitcoin, dollar, euro or dirham is largely indistinguishable from the next. Nothing ties a dollar bill to a particular owner, for example. Nor does it tie you to to any goods, services or assets you bought with that currency. In contrast, NFTs confer specific ownership,” Mr Das says.

This makes NFTs closer to a piece of intellectual property such as a work of art or licence, as you can claim royalties or profit by exchanging it at a higher value later, Mr Das says. “They could provide a sustainable income stream.”

This income will depend on future demand and use, which makes NFTs difficult to value. “However, there is a credible use case for many forms of intellectual property, notably art, songs, videos,” Mr Das says.

Conflict, drought, famine

Estimates of the number of deaths caused by the famine range from 400,000 to 1 million, according to a document prepared for the UK House of Lords in 2024.
It has been claimed that the policies of the Ethiopian government, which took control after deposing Emperor Haile Selassie in a military-led revolution in 1974, contributed to the scale of the famine.
Dr Miriam Bradley, senior lecturer in humanitarian studies at the University of Manchester, has argued that, by the early 1980s, “several government policies combined to cause, rather than prevent, a famine which lasted from 1983 to 1985. Mengistu’s government imposed Stalinist-model agricultural policies involving forced collectivisation and villagisation [relocation of communities into planned villages].
The West became aware of the catastrophe through a series of BBC News reports by journalist Michael Buerk in October 1984 describing a “biblical famine” and containing graphic images of thousands of people, including children, facing starvation.

Band Aid

Bob Geldof, singer with the Irish rock group The Boomtown Rats, formed Band Aid in response to the horrific images shown in the news broadcasts.
With Midge Ure of the band Ultravox, he wrote the hit charity single Do They Know it’s Christmas in December 1984, featuring a string of high-profile musicians.
Following the single’s success, the idea to stage a rock concert evolved.
Live Aid was a series of simultaneous concerts that took place at Wembley Stadium in London, John F Kennedy Stadium in Philadelphia, the US, and at various other venues across the world.
The combined event was broadcast to an estimated worldwide audience of 1.5 billion.

Updated: August 11, 2024, 4:53 AM`