
Africa declared free of wild polio - riffraff
https://www.bbc.com/news/world-africa-53887947
======
rmason
My generation was the first to be spared from polio. But I had relatives that
were not as lucky. I knew kids just a few years older than me who lived in
iron lungs. This is a massive accomplishment that should be celebrated.

~~~
koheripbal
I think the celebration is slightly premature. Several areas in the African
interior are inaccessible due to conflict, so testing is not possible. ... so
we are not really certain it's been eradicated in those areas.

Also important is the possibility of environmental reservoirs for the disease
in nature. Hopefully not, but it is still possible.

Only continued vigilance can guarantee victory. Many areas were declared polio
free once before, only to have it resurface.

~~~
TempLogsForOne
You mustn't twist yourself into knots. You are correct, and this WHO body
declaration has nothing to do with the facts on the face of things.

~~~
koheripbal
> this WHO body declaration has nothing to do with the facts

...par for the course these days.

------
melling
Now the world needs to go after malaria in Africa.

Throughout the world a child dies every 2 minutes from malaria.

[https://www.weforum.org/agenda/2020/08/infectious-
diseases-c...](https://www.weforum.org/agenda/2020/08/infectious-diseases-
covid19-malaria-hiv-aids-africa/)

I’ve been to South Africa twice. Most other Subsaharan countries have large
malaria problems.

Looking forward to that not being a problem in my lifetime.

~~~
Technetium
Florida is about to release 750 million mosquitoes genetically modified to die
shortly after birth. Hopefully that's progress towards ending mosquitoes once
and for all. Source: [https://www.cnn.com/2020/08/19/health/gmo-mosquitoes-
approve...](https://www.cnn.com/2020/08/19/health/gmo-mosquitoes-approved-
florida-scn-wellness/index.html)

~~~
zucked
Is that such a good idea? I find the idea of futzing with nature's systems in
this way a bit concerning.

~~~
culturestate
We’ve been committing mass murder of mosquitos for decades and, as far as I
know, nobody has ever found evidence that it’s problematic. Mosquitos seem to
be one of the few truly unnecessary (and universally unwanted) bits of the
natural order.

~~~
zucked
I genuinely don't know the answer to this, but are they not a significant
source of food for any predator such that their elimination wouldn't be
noticed?

I'm reluctant to be playing god on this front, especially in light of the fact
that it seems like the insect population is not doing well, globally, and
forms the base for a complex food chain.

~~~
modmans2nd
Bat eat mosquitoes

~~~
pzone
That’s more something bat enthusiasts say to get people to like the critters.
In reality insectivorous bats primarily eat larger, easier to catch prey like
moths.

------
sparrish
This is the best news I've heard in weeks. What a great milestone and a
wonderful world we live in. Congrats to all the NGOs, African and
international, that worked so hard.

~~~
lucb1e
For more uplifting news, I spent a few hours today diving into figures about
human development for a small project about greatest differences between
neighbouring countries. They're basically all going up. Aside from countries
at war (e.g. Syria) and minor setbacks like 2008, we're doing better all the
time. I actually made a wallpaper from one of them:

[https://lucb1e.com/tmp/hn-whatsthisgraph.png](https://lucb1e.com/tmp/hn-
whatsthisgraph.png) What does this show?

Answer in rot13: Rnpu yvar vf n pbhagel, fubjvat yvsr rkcrpgnapl ng ovegu.
Gurer ner fbzr boivbhf bhgyvref ohg 'orgjrra gur yvarf' vf nyfb n pbhagel gung
qrpyvarq funecyl: Flevn. Yrg'f whfg abg qb jne ntnva, 'xnl?

You can find this graph interactively on the United Nations Development
Programme website: [http://hdr.undp.org/en/data](http://hdr.undp.org/en/data)
(this graph can be found in (rot13) urnygu -> yvsr rkcrpgnapl ng ovegu).

------
tsewlliw
Here's hoping we double down on Polio efforts and ensure it is entirely
eliminated. Finishing is super important, and this milestone shows this is
something humanity can finish.

~~~
baybal2
Especially in light of what is happening in Pakistan, and India now. Polio was
"almost" done there in all, but a few most remote, and backward areas.

And it was exactly because these tiny reservoirs were left, it came back to
Karachi, and Mumbai.

~~~
xerxesaa
As far as I know, it's only in Pakistan and Afghanistan (not India). Where did
you get the news about Mumbai?

~~~
baybal2
[https://timesofindia.indiatimes.com/city/mumbai/post-
scare-b...](https://timesofindia.indiatimes.com/city/mumbai/post-scare-bmc-to-
start-special-polio-vaccine-drive-today/articleshow/66112947.cms)

------
JumpCrisscross
I’ve always found it interesting to note that while the list of infectious
diseases in humans [1] is long, it isn’t _that_ long.

[1]
[https://en.m.wikipedia.org/wiki/List_of_infectious_diseases](https://en.m.wikipedia.org/wiki/List_of_infectious_diseases)

~~~
ruffrey
I hope that soon, aging is classified as a disease, and makes it onto that
list.

~~~
xplune
As fun as it sounds, I think aging is what drives humans to progress and
evolve. So just in my opinion, I don't think classifying aging as disease is a
good idea.

~~~
fooyc
Are we still evolving, since we usually die much after breeding ?

~~~
mkoubaa
We're currently selecting against drug addicts. It might take a few dozen
generations to notice the effect

~~~
fooyc
Reducing aging wouldn’t have any effect on that, though?

------
aazaa
The BBC article doesn't explain what "wild" means in detail. This NPR article
does:

> And there's another type of polio that's problematic. Sixteen African
> nations are currently battling outbreaks of what's called "vaccine-derived
> polio." This is a form of polio that stems from the oral polio vaccine used
> in lower income countries because it is cheap and easy to administer.

> The oral vaccine contains a live but weakened version of the polio virus.
> The virus replicates inside the child's intestine and eventually is
> excreted. In places with poor sanitation, fecal matter can enter the
> drinking water supply and the virus is able to start spreading from person
> to person.

[https://www.npr.org/sections/goatsandsoda/2020/08/25/9058847...](https://www.npr.org/sections/goatsandsoda/2020/08/25/905884740/africa-
declares-wild-polio-is-wiped-out-yet-it-persists-in-vaccine-derived-cases)

~~~
mleonhard
A concise explanation of vaccine-derived polio:

[https://www.who.int/westernpacific/news/q-a-detail/what-
is-v...](https://www.who.int/westernpacific/news/q-a-detail/what-is-vaccine-
derived-polio)

------
cmckn
The stories about this introduced me to the concept of a vaccine-derived
polio.

Basically, the weakened form of polio that is in the vaccine, which usually
survives in your GI tract for a couple weeks before being eliminated, can be
passed onto others if there is a lack of basic sanitation (polio is primarily
transmitted through infected fecal matter). If this is in a community with low
immunization rates, the vaccine-derived virus can survive much longer than
intended. This can actually provide a benefit to others, because they will
achieve some level of immunity from the weakened virus. However, if the
weakened virus is allowed to circulate for a long time (>1 year), it has the
(unlikely) chance to mutate and become less weak.

Of course, the number of severe polio cases that have been avoided by the
vaccine vastly outweighs the number of vaccine-derived cases. But I thought
this was an interesting concept!

> ...more than 13 million cases of polio have been prevented, and the disease
> has been reduced by more than 99%. During that time, 24 cVDPV (circulating
> vaccine-derived polio virus) outbreaks occurred in 21 countries, resulting
> in fewer than 760 VDPV cases.

More here: [https://www.who.int/westernpacific/news/q-a-detail/what-
is-v...](https://www.who.int/westernpacific/news/q-a-detail/what-is-vaccine-
derived-polio)

~~~
jacquesm
This is the sort of thing anti-vaxxers seize on and distort.

~~~
cmckn
Unfortunately, yes.

Modern medicine has created a sort of utopia that humanity couldn't have
imagined a few hundred years ago. But there is a dark side that includes
conspiratorial thinkers like anti-vaxxers.

------
microcolonel
Massive congratulations! Let's see about malaria next.

I have heard that it might not be crazy to apply DDT sparingly and
appropriately to this problem. To my knowledge, it was a big part of how
mosquito-borne disease was virtually eradicated in North America.

Wetland habitat destruction is a real concern, but so is the untimely deaths
of hundreds of millions of people.

~~~
hamandcheese
Genetically modified mosquitoes seems to me like a much better way to deal
with the problem, though it is controversial:
[https://www.sciencenews.org/article/genetically-modified-
mos...](https://www.sciencenews.org/article/genetically-modified-mosquitoes-
florida-test-release)

------
yyyk
Good, but I am unaware of any good solution to the endemic AfPak area. This is
IMHO a mirror of world trends: Africa seems to be getting better (if slowly),
but parts of Asia are slipping behind. It's possible that the program is in an
undeclared race: Can we eliminate polio before these areas get even worse?

------
adaisadais
This is the sort of news the world needs today. Let’s keep the ball rolling.
Keep making things happen, HN Community.

~~~
andbberger
Ah, yes, the hacker community is well known for their public health
contributions

------
Symmetry
Hey polio, hope you can say hello to smallpox for us soon.

------
AnonHP
This has been a very long fight, and there are a few pockets to defeat to
declare that we’ve eradicated polio. I see many comments talking about
malaria. One of the most effective ways to tackle that is through the work
done by organizations, like Against Malaria Foundation (AMF), that are also
supported by Effective Altruism based organizations (like GiveWell, Effective
Altriusm Funds), etc.). The cost of saving a life from malaria is quite low
with this. I would strongly encourage people who donate to charities to donate
at least a small amount regularly to AMF or the others mentioned above.

------
smabie
I went to college with a girl from Africa who had Polio and was wheelchair
bound. Good to know it's not a problem anymore!

She actually told me when she first came to America a doctor asked why she was
in a wheelchair and she said Polio. The doctor didn't believe her!

------
hermitcrab
This is an amazing achievement and I salute everyone who worked so hard to get
this far.

My grandfather had polio and was lucky to survive. He spent quite a bit of
time in an iron lung. Apparently it changed his personality significantly for
the worse.

------
actuator
I know some people in tech don't like his Microsoft past but considering the
role of Melinda and Bill Gates foundation in this and his continued funding
for other such initiatives including Covid-19 vaccines, I think if someone
deserves a symbolic award like Nobel Peace Prize(or whatever the equivalent
would be in this case) it would be both of them.

~~~
Oblouk
Absolutely

------
taylorbuley
If you're into "service over self" I encourage you to join your local Rotary
club. Here are our "four way test" of the things we think, say and do: * Is it
the truth? * Is it fair to all concerned? * Will it build goodwill and better
friendships? * Will it be beneficial to all concerned?

Finding Nash equilibria for #4 isn't easy but it's a good set of guiding
principles and if you believe them, you should think about surrounding
yourself with others who do too.

------
tus88
Is there some other kind of polio still rampant?

~~~
dennis_jeeves
Yes, the polio induced by the vaccine is actually the the more prevalent one
today. They call it by fancy name: 'paralysis-something-something' so that the
vaccine is not blamed for the polio.

~~~
mkl
It's explicitly called "vaccine-derived polio" in every article I've read
about it, including from the WHO:
[https://www.who.int/westernpacific/news/q-a-detail/what-
is-v...](https://www.who.int/westernpacific/news/q-a-detail/what-is-vaccine-
derived-polio)

------
hkmurakami
For those who are interested and able, Rotary International and the Gates
Foundation have been doing a 2 for 1 match for years, tripling your gift
towards ending polio.

[https://www.endpolio.org/home](https://www.endpolio.org/home)

As a past contributor, it brings me great joy to see this milestone today.

------
ISaIF73
Unfortunately this will not change the situation if Africa that much. As the
Malthusian Trap is still live there and the cause of the great divergence
between the first worl and the third world.

~~~
scollet
Africa is certainly not a set of countries?

------
ConsiDisc
Luckily friends do ashamed to do suppose Polio.

------
scandox
Just read a biography of Jonas Salk and a major portion of it is devoted to
the issue of the oral vaccine (OPV) versus the injected vaccine (IPV).

Salk spent a large portion of his later life pressing for the OPV to be
delicensed because he considered any risk of live vaccine infecting immuno-
suppressed persons or of the weakened virus becoming reactivated unacceptable.

As I understand it the OPV was still in use in the US until 1999. It was an
interesting case study in the different forces that kept a vaccine proven to
cause some cases of Polio every year in use.

------
EGreg
I show stuff like this to anti vaxxers and ask if there have ever been any
vaccines they like.

They say that about cowpox and polio sanitation played a major role, etc. And
that we don’t look at other variables.

------
makomk
This is not the big, massive victory that the article makes it sound like. The
caveat "wild" is doing a lot of work that isn't properly explained. What this
means is that for the last several years, all the cases of polio in Africa
have been from circulating vaccine-derived poliovirus - basically, a version
of the weakened virus used in the vaccine which has circulated for long enough
to reverse the mutations that weaken it. It spreads like wild virus and
paralyzes like wild virus, but technically it's not wild-type virus. (As I
understand it, the only practical difference is that we can tell from genetic
sequencing that it came from the vaccine rather than being wild-type.) And
this can't be fixed by stopping the vaccination program - in fact, that
actually makes things worse, since it gives the deadly vaccine-derived
poliovirus more people who don't have immunity to infect.

Some of the other news coverage like the Reuters article is a little better at
correctly pointing this caveat out: [https://uk.reuters.com/article/uk-health-
polio-africa/wild-p...](https://uk.reuters.com/article/uk-health-polio-
africa/wild-polio-sufferers-reflect-as-africa-declared-free-of-the-disease-
idUKKBN25L14I)

It's not even clear that it's poasible to actually eliminate polio in
developing countries with this vaccine or any existing vaccines. The developed
countries managed it but they had far better infrastructure to roll out first
the oral vaccine and then the inactivated vaccine to everyone, and also far
better sanitation, and it's likely both of these things mattered - under-
vaccination makes this problem a lot worse, and whilst the inactivsted vaccine
protects people from polio there's some doubt as to whether it can stop them
spreading it via the oral-fecal route due to poor immunity in the gut. The
current hope seems to be developing and deploying a new, better live vaccine
which cannot easily regain its original virulence.

~~~
yyyk
CVDPV still is weaker than "wild" polio - only about 1000 cases ever (out of
billions of vaccinations), and outbreaks are controlled quickly (if slower
than the original expectation). Apparently both due to remaining mutations and
since it's nearly all polio type 2 - which was otherwise eradicated a long
time ago, apparently that type is a bit less "fit".

It's a problem, but one that can be managed by the existing tools which
brought polio down to this level - many countries switched from trivalent OPV
or removed OPV2 precisely to avoid this scenario, and a new OPV2 vaccine will
hopefully eliminate the problem in the affected areas:

[http://polioeradication.org/wp-
content/uploads/2020/07/cVDPV...](http://polioeradication.org/wp-
content/uploads/2020/07/cVDPV2-nOPV2-fact-sheet-July-2020.pdf)

------
screamingninja
Sometime in 2065: Africa declared free of wild COVID-19

~~~
pinkfoot
Probably before the rest of you.

------
tombert
Finally, some really good news in 2020. This has brightened up my exceedingly
crappy week :).

I've read about polio a few times, and every time I do I feel grateful to be
born after they started vaccinating every child in the United States. It's a
terrible disease and it would be amazing if it went the way of smallpox and
(hopefully soon) Dracunculiasis.

------
babu_bhaiya
Victory

------
sassycassie
This is absolutely incredible

------
tempsy
more children had been getting polio from polio vaccines than getting it in
the wild for a long time

~~~
vanderZwan
You know what they say: extraordinary claims require extraordinary evidence.
Based on what data do you make this statement?

~~~
tgb
I was surprised too, but the WHO backs up the existence of "vaccine-associated
paralytic polio", though I'm finding some conflicting numbers it's on the
order of 1 in a million paralysis cases per vaccine. That presumably outpaces
wild polio paralysis cases due to the non-existence of wild polio, in certain
regions. WHO evens says it's possible for others to catch the paralysis from
close contact with a recently-vaccinated individual, though it's never spread
beyond that.

[https://www.who.int/immunization/diseases/poliomyelitis/endg...](https://www.who.int/immunization/diseases/poliomyelitis/endgame_objective2/oral_polio_vaccine/VAPPandcVDPVFactSheet-
Feb2015.pdf)

~~~
makomk
There are two similar but crucially different problems with the current live
polio vaccine that both end in cases of paralytic polio. Vaccine-associated
paralytic polio is a very rare complication where someone gets full-on
paralytic polio as a result of being vaccinated; it can also happen to people
who catch the vaccine virus from someone else rather than from vaccination,
but it's just as rare there. Circulating vaccine-derived poliovirus is the one
that's really nasty for elimination efforts - once the vaccine poliovirus
circulates unchecked within a community for a while, it mutates and basically
turns back into full-on real, unweakened polio in all its contagious paralytic
awfulness, at which point anyone who's exposed to it is at much higher risk.
As I understand it, cVDPV makes up the large majority of both polio cases and
paralytic polio cases across the globe these days, and 100% of cases in Africa
now the wild-type virus has been eliminated from there.

If VAPP was the only problem it could easily be fixed just by eliminating
polio and then ending the live vaccination program. Unfortunately, that would
make the cVDPV problem worse because it's an actual, circulating virus that
primarily infects people who haven't been vaccinated, and ending vaccination
would increase the number of people at risk from it. As the document from 2015
you've found suggests, the folks trying to eliminate polio hoped that if they
phased out the live oral polio vaccine carefully and in well-coordinated ways
they could avoid major cVDPV outbreaks afterwards. This doesn't seem to have
worked out as well as they hoped back then. In particular, this article and HN
discussion from a few months ago which someone helpfully dug up is mostly
about the failure of this endgame plan in Africa:
[https://news.ycombinator.com/item?id=21920406](https://news.ycombinator.com/item?id=21920406)

------
qwerty456127
Again?

------
sm4rk0
Perfect timing!

Just before the first non-Russian CoViD-19 vaccine gets approved, so people
can more easily accept its shorter/skipped testing phases.

------
bluedays
Oh good, now we only have domesticated polio

------
just_throw_away
Great we've traded the polio that doesn't make us money for polio that makes
us tons of money. Time to celebrate.

------
torgian
I'm not gonna lie, I first read this as "Free from wild potato".

Good to see wild polio is going down.

