Africa steps up access to high-quality laboratory data for polio eradication

31 May 2023

Brazzaville/Accra - While Africa has made significant progress in the fight against polio, the World Health Organization (WHO) is prioritizing the strengthening of in-country laboratory capacity in recognition of the critical role of high-quality data in the detection of poliovirus outbreaks.

In partnership with the Global Polio Laboratory Network (GPLN), WHO is capacitating countries including Cameroon, the Democratic Republic of the Congo, Kenya and Senegal in poliovirus sequencing techniques.

Most recently, a one-week meeting to enhance early detection and country capacity amongst polio laboratory directors was hosted in Accra, Ghana, by WHO's Polio Eradication Programme. Ongoing workshops for laboratory technicians in these countries are also being hosted, to improve skills such as rapid sample analysis techniques.

In addition, WHO is supporting 16 polio laboratories in the African region who are providing environmental surveillance support, testing for poliovirus in stool and wastewater samples to track geographic patterns of spread.

At the Accra meeting, more than 50 participants from 14 countries shared ideas on how to enhance the role of laboratories in polio eradication efforts, agreeing on a way forward to expand sequencing capacity in Africa. The programme included break-out sessions with specific countries to target national issues, with a view to providing solutions.

"Now more than ever, enhancing the quality and capacity of the polio laboratories to ensure prompt testing is key to accelerating the polio eradication efforts," said the WHO Representative to Ghana, Dr Francis Kasolo at the polio laboratory director's in Ghana.

Another focus was the improvement of timely data-driven decisions during polio outbreaks, along with how to most effectively leverage innovative technologies in the fight against polio. This is especially significant since the virus that can invade the nervous system and cause paralysis in a matter of hours.

Dr Jude Kfutwah, coordinator of the Regional Polio Laboratory Network at the WHO Regional Office for Africa, says: "Teams were working to address the needs at country level, including enhanced capacities for multi-pathogen detections from environmental samples, that ultimately serve to identify infectious organisms and provide relevant information to health systems on circulating pathogens. ¨

With only one in 200 individuals infected with poliovirus associated with paralysis, laboratory investigation is key. Most infections are asymptomatic or result in only mild illness, and so are not detected by Acute Flaccid Paralysis surveillance (which entails actively seeking out children with signs of paralysis to identify potential cases).

Improved genetic sequencing and analysis capacity has become increasingly urgent, as incidence of poliovirus rises in Africa. Since July 2022, more than 799 polioviruses have been detected in 19 countries in the Africa region, all being laboratory-confirmed.

Without the polio laboratory network, it is highly likely that at least some would have gone undetected or unconfirmed, hampering containment and eradication efforts.

As such, laboratories are not only a key surveillance tool in maintaining the region´s certification as free of indigenous wild polio, but also in detecting and tracking ongoing outbreaks of circulating variant polioviruses (cVDPVs) that persist in Africa.

During the training in Accra, participants highlighted many of their challenges with polio laboratory data management, noting the need to especially strengthen collaboration among countries.

"It is critical that we deepen the sharing of technology, experiences and ideas within the continent to consolidate our gains and accelerate progress towards polio eradication," says Dr John Kofi Odoom, head of Ghana's Polio Laboratory.

With a presence in 47 African Member States, the polio programme is one of the largest public-private health partnerships in history. While the polio eradication infrastructure in Africa helps advance the world towards polio-free status, it also serves as a platform to fight and protect against other diseases.

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