To swiftly contain a recent polio outbreak in Gaza, a World Health Organization (WHO) official emphasized on Thursday, Aug. 29 the urgent need for a halt in the conflict to administer two doses of life-saving vaccinations to approximately 640,000 vulnerable children. Humanitarian groups attribute the first polio case in 25 years in Gaza to the breakdown of water and sanitation systems and disruptions to routine vaccination programs due to the nine-month Israel–Hamas war, which has affected 2.3 million people across the region.
Polio is a highly infectious disease that spreads rapidly, especially in areas of dense population, poor sanitation, and compromised healthcare systems. In August, an unvaccinated 10-month-old boy tested positive for a polio strain which has left him partially paralyzed. First detected in wastewater in July by Gaza health officials, this strain of polio spreads through wastewater and was found at two densely populated Gaza camps.
The polio-stricken child — who was born during the conflict — joins thousands of children in Gaza who have missed routine vaccinations due to mass displacement, food insecurity, water scarcity, and the collapse of sanitation and healthcare systems.
Since the launch in 1988 of the Global Polio Eradication Initiative (GPEI), over 2.5 billion people have been vaccinated, preventing paralysis in 20 million individuals. Yet the situation in Gaza underscores the need for ongoing vaccination efforts that prioritize areas at risk of polio reemergence from conflict and humanitarian crisis.
Speaking to Global Citizen, Oliver Rosenbauer, a spokesperson for the World Health Organization (WHO) on the Global Polio Eradication Initiative, explained that a temporary pause in the conflict to carry out a rapid vaccination campaign to protect against a full polio outbreak is “essential not only for the safety of health staff but also to ensure that families feel safe enough to bring their children out for vaccination.”
Accordingly, on Thursday, Aug. 29, Israel’s prime minister announced the first of a series of partial suspensions of military operations in Gaza to allow young children to be vaccinated in a bid to prevent the spread of the disease across the region. The United Nations International Children’s Emergency Fund (UNICEF) has already delivered 1.2 million doses of polio vaccine, along with necessary refrigeration equipment, to Gaza. In collaboration with other organizations on the ground, UN groups began the vaccination campaign on Sept. 1, which will continue over three three-day periods until Sept. 12.
Regions at Risk Despite Years of Progress on Polio
When Rotary International — a global service organization fighting disease — launched its polio eradication efforts in 1979, approximately 350,000 children were paralyzed each year, and polio was endemic in 125 countries. Today, wild polio is only circulating in Afghanistan and Pakistan. However, periodic outbreaks still occur in regions like Gaza, where conflict has weakened health systems, said WHO’s Rosenbauer.
“That's the risk, that will continue until you eradicate it, that it will reemerge,” he said. The Gaza outbreak is part of a broader pattern of impacts to global health seen in other conflict-affected areas, like Syria and Ukraine, where “suffering immunization systems, lack of access to safe drinking water, and malnutrition create an ideal scenario for diseases such as polio to reemerge and spread,” said Rosenbauer.
Since 1988 the number of children affected by polio has been reduced by 99 percent, but until the disease is eradicated globally, children everywhere are at risk of disease reemergence in times of crisis. For example, recently cases of polio have occurred in other conflict zones, such as Ukraine and Yemen.
The conflict that began in Gaza October, 2023 has disrupted immunization programs, with only three months into the conflict already 16,854 children had missed their routine vaccinations. Globally, more than half of the 14.5 million children that have not received a single dose of vaccination are living in countries affected by armed conflicts or other humanitarian crises. “That is what we're seeing in Gaza,” said Rosenbauer. “The critical thing now is to rapidly interrupt this outbreak by doing an effective outbreak response.”
“Days of Tranquility” or Conflict Pauses Are Successful Humanitarian Efforts
A UNICEF staff member inspects polio vaccines and cold storage equipment at Tel Aviv Ben Gurion airport, for use in the vaccination campaign in the Gaza Strip.
The successful delivery of the polio vaccination campaign in Gaza hinges on the ability of the immunization teams to operate in relative safety for both health workers and Palestinian families. “We need the families to feel secure when we're asking them to come out of their homes to have their children vaccinated, but if there's shelling going on, they're not going to risk their lives to get an immunization,” Rosenbauer said.
To facilitate the polio vaccination campaign in Gaza, the WHO and UNICEF have requested "days of tranquility,” or a temporary pause in conflict, which have been successful in previous crisis situations. The first-ever days of tranquility to allow for immunization campaigns were negotiated by UN Secretary-General Kofi Annan in 1999 in the Democratic Republic of the Congo. Since then, days of tranquility and peace corridors have been widely used to deliver life-saving vaccines and other critical health services in conflict zones.
According to Rosenbauer, speaking about Gaza, “This outbreak can be rapidly stopped, and we've seen it in similar settings in the past, notably in Syria by bringing all parties together and trying to agree on certain days when hostilities will stop.”
Global Health Systems Remain Fragile, Especially in Times of Conflict
The polio case in Gaza and the potential outbreak highlights the fragility of global health systems, especially in conflict zones, and why finding and vaccinating children — despite conflict — should be a priority around the world. “Whether it's due to conflict, whether it's due to parental resistance, whether it's due to lack of infrastructure, whatever the reason is, poliovirus doesn't care but we have to care,” says Rosenbauer.
For humanity’s fight against the devastating effects of polio, peace is essential to ensure against the reemergence of the disease in areas where it has previously been eliminated, and to continue making progress towards the goal of eradicating polio globally, once and for all.