Independent Monitoring Board - Global Polio Eradication Initiative

AngolaLuandaHome to a third of the country’s population, with many people lacking access toclean water and adequate sanitation, it is no surprise that Luanda has been thedriver of polio transmission in Angola.AT A GLANCELuanda is the natural home forpolio in AngolaIndependent monitoring data have their limitations, but the trend that they show inLuanda is concerning. The percentage of children missed by vaccination days hasincreased steadily over the last year. In March 2012, eight of the nine municipalitiesmissed more than 10% of children. This is not a war-zone. Nor is it a far flunginaccessible part of the country. These children sleep at night in the heart of thenation’s capital. This is not a situation that should be tolerated.Children sleep in the heartof the nation’s capital,unprotected by vaccineThe Programme was able to clearly set out some of the reasons why childrenare still being missed: vaccinator ‘no-show’, poor recruitment, poor outreach tocommunities. It was able to describe credible solutions: inclusion of polio in healthworker appraisals, criteria for timely recruitment, co-working with religious leaders.Luanda’s problems andsolutions have been set outwith clarityWe repeat previously expressed concerns about the quality of surveillance inLuanda. The Programme accepts these concerns and has taken some importantsteps forward, such as procuring additional vehicles and building awarenessamongst local communities. However, Luanda’s average AFP rate remains barelyhigher than the threshold regarded as acceptable and lower than the average overthe last two years. The country does need to show greater ambition to strengthensurveillance further. If a case occurs in Luanda and is not rapidly detected,transmission could readily take hold amongst this densely packed population.Poor surveillance andunacceptable levels of missedchildren are putting Luanda athigh risk28Independent Monitoring Board of the Global Polio Eradication Initiative Every Missed Child