Feature: Laos' commitment to polio response after fatal case attracts international kudos

The sad news of the death of an eight-year-old Lao boy from a variant of the polio virus in October a decade and a half after Laos was declared free of the polio virus has drawn international attention to this Southeast Asian nation with a young and growing population.

A month and a half later after the outbreak, which fortunately had only two fatalities from four confirmed cases, local and international health authorities have expressed confidence that the situation has been remedied.

The coordinated local and national OPV (oral polio vaccine) immunization campaign, that started in the affected districts but has since expanded to reach every child in Laos with a combination of national and multilateral donor funding, has been hailed by the World Health Organization (WHO).

Health authorities here said that the country has followed through a strategy of community engagement, focusing on the country's far-flung and multi-ethnic communities.

The country's geography and the remote and dispersed nature of many multi-ethnic communities continue to present particular demands in both disease prevention and in the general provision of health and essential services.

However, the personal involvement of Lao Prime Minister Thongsing Thammavong, with the full support of all provincial governors and the the Ministry of Health, has created a template for future action, impressing international development partners.

Speaking to Xinhua at the ministry's Emergency Operations Centre, Minister of Health Dr. Eksavang Vongvichit said while disease knows no international boundaries, the localized nature of the outbreak posed little or no risk at all to neighboring countries or visitors to the area who have already been immunized.

"The current outbreak is isolated in affected communities and these are not provinces next to the border crossings, though travel across provinces and to Vietnam are not uncommon. It is important to remember that all countries have been working tirelessly to build the capacity to detect and respond to public health emergencies. Laos PDR is doing its part and I am sure our neighbors are as well," Dr. Eksavang said.

He reaffirmed the administration's commitment to seeing all forms of the virus removed once and for all, while overcoming the barriers presented by geography and linguistics.

"There are challenges in all polio outbreaks. In designing an effective way of eradicating polio, language, culture and religious beliefs should be considered as well as vaccine hesitancy among some sectors," Eksavang said.

Eksavang said that the Lao government has been proactive in engaging with key leaders from diverse communities, informing them of the upcoming vaccination campaigns and emphasizing the importance of the polio vaccine in protecting their children.

According to Eksavang, to achieve this, the ministry and multiple levels of government had been acting in concert with WHO and other international experts in working to immunize areas with high risk of contamination due to poor sanitation and the negative reaction to anti-polio vaccines due to religious or cultural beliefs.

The disadvantages experienced by heath workers in such communities are often correlated with other development gaps, such as lack of proper nutrition and sanitation and school attendance.

Requiring application of three doses orally, administration of the OPV requires the commitment and follow-up to ensure all children receive their full quota for protection, a task not always as simple especially in remote areas where challenging terrain can mean long distances of foot travel.

Starting in the most at-risk provinces of Bolikhamxay, Xaysomboun, and Xiengkhuan and spreading nationwide, the vaccine will ensure that all children across the country be vaccinated.

This effort comes in addition to the introduction in Laos of an Inactivated Polio Vaccine (IPV) program to further boost immunity against polio for children under 12 months of age with the support of Global Alliance for Vaccines and Immunizations (GAVI).

In addition to immunization, health workers have also emphasized sanitation and cleanliness among the targeted communities.

The replacement of latrines and other forms of open defecation with toilets is also a key priority in most areas.

Such messages are carried by well-trained community members to their fellows in their mother tongues thanks to training programs to raise capacity of health workers.

The success of the coordinated and multi-faceted approach and ongoing effort has been warmly welcomed by WHO representative for Lao PDR, Dr. Juliet Fleischl.

She said that the approach has not only resulted in a swift and effective response to the outbreak but has also strengthened institutional frameworks in Laos which are vital to address any future health challenges in the country. Endit