The fight against polio in Africa has reached a pivotal moment. Health leaders from across the continent recently gathered in Addis Ababa, Ethiopia, at the Seventy-sixth session of the WHO Regional Committee for Africa. Their crucial decision: to adopt a new 10-year plan, the 'Framework for Polio Transition and Sustainability in the WHO African Region 2026–2035.' This strategic blueprint is designed to not only protect Africa's hard-won victories against polio but also to strengthen its entire public health infrastructure for future challenges. ## Understanding Polio: A Persistent Threat Polio, or poliomyelitis, is a highly infectious viral disease that primarily affects young children. It invades the nervous system and can cause total paralysis in a matter of hours. The virus spreads mainly through the faecal-oral route, often through contaminated water or food, and can also be transmitted via infected droplets from sneezes or coughs. While many people infected with poliovirus show no symptoms, they can still spread the virus, making it a silent threat. In severe cases, polio can lead to permanent paralysis, typically in the legs, and can even be fatal if the breathing muscles are affected. Thanks to global vaccination efforts, wild poliovirus — the naturally occurring form — has been eradicated in most parts of the world, including Africa. However, the emergence of 'variant polioviruses' presents an ongoing challenge, particularly in areas with low vaccination coverage. ## Africa's Triumph and Ongoing Challenges Africa’s journey towards a polio-free future has been marked by incredible dedication and significant achievements. In 2020, the World Health Organization (WHO) proudly certified the African region free of indigenous wild poliovirus, a monumental milestone that was the result of decades of coordinated vaccination campaigns, surveillance, and public health interventions. This success demonstrated what is possible when countries and global partners unite against a common health threat. Millions of children were vaccinated, and robust health networks were established to track and contain the disease. This achievement brought the world closer than ever to total polio eradication. However, the fight isn't over. While wild poliovirus has been eliminated, countries in the region continue to grapple with outbreaks of circulating variant polioviruses. These variants can emerge in communities with low immunity where the attenuated (weakened) live virus in oral polio vaccines can circulate and, in rare instances, regain the ability to cause paralysis. These outbreaks underscore the critical need for continued vigilance and high vaccination rates. In 2026 alone, the African Region has reported over 180 polio detections, with the Lake Chad Basin and the Horn of Africa identified as critical transmission hotspots. These numbers highlight the ongoing vulnerability and the urgent need for comprehensive action to protect all children. ## A Strategic Blueprint for Health Security Recognizing that sustaining polio gains requires more than just stopping outbreaks, African health ministers have endorsed a holistic, 10-year plan. The Framework for Polio Transition and Sustainability in the WHO African Region 2026–2035 is designed to embed the expertise and infrastructure developed during the polio eradication effort into the continent's broader health systems. This strategic roadmap outlines several key priorities: * **Maintaining High-Quality Surveillance:** Ensuring robust systems are in place to quickly detect any new poliovirus cases, whether wild or variant. * **Preserving Laboratory and Emergency Response Capacity:** Keeping the specialized laboratories and rapid response teams that were built for polio ready to tackle any public health emergency. * **Strengthening Routine Immunization:** Integrating polio vaccination efforts more deeply into national child immunization programs to ensure high population immunity against all vaccine-preventable diseases. * **Ensuring Sustainable Domestic Financing:** Gradually shifting the financial responsibility for these essential public health functions from international funding to national budgets. * **Reinforcing Governance and Accountability:** Establishing clear leadership, roles, and oversight mechanisms to ensure the framework's successful implementation. * **Supporting Country-Led Transition Planning:** Empowering individual countries to develop tailored plans that best suit their specific health system needs and priorities. Dr. Mohamed Gedi, Polio Eradication Programme Coordinator at the WHO Regional Office for Africa, emphasized that “Sustaining Africa’s polio gains requires strong country ownership, sustainable financing and the integration of polio assets into broader health systems.” This integration is key to safeguarding the progress achieved and building a more resilient health future. ## Polio's Legacy: Building Broader Health Resilience The infrastructure and personnel mobilized during the Global Polio Eradication Initiative (GPEI) represent one of the world's largest disease surveillance and response networks. This vast network, initially built to track and contain poliovirus, has repeatedly proven its value far beyond its original mandate. Across Africa, polio-funded staff and resources have been instrumental in responding to numerous other public health crises. From Ebola and Marburg virus disease outbreaks to mpox, cholera, and yellow fever, these dedicated teams and robust systems have provided crucial support, demonstrating the versatility and importance of these investments. By leveraging the capacities built to fight polio – including experienced public health workers, sophisticated laboratory networks, emergency operations centers, and extensive community outreach programs – countries are better equipped to detect and respond rapidly to a wide array of emerging infectious diseases. This dual-use capability underscores the framework’s importance in achieving broader health security objectives and advancing universal health coverage across the continent. It’s about ensuring that the investment made in ending polio becomes a lasting legacy for stronger, more responsive health systems for generations to come. ## Sustaining Progress: Financing and Collaboration A critical aspect of the new framework addresses the anticipated decline in dedicated polio eradication funding as the world moves closer to global eradication. The plan supports countries in progressively institutionalizing and financing essential functions within their national health systems. This shift towards sustainable domestic financing is crucial for long-term success and autonomy. Member States have committed to developing or strengthening their national transition plans, integrating essential polio functions into wider health programs, mobilizing internal resources, and monitoring their progress through a regional accountability framework. The WHO will provide ongoing technical support, facilitate knowledge exchange, and report annually on the implementation across the region. The Global Polio Eradication Initiative (GPEI), a partnership led by national governments and key organizations like WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF, and the Bill & Melinda Gates Foundation, is extending its efforts to 2029. This extension, coupled with the new regional framework, aims to prepare for the long-term sustainability of vital public health functions beyond polio certification. Mike McGovern, Chair of the International PolioPlus Committee, Rotary International and Chair of the GPEI Polio Oversight Board, reaffirmed Rotary's commitment, stating, "We are closer than ever to ending polio, but reaching that goal will require us to stay the course. Rotary remains fully committed to working alongside governments, WHO and all GPEI partners to protect every child, strengthen immunization systems and sustain the financing needed for the final push." ## The Road Ahead: A Stronger, Healthier Africa The adoption of this framework marks a significant step forward in Africa's health journey. It reflects a shared vision: to safeguard the continent’s hard-won polio achievements while transforming one of the world’s largest public health programs into a powerful legacy. By ensuring that the extensive networks, skilled workforce, and robust systems developed during the polio eradication campaign continue to serve communities, Africa is building more resilient health systems, better prepared to protect its people against current and future health threats. It's a testament to the power of sustained global collaboration and national commitment in the pursuit of a healthier world for all.