Polio transition in the African Region: progress, challenges and prospects for health systems integration.

Abstract

Background: The Global Polio Eradication Initiative (GPEI) has made substantial progress towards global eradication of polio. As regions, including Africa, approach the final stages of this goal, countries must ensure that essential polio functions are sustained and effectively integrated into national health systems. To support this transition, the World Health Organization(WHO), through its regional offices, has guided countries using the Polio Transition Global Vision and its Monitoring and Evaluation Framework. This paper reviews progress made in transition planning across 15 polio transition priority countries in the WHO African Region and anticipated challenges, opportunities, and prospects for integrating polio assets and essential functions into broader health systems.

Method: A secondary review of polio transition indicator performance across 15 priority countries in the African region was conducted using programme data from 2015 to 2024(or years with available data). Trends were assessed across indicators defined in the Polio Transition M&E Framework, including routine immunization coverage, emergency preparedness capacities and domestic health financing.

Results: Over the past decade, none of the 15 priority countries consistently achieved ≥ 90% routine polio containing vaccine coverage. Only Burkina Faso and Kenya have been closest to these coverage levels in the region. Timely shipment of polio samples remains a consistent challenge, particularly in countries where GPEI support has declined. The regional International Health Regulations(IHR) average capacity score remains suboptimal, averaging 51, below the global score over the last 10 years. These underscore weaknesses in epidemic preparedness and response capacities. These weaknesses, within a broader context of low domestic health prioritization, as reflected in national health accounts, further constrain transition readiness.

Conclusion: Progress on polio transition in the African region remains limited, with gaps in immunization, emergency preparedness and financing, gaps made riskier by declining donor support. To protect Polio eradication gains, countries must strengthen transition planning, improve coordination amongst partners and increase domestic health investments. Successful implementation of country national plans can only be achieved with increased domestic financing through innovative funding models, improved polio transition governance, and integration strategies towards safeguarding polio gains and reinforcing broader health system resilience for a polio free world.