Why is polio, a disease once thought to be on the brink of eradication, making a comeback in Gaza? For many, this resurgence is alarming, especially since polio had been absent from the region for over two decades. But as we’ll explore in this article, the ongoing conflict and humanitarian crisis in Gaza have created the perfect storm for the reappearance of this preventable disease. By the end of this post, you'll understand not only the reasons behind the resurgence but also the massive, complicated vaccination efforts underway to control the spread.
On September 1, mass vaccination against polio began in the central area of the Gaza Strip. Next, it will move to the southern area and eventually reach the north. Getty Images
Polio: A Global Health Challenge Thought to Be Conquered
Polio, short for poliomyelitis, is an infectious disease caused by the poliovirus, an aggressive pathogen that primarily targets the nervous system. It spreads through contaminated water and food, as well as close person-to-person contact, making areas with poor sanitation particularly vulnerable. In severe cases, it can cause irreversible paralysis or even death.
For decades, global health organizations have worked tirelessly to eradicate polio, and their efforts bore fruit. By the early 2000s, polio was eliminated from nearly all countries, save for a few regions like Pakistan and Afghanistan. It seemed the disease was heading the way of smallpox, becoming nothing more than a distant memory.
Why Polio Has Re-Emerged in Gaza
So why has polio resurfaced in Gaza after being absent for 25 years? The answer is multifaceted and deeply rooted in the socio-political environment. The ongoing conflict in Gaza has destabilized almost every facet of life, from healthcare infrastructure to basic sanitation.
According to reports, over 1.9 million people in Gaza live in extremely precarious conditions, with many displaced from their homes. Crowded refugee camps, where access to clean water is limited, have become breeding grounds for viruses like polio. Moreover, the area's sanitation systems have been severely damaged by constant bombardment, making it easier for contaminated water to spread the virus.
Another critical factor is the disruption of vaccination campaigns. Before the conflict intensified, Gaza had high vaccination rates. However, war has interrupted regular immunization schedules, and coverage has dropped significantly. UNICEF noted that in areas affected by ongoing violence, as much as 40% of children might not be fully vaccinated. This incomplete coverage has left many young children vulnerable to the disease.
The Role of Conflict in the Spread of Epidemics
It's no coincidence that infectious diseases like polio thrive in regions plagued by war. Conflict leads to the breakdown of sanitation systems, healthcare services, and routine immunizations. Without functioning sewage systems, untreated wastewater contaminates local water sources, which is exactly what happened in Gaza. In July 2024, UNICEF detected traces of poliovirus in Gaza’s wastewater, marking the beginning of the current outbreak. Soon after, the first case of paralysis was reported in an 11-month-old infant.
Beyond physical infrastructure, war disrupts society's ability to respond to health crises. Hospitals and clinics in Gaza have been severely damaged, with two-thirds of the area’s healthcare facilities either destroyed or rendered non-operational. Those still standing are overwhelmed with casualties from the conflict, further limiting their ability to address outbreaks like polio.
How Is the Virus Spread?
The poliovirus spreads through fecal-oral transmission, meaning that people become infected when they ingest water or food contaminated by feces. This makes areas with poor sanitation, like Gaza’s overcrowded refugee camps, particularly vulnerable. Additionally, the virus can spread through droplets in the air when an infected person sneezes or coughs.
The symptoms of polio are deceptively mild at first—fever, fatigue, headaches, and vomiting. However, in about 1 in 200 cases, the virus invades the central nervous system, causing permanent paralysis.
A Herculean Vaccination Effort Amid the Chaos
In response to the re-emergence of polio, health authorities have launched one of the most complex vaccination campaigns in the world. The goal is to vaccinate 640,000 children under the age of 10, reaching a 95% coverage rate to achieve herd immunity. The campaign, spearheaded by the United Nations Relief and Works Agency (UNRWA) and supported by the World Health Organization (WHO), faces tremendous obstacles.
Challenges of Vaccinating in a War Zone
Organizing a mass vaccination campaign in a war zone presents unprecedented challenges. For starters, healthcare workers have limited access to many areas, and transport is hindered by damaged infrastructure and fuel shortages. The few remaining roads are often dangerous, with active military engagements in the vicinity.
Moreover, maintaining the cold chain required for vaccines is another massive hurdle. Polio vaccines must be stored at very low temperatures to remain effective. In Gaza, where electricity is unreliable, ensuring that vaccines are kept cold has become a logistical nightmare. To mitigate this, UNICEF has provided cold storage equipment, but the situation remains delicate.
There is also the issue of gaining the trust of the local population. Many families are skeptical of the vaccination campaign, and misinformation has spread, complicating efforts further. Public health workers are conducting awareness campaigns to educate the population about the importance of vaccines, but with limited communication resources, the task is monumental.
Global Implications: Is Gaza a Warning for Other Countries?
While Gaza’s situation may seem distant, it serves as a cautionary tale for the rest of the world. Polio is only a plane ride away. Regions neighboring Gaza, such as Egypt and Israel, are also at heightened risk. In Israel, ultra-Orthodox communities have historically resisted vaccination campaigns, and recent data suggests that approximately 175,000 children remain unvaccinated. This raises fears that the virus could easily cross borders, reigniting polio in other parts of the Middle East.
What’s Next? Eradicating Polio Once and For All
Global health organizations have a shared goal of eradicating polio by 2026. However, the situation in Gaza has highlighted how fragile the progress is. Until peace is achieved, and basic infrastructure like clean water and functioning healthcare are restored, the region will remain at risk of future outbreaks.
Eradicating polio will require renewed focus, not just in war-torn areas but globally. Vaccination campaigns must continue, even in the face of conflict, and global cooperation is essential. The fight against polio serves as a reminder that the health of one region impacts us all.
Conclusion
The resurgence of polio in Gaza is a stark reminder of how conflict can unravel decades of progress in public health. War, poor sanitation, and broken healthcare systems have created a perfect breeding ground for the virus. Yet, the global response, despite its challenges, demonstrates resilience and hope. Through mass vaccination and international cooperation, there is a path forward to not only control this outbreak but to eliminate polio altogether. At FreeAstroScience, we believe that scientific understanding and global action are key to tackling these challenges. Together, we can turn the tide against this and other preventable diseases.
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