For over 25 years, Gaza remained free from polio. However, after 10 months of conflict with Israel, the highly contagious virus has returned, posing a significant public health threat in an area already devastated by war. The reappearance of polio in Gaza, where healthcare systems and basic sanitation have crumbled, highlights the vulnerability of war-torn regions to diseases that many thought had been eradicated.
In October 2023, Gaza saw its first confirmed case of polio in decades when a baby became partially paralyzed after contracting the virus. This sudden reemergence of a long-vanquished disease has alarmed health officials and the international community, prompting urgent calls for action.
The Impact of War on Public Health in Gaza
The war between Israel and Gaza has decimated the region's healthcare system, creating dangerous living conditions for Palestinians. In response to the escalating health crisis, UN Secretary-General António Guterres called for an immediate humanitarian ceasefire to allow for a mass vaccination campaign aimed at containing the spread of polio.
Israel has since agreed to several three-day humanitarian pauses in the northern, central, and southern parts of Gaza. This temporary respite has enabled the World Health Organization (WHO) to begin a critical vaccination campaign, which has already reached more than 161,000 children under the age of 10. Despite this progress, health officials face the daunting task of vaccinating 90% of Gaza's 640,000 children under 10 years old—each of whom needs two doses of the vaccine. The second round of vaccinations is scheduled to begin four weeks after the first.
The Challenge of Eradicating Polio in a Conflict Zone
The logistics of a large-scale vaccination campaign in Gaza are immensely challenging. The war continues to displace thousands of people, destroy infrastructure, and create unsafe conditions for both healthcare workers and families. Julia Bleckner, a senior health researcher at Human Rights Watch, expressed concern that ongoing attacks and frequent evacuation orders would make it difficult for humanitarian workers to safely administer vaccines.
“The conflict is not just a barrier to reaching those in need, but also puts health workers and facilities at risk,” Bleckner noted. “Continued attacks on infrastructure make it harder to provide not just polio vaccines but also care for other diseases."
Understanding Polio’s Resurgence
Polio is a highly infectious disease that primarily affects children under five. It attacks the nervous system and can cause irreversible paralysis within hours. While there is no cure, polio is entirely preventable with vaccines. The Global Polio Eradication Initiative, launched in 1988, has dramatically reduced polio cases by 99% worldwide.
Gaza, like many other regions, had successfully eliminated polio. However, in July 2023, health officials detected the virus in wastewater samples in Khan Younis and Deir al Balah. This resurgence is linked to vaccine-derived strains of the virus. One version of the polio vaccine contains a weakened form of the virus, which can sometimes be shed through bodily waste. In unsanitary and overcrowded conditions like those in Gaza, the virus can mutate back into a more dangerous form, capable of causing outbreaks.
Before the conflict, vaccination rates in Gaza were high, with 99% of the population routinely immunized. However, as the war escalated, these numbers dropped, leaving a vulnerable population exposed to diseases like polio.
The Race to Vaccinate Gaza’s Children
The most pressing goal for health officials is to ensure that at least 90% of Gaza's children under 10 are vaccinated to halt the spread of the virus. The early results of the vaccination campaign have been promising, with the WHO surpassing its initial target of vaccinating 150,000 children in just two days. However, sustaining this momentum will be difficult given the unpredictable nature of the conflict.
There is also concern about vaccine hesitancy. While polio has been nearly eradicated worldwide, misinformation and distrust in the international community have caused some parents in Gaza to be skeptical of the vaccination campaign. “People here have lost faith in anything global or Western,” one Palestinian mother told Al Jazeera, highlighting the deep-rooted skepticism that complicates public health efforts.
Additionally, safety remains a significant concern. Many parents are hesitant to take their children to healthcare centers, many of which have been damaged or destroyed in the conflict. Recent attacks on refugee camps, schools, and hospitals have further eroded trust in these facilities.
A Global Public Health Concern
Polio remains endemic in only two countries—Afghanistan and Pakistan. However, the virus poses a global threat, particularly to low-income regions with inadequate healthcare systems. Until polio is eradicated everywhere, countries around the world remain at risk. In recent years, wild polio cases have reemerged in countries like Mozambique and Malawi, underscoring the need for continued vigilance.
In Gaza, the stakes are particularly high. If the current vaccination campaign fails to reach the necessary threshold, the consequences could extend beyond the region. The risk of a broader outbreak looms, threatening not just Palestinians but neighboring countries as well.
The Importance of Urgent Action
Health officials agree that time is running out to prevent a full-blown polio outbreak in Gaza. The conditions in which many Palestinians are living—overcrowded, unsanitary, and without access to consistent healthcare—are ideal for the spread of infectious diseases.
“There’s no reason why any child in 2024 should have polio,” Bleckner emphasized. “It’s an entirely preventable disease. Even one confirmed case is already too many. We’re in a race against time to stop this outbreak before it becomes catastrophic.”
A Call for Global Support
The reemergence of polio in Gaza is a stark reminder of how quickly preventable diseases can spread in conflict zones. The war has decimated public health infrastructure, leaving children at risk of diseases that the world had nearly eradicated. While the vaccination efforts so far have been promising, the challenges ahead are immense. A sustained international effort, coupled with a commitment to ceasefires and humanitarian aid, is essential to protecting the children of Gaza and preventing a larger outbreak.
As the situation unfolds, global health organizations, governments, and humanitarian groups must prioritize the safety and well-being of Gaza’s population. This crisis is a reminder that no region is safe from diseases like polio until they are eradicated everywhere.