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Experts: Baby in Gaza Has Strain of Polio Linked to Mistakes in Eradication Campaign

The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
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Experts: Baby in Gaza Has Strain of Polio Linked to Mistakes in Eradication Campaign

The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed

The baby in Gaza who was recently paralyzed by polio was infected with a mutated strain of the virus that vaccinated people shed in their waste, according to scientists who say the case is the result of “an unqualified failure” of public health policy.
The infection, which marked the first detection of polio in the war-torn Palestinian territory in more than 25 years, paralyzed the lower part of one leg in the unvaccinated 10-month-old child. The baby boy was one of hundreds of thousands of children who missed vaccinations because of the fighting between Israel and Hamas.
Scientists who have been monitoring polio outbreaks said the baby's illness showed the failures of a global effort by the World Health Organization and its partners to fix serious problems in their otherwise largely successful eradication campaign, which has nearly wiped out the highly infectious disease. Separately, a draft report by experts deemed the WHO effort a failure and “a severe setback.”
The polio strain in question evolved from a weakened virus that was originally part of an oral vaccine credited with preventing millions of children worldwide from being paralyzed. But that virus was removed from the vaccine in 2016 in hopes of preventing vaccine-derived outbreaks.
Public health authorities knew that decision would leave people unprotected against that particular strain, but they thought they had a plan to ward off and quickly contain any outbreaks. Instead, the move resulted in a surge of thousands of cases, The Associated Press reported.
“It was a really horrible strategy,” said Columbia University virologist Vincent Racaniello, who was not involved with the report or the WHO. “The decision to switch vaccines was based on an incorrect assumption, and the result is now we have more polio and more paralyzed children.”
A draft copy of the report commissioned by the WHO and independent experts said the plan underestimated the amount of the strain in the environment and overestimated how well officials would be able to squash outbreaks.
The plan led to vaccine-linked polio outbreaks in 43 countries that paralyzed more than 3,300 children, the report concluded.
Even before the Gaza case was detected, officials reviewing the initiative to tinker with the vaccine concluded that “the worst-case scenario has materialized,” the report said.
The report has not yet been published, and some changes will likely be made before the final version is released next month, the WHO said.
The strain that infected the baby in Gaza had lingered in the environment and mutated into a version capable of starting outbreaks. It was traced to polio viruses spreading last year in Egypt, according to genetic sequencing, the WHO said.
In 2022, vaccine-linked polio viruses were found to be spreading in Britain, Israel and the US, where an unvaccinated man was paralyzed in upstate New York.
Scientists now worry that the emergence of polio in a war zone with an under-immunized population could fuel further spread.
Racaniello said the failure to track polio carefully and to sufficiently protect children against the strain removed from the vaccine has had devastating consequences.
“Only about 1% of polio cases are symptomatic, so 99% of infections are silently spreading the disease,” he said.
The oral polio vaccine, which contains a weakened live virus, was withdrawn in the US in 2000. Doctors continued to vaccinate children and eventually moved to an injected vaccine, which uses a dead virus and does not come with the risk that polio will be present in human waste. Such waste-borne virus could mutate into a form that triggers outbreaks in unvaccinated people.
The report's authors faulted leaders at the WHO and its partners, saying they were unable or unwilling “to recognize the seriousness of the evolving problem and take corrective action.”
WHO spokesman Oliver Rosenbauer acknowledged that the vaccine strategy “exacerbated” the risk of epidemics linked to the vaccine.
He said in an email that immunization “was not implemented in such a way to rapidly stop outbreaks or to prevent new strains from emerging.” Rosenbauer said not hitting vaccination targets was the biggest risk for allowing vaccine-linked viruses to emerge.
“You need to reach the children with the vaccines ... regardless of which vaccines are used,” he said.
The WHO estimates that 95% of the population needs to be immunized against polio to stop outbreaks. The UN health agency said only about 90% of Gaza’s population was vaccinated earlier this year.
To try to stop polio in Gaza and the wider region, the WHO and its partners plan two rounds of vaccination campaigns later this week and next month, aiming to cover 640,000 children. Authorities will use a newer version of the oral polio vaccine that targets the problematic strain. The weakened live virus in the new vaccine is less likely to cause vaccine-derived outbreaks, but they are still possible.
Racaniello said it was “unethical” that the WHO and its partners were using a vaccine that is unlicensed in rich countries precisely because it can increase the risk of polio in unvaccinated children.
The oral polio vaccine, which has reduced infections globally by more than 99%, is easy to make and distribute. Children require just two drops per dose that can be administered by volunteers. The oral vaccine is better at stopping transmission than the injected version, and it is cheaper and easier to administer.
But as the number of polio cases caused by the wild virus have plummeted in recent years, health officials have been struggling to contain the increasing spread of vaccine-linked cases, which now comprise the majority of polio infections in more than a dozen countries, in addition to Afghanistan and Pakistan, where transmission of the wild virus has never been stopped.
“This is the result of the Faustian bargain we made when we decided to use" the oral polio vaccine, said Dr. Paul Offit, director of the Vaccine Education Center at the University of Philadelphia. “If we really want to eradicate polio, then we need to stop using the vaccine with live (weakened) virus.”

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10 Years after Europe's Migration Crisis, the Fallout Reverberates in Greece and Beyond

File photo: Migrants of African origin trying to flee to Europe are crammed on board of a small boat, as Tunisian coast guards prepare to transfer them onto their vessel, at sea between Tunisia and Italy, on August 10, 2023. (Photo by FETHI BELAID / AFP)
File photo: Migrants of African origin trying to flee to Europe are crammed on board of a small boat, as Tunisian coast guards prepare to transfer them onto their vessel, at sea between Tunisia and Italy, on August 10, 2023. (Photo by FETHI BELAID / AFP)
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10 Years after Europe's Migration Crisis, the Fallout Reverberates in Greece and Beyond

File photo: Migrants of African origin trying to flee to Europe are crammed on board of a small boat, as Tunisian coast guards prepare to transfer them onto their vessel, at sea between Tunisia and Italy, on August 10, 2023. (Photo by FETHI BELAID / AFP)
File photo: Migrants of African origin trying to flee to Europe are crammed on board of a small boat, as Tunisian coast guards prepare to transfer them onto their vessel, at sea between Tunisia and Italy, on August 10, 2023. (Photo by FETHI BELAID / AFP)

Fleeing Iran with her husband and toddler, Amena Namjoyan reached a rocky beach of this eastern Greek island along with hundreds of thousands of others. For months, their arrival overwhelmed Lesbos. Boats fell apart, fishermen dove to save people from drowning, and local grandmothers bottle-fed newly arrived babies.

Namjoyan spent months in an overcrowded camp. She learned Greek. She struggled with illness and depression as her marriage collapsed. She tried to make a fresh start in Germany but eventually returned to Lesbos, the island that first embraced her. Today, she works at a restaurant, preparing Iranian dishes that locals devour, even if they struggle to pronounce the names. Her second child tells her, “‘I’m Greek.’”

“Greece is close to my culture, and I feel good here,” Namjoyan said. “I am proud of myself.”

In 2015, more than 1 million migrants and refugees arrived in Europe — the majority by sea, landing in Lesbos, where the north shore is just 10 kilometers (6 miles) from Türkiye. The influx of men, women and children fleeing war and poverty sparked a humanitarian crisis that shook the European Union to its core. A decade later, the fallout still reverberates on the island and beyond.

For many, Greece was a place of transit. They continued on to northern and western Europe. Many who applied for asylum were granted international protection; thousands became European citizens. Countless more were rejected, languishing for years in migrant camps or living in the streets. Some returned to their home countries. Others were kicked out of the European Union.

For Namjoyan, Lesbos is a welcoming place — many islanders share a refugee ancestry, and it helps that she speaks their language. But migration policy in Greece, like much of Europe, has shifted toward deterrence in the decade since the crisis. Far fewer people are arriving illegally. Officials and politicians have maintained that strong borders are needed. Critics say enforcement has gone too far and violates fundamental EU rights and values.

“Migration is now at the top of the political agenda, which it didn’t use to be before 2015,” said Camille Le Coz Director of the Migration Policy Institute Europe, noting changing EU alliances. “We are seeing a shift toward the right of the political spectrum.”

A humanitarian crisis turned into a political one

In 2015, boat after boat crowded with refugees crashed onto the doorstep of Elpiniki Laoumi, who runs a fish tavern across from a Lesbos beach. She fed them, gave them water, made meals for aid organizations.

“You would look at them and think of them as your own children," said Laoumi, whose tavern walls today are decorated with thank-you notes.

From 2015 to 2016, the peak of the migration crisis, more than 1 million people entered Europe through Greece alone. The immediate humanitarian crisis — to feed, shelter and care for so many people at once — grew into a long-term political one.

Greece was reeling from a crippling economic crisis. The influx added to anger against established political parties, fueling the rise of once-fringe populist forces.

EU nations fought over sharing responsibility for asylum seekers. The bloc’s unity cracked as some member states flatly refused to take migrants. Anti-migration voices calling for closed borders became louder.

Today, illegal migration is down across Europe While illegal migration to Greece has fluctuated, numbers are nowhere near 2015-16 figures, according to the International Organization for Migration. Smugglers adapted to heightened surveillance, shifting to more dangerous routes.

Overall, irregular EU border crossings decreased by nearly 40% last year and continue to fall, according to EU border and coast guard agency Frontex.

That hasn’t stopped politicians from focusing on — and sometimes fearmongering over — migration. This month, the Dutch government collapsed after a populist far-right lawmaker withdrew his party’s ministers over migration policy.

In Greece, the new far-right migration minister has threatened rejected asylum seekers with jail time.

A few miles from where Namjoyan now lives, in a forest of pine and olive trees, is a new EU-funded migrant center. It's one of the largest in Greece and can house up to 5,000 people.

Greek officials denied an Associated Press request to visit. Its opening is blocked, for now, by court challenges.

Some locals say the remote location seems deliberate — to keep migrants out of sight and out of mind.

“We don’t believe such massive facilities are needed here. And the location is the worst possible – deep inside a forest,” said Panagiotis Christofas, mayor of Lesbos’ capital, Mytilene. “We’re against it, and I believe that’s the prevailing sentiment in our community.”

A focus on border security

For most of Europe, migration efforts focus on border security and surveillance.

The European Commission this year greenlighted the creation of “return” hubs — a euphemism for deportation centers — for rejected asylum seekers. Italy has sent unwanted migrants to its centers in Albania, even as that faces legal challenges.

Governments have resumed building walls and boosting surveillance in ways unseen since the Cold War.

In 2015, Frontex was a small administrative office in Warsaw. Now, it's the EU's biggest agency, with 10,000 armed border guards, helicopters, drones and an annual budget of over 1 billion euros.

On other issues of migration — reception, asylum and integration, for example — EU nations are largely divided.

The legacy of Lesbos

Last year, EU nations approved a migration and asylum pact laying out common rules for the bloc's 27 countries on screening, asylum, detention and deportation of people trying to enter without authorization, among other things.

“The Lesbos crisis of 2015 was, in a way, the birth certificate of the European migration and asylum policy,” Margaritis Schinas, a former European Commission vice president and a chief pact architect, told AP.

He said that after years of fruitless negotiations, he's proud of the landmark compromise.

“We didn’t have a system,” Schinas said. “Europe’s gates had been crashed."

The deal, endorsed by the United Nations refugee agency, takes effect next year. Critics say it made concessions to hardliners. Human rights organizations say it will increase detention and erode the right to seek asylum.

Some organizations also criticize the “externalization” of EU border management — agreements with countries across the Mediterranean to aggressively patrol their coasts and hold migrants back in exchange for financial assistance.

The deals have expanded, from Türkiye to the Middle East and across Africa. Human rights groups say autocratic governments are pocketing billions and often subject the displaced to appalling conditions.

Lesbos still sees some migrants arrive Lesbos' 80,000 residents look back at the 2015 crisis with mixed feelings.

Fisherman Stratos Valamios saved some children. Others drowned just beyond his reach, their bodies still warm as he carried them to shore.

“What’s changed from back then to now, 10 years on? Nothing,” he said. “What I feel is anger — that such things can happen, that babies can drown.”

Those who died crossing to Lesbos are buried in two cemeteries, their graves marked as “unknown.”

Tiny shoes and empty juice boxes with faded Turkish labels can still be found on the northern coast. So can black doughnut-shaped inner tubes, given by smugglers as crude life preservers for children. At Moria, a refugee camp destroyed by fire in 2020, children’s drawings remain on gutted building walls.

Migrants still arrive, and sometimes die, on these shores. Lesbos began to adapt to a quieter, more measured flow of newcomers.

Efi Latsoudi, who runs a network helping migrants learn Greek and find jobs, hopes Lesbos’ tradition of helping outsiders in need will outlast national policies.

“The way things are developing, it’s not friendly for newcomers to integrate into Greek society,” Latsoudi said. "We need to do something. ... I believe there is hope.”