For the second time in two months, fighting related to the civil war in Côte d’Ivoire has disrupted polio immunization efforts in the country, according to the World Health Organization. Now three new cases of the disease have been identified, the first set of new cases in the West African country in a decade.

“Polio has been gaining ground again in Côte d’Ivoire because many children have not been able to receive the vaccine in recent months due to the crisis,” said Hervé Ludovic de Lys, designated representative of the UN Children’s Fund (UNICEF). “It is therefore important to catch up with vaccinating as many as possible to prevent children contracting polio and becoming paralysed for life.”

Immunization campaigns are particularly vulnerable to conflicts. They often require small teams of health workers to operate in remote areas for extended periods of time. Unfortunately, these are the same regions favored by rebel groups and criminal organizations due to their isolation from government security forces. When insecurity in these regions forces immunization campaigns to shut down, it is a major setback in because the delay provides a window of opportunity for the disease can gain a foothold in the human population.

One of the most effective strategies to conducting immunization campaigns during periods of conflict are so called “Days of Tranquility”. These are ceasefire agreements between warring factions — organized by the international community — for the sole purpose of allowing humanitarians to conduct relief and immunization efforts in regions of conflict. This type of “medical ceasefire” has had great success in Sudan, El Salvador, and elsewhere. Whether a Day of Tranquility can be organized in support of polio immunizations programs in Côte d’Ivoire is yet to be seen.

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