South Africa regains polio-free status: Processes involved and lessons learnt

The World Health Organization recommends continuous immunisation coverage and polio surveillance standards for countries to sustain a polio-free status. We highlight experiences and lessons learnt by South Africa (SA) in losing – and subsequently regaining – its polio-free status. Following some decline in achieving acute flaccid paralysis surveillance and immunisation coverage targets, SA had its polio-free status withdrawn in 2017. Existing gaps were addressed and the polio-free status was regained in 2019. Lessons learnt from this experience include reaffirming the importance of continued commitment to polio eradication efforts, strengthening health systems through quality improvement projects, ensuring accountability in supervision, and monitoring of polio-related indicators. Consistent political commitment, collaboration and accountability are critical in sustaining the country’s health programmes, including maintaining a polio-free status and closing identified gaps.