African leaders have never been short of promises.
Every year, health ministers pledge to end preventable child deaths, strengthen primary healthcare and ensure that no child is left behind by vaccination programmes. Polio regularly features among those commitments.
But Africa has reached the point where another promise is not enough.
At the 76th session of the World Health Organization Regional Committee for Africa in Addis Ababa, ministers endorsed a new strategy for child health and survival and a programme aimed at training, employing and retaining three million additional health workers by 2035.
The ambitions are welcome. The test is whether they will survive beyond the conference hall.
Africa has already demonstrated that polio can be beaten. In 2020, the continent was certified free of wild poliovirus—a remarkable achievement built through years of vaccination, surveillance and community mobilisation.
Yet the job is not finished.
Variant poliovirus continues to cause outbreaks, while children in conflict-affected, remote and underserved communities remain at risk. The final mile is proving to be the hardest.
That is why Africa must now move from polio campaigns to polio systems.
A vaccination drive can reach a child once. A functioning health system can protect that child throughout childhood.
The distinction matters. A child who misses a vaccine is often also missing nutrition services, clean water, sanitation and basic healthcare. Reaching such children requires more than periodic vaccination teams. It requires health workers who are present, equipped and trusted in their communities.
Africa faces a projected shortage of more than six million health professionals by 2035. In 2024, the continent had only about 46 percent of the health workforce it needs.
That shortage is not an abstract statistic. It directly affects polio.
Someone must find children who have been missed. Someone must investigate suspected cases. Someone must maintain surveillance, track vaccination records and respond immediately when the virus is detected.
Without enough health workers, even the best regional strategy will remain just that—a strategy.
The proposed Health Workforce Management Programme for Africa is therefore critical to the continent’s polio ambitions. But recruitment alone will not solve the problem.
Health workers must be trained well, deployed where they are needed and given the transport, supplies, supervision and data tools required to work effectively. In communities where government services are weak and misinformation travels quickly, they must also have something no policy can simply manufacture: community trust.
For years, polio has been fought largely through emergency campaigns and short-term targets. Those campaigns have saved countless children. But they can also hide the weaknesses of routine health services.
When the campaign ends, the health system must remain.
That is the real opportunity before African governments now. Immunisation must become part of everyday primary healthcare. A child receiving nutrition services should have their vaccination status checked. A community health worker visiting a vulnerable household should be able to provide or connect the family to immunisation services. Surveillance should continue whether or not an outbreak is making headlines.
This approach is not only better health policy. It is the only sustainable path to zero.
Donor money will not last forever. Health priorities are competing for the same limited resources. Polio programmes must therefore demonstrate that they are building stronger health systems—not creating parallel ones.
The responsibility ultimately lies with African governments.
The continent does not lack the technology to stop polio. It does not lack the experience. It has already eradicated wild poliovirus.
What it needs now is political consistency.
Zero polio is a test of whether governments are willing to invest in the children who are hardest to reach. It is a test of whether health workers will be supported rather than celebrated only during campaigns. And it is a test of whether regional institutions and development partners can align behind national priorities instead of scattering resources across disconnected initiatives.
The pledges made in Addis Ababa are a good beginning.
But history will not remember the wording of another resolution. It will remember whether African children remained protected.
Africa has already shown that it can defeat wild polio.
Now it must show that it can finish the job.
Not with another campaign. Not with another pledge.
With health systems that deliver—every day, in every community, until zero becomes reality.
