Abstract

The African region achieved certification for the eradication of wild poliovirus (WPV) from the African Regional Certification Commission (ARCC) in 2020. Polio surveillance remains a critical component for sustaining this achievement. The gold standard for poliovirus detection within the Global Polio Eradication Initiative (GPEI) is Acute Flaccid Paralysis (AFP) surveillance, while Environmental Surveillance (ES) serves as a complementary approach. ES involves the regular collection of sewage or wastewater contaminated with human fecal matter and laboratory testing of these samples for the presence of poliovirus. The African region first initiated ES in Nigeria in 2011, and by December 2024, 46 of the 47 countries in the region had implemented ES. With the anticipated eradication of polio in the coming years, questions arise regarding the sustainability of polio surveillance, particularly AFP surveillance, due to ongoing financial, operational, and political challenges. One strategy to address these challenges is the expanded deployment of ES to complement AFP surveillance, especially in areas with suboptimal performance, and to facilitate the detection of other pathogens of public health significance beyond poliovirus. It is therefore imperative for the region to transition ES into an integrated early warning system, given its cost-effectiveness, sustainability, and potential to strengthen broader public health monitoring.

Key words: Poliovirus, environmental surveillance, multi-pathogen.