On Christmas Eve in 2025, there was no Santa or candies for a seven-year-old from Makhetha Township in Blantyre, who was diagnosed with a once-eliminated polio virus.
The unvaccinated child was on oxygen treatment at Queen Elizabeth Central Hospital in Blantyre, surrounded by doctors who collected his stools to understand his breathing difficulty.
vaccinates a baby
The patient and caregivers had to wait until January 22 this year to confirm that polio had paralysed his chest.
Not fit for the purpose
The 29-day suspense is not unusual for the country to watch in the global fight against the return of polio.
Malawi endures a long wait for the results of stools flown to South Africa for laboratory tests.
“The stools are analysed in South Africa because we do not have an authorised lab,” says Joyce Beyamu. “We only keep samples for transit to South Africa.”
She is the national surveillance officer at the Expanded Programme on Immunisation (EPI), which leads nationwide efforts to track and avert the possible polio comeback.
The country’s first polio case since 2023 was confirmed alongside the discovery of similar poliovirus in stools collected on September 8 2025 from Manase and Soche sewage sites in Blantyre.
Beyamu narrates: “Clinical assessments of every child who presents with sudden paralysis of limbs and other parts help us understand whether routine immunisation and reactive vaccinations are truly protecting our children.
“We also take samples from 11 sewage sites across the country. We may not tell who has the virus, but it helps us understand what is happening in the community. The results usually arrive two weeks or more.”
The waiting period includes a day or two for clinical staff to dispatch a specimen to the Public Health Institute of Malawi (Phim) in Area 3, Lilongwe.
The national laboratory must clear the consignment for flight to South Africa, where analysis typically takes about a week.
“The period can go up to 35 days in worst-case scenarios, even though the sample quality and the reliability of the outcome wane with time,” the EPI official says.
Global experts last inspected Phim labs in 2023, when a 15-year-old in Ndirande Township, near Makhetha, was found with wild poliovirus type 1.
“We have skilled personnel, but need laboratories with the capacity to contain the spread of the sensitive virus in the laboratory and beyond,” Beyamu says.
The Ministry of Health and Sanitation plans to establish a secure laboratory that will dramatically reduce delays and forex losses.
“Phim has acquired land at Lilongwe Air Wing and plans to use 40 percent of the Malawi Health Emergency Preparedness, Response and Resilience Project to build modern labs and offices as well as a new district hospital in Lilongwe. In five years, we should have something to show,” says principal health promotion officer Alvin Chidothi Phiri.
The World Bank funds the project to strengthen the healthcare system to effectively manage emergencies following the Covid-19 disruptions.
Next door, the Zambia Institute of Public Health’s laboratory takes three to seven days to analyse samples from polio suspects.
Timely testing allows that country to quickly respond to detected contagious diseases and avert potential outbreaks, an insider said.
However, Malawi waited for a month to declare the polio emergency on January 23 this year.
Further tests revealed that the Makhetha boy and stools from two sewage sites had wild poliovirus type two genetically linked to a case in Harare, Zimbabwe.
“As a country, we stopped giving polio type 2 vaccinations in 2016 because we eradicated the virus, so we are seeing the re-emergence of an old disease that we thought we had eradicated 10 years ago,” says Beyamu.
The vaccine-derived poliovirus is different from the strain detected in a three-year-old girl in Lilongwe in February 2022 and the Ndirande case of January 2023.
The good news is…
Immunisation, sanitation and hygiene remain trusted weapons to end the crippling disease transmitted through contaminated human excreta via food, water and dirty hands.
Two months ago, healthcare workers vaccinated 1.3 million children in five days.
“Polio is a debilitating disease that can leave one with lifetime disability and sometimes death. But the good news is that it’s preventable through vaccination, good personal hygiene, and sanitation,” says Deputy Minister of Health and Sanitation Charles Chilambula, launching the vaccination campaign for children aged 10 and below.
Another vaccination campaign is scheduled for this month.
Similar vaccination rounds happened in 2023 when health workers criss-crossed hills, valleys, islands, cities and the countryside to deliver life-saving shots to every child under 15.
The new wave threatens to undo what the World Health Organisation termed “a triumph of dedication”.
WHO first declared Malawi polio-free in 1992, when it recorded the last case of the 20th century.
