Global Polio Eradication Initiative; annual report 2009
Corporate Authors:World Health Organization, Global Polio Eradication Initiative. ; Centers for Disease Control and Prevention (U.S.) ; Rotary International ; ... More ▼
Description:1. Executive Summary -- 2. Context of the Programme of Work 2009 -- 3. Independent evaluation of the major barriers to interrupting poliovirus transmission -- 4. Key events 2009 -- 5. Sustained implementation of core eradication strategies and assessment of new strategic approaches -- 6. Development and evaluation of new tools -- 7. Management of post-eradication risks -- 8. Finalization of multi-year Strategic Plan and budget -- Annex: Major expected results of Programme of Work 2009
For the Global Polio Eradication Initiative (GPEI), 2009 was a pilot year: an irony for a 20-year effort, but one that breathed innovation and fresh thinking into the initiative. At the beginning of the year, poliovirus survived in parts of four countries and was causing a large-scale international outbreak for the second time in five years. Poliovirus had -- for the first time -- re-established transmission in several countries. Noting that the strategies which successfully eradicated polio from 99% of the world were not working in the remaining 1%, the World Health Assembly in 2008 had called on the GPEI to develop new approaches to tackle the surviving reservoirs of wild poliovirus. In response, the GPEI developed a special one year Programme of Work 2009, embarking on an independent evaluation of the remaining barriers to stopping polio, introducing new strategies to tackle those barriers and evaluating new vaccines to enhance the impact of each contact with a child. The situation had improved enough by the end of the year for the Strategic Advisory Group of Experts on Immunization (SAGE) and the Advisory Committee for Poliomyelitis Eradication (ACPE) to recommend the development of a new, three-year programme of work to exploit these new approaches and urgently interrupt wild poliovirus transmission. 2009 was marked by a type of progress in the polio endemic countries which had not been seen before. In Nigeria, the unprecedented ownership of the programme by all levels of government, and critically, the traditional and religious leadership, quickly closed vaccination gaps and drove immunization levels upwards, resulting in case numbers falling by more than 99%. India now faces the final surviving genetic chain of type 1 transmission, down from nine chains four years ago. Sustained monovalent oral polio vaccine type 1 (mOPV1) campaigns targeted this chain throughout 2009, and the new 107-Block Plan for the remaining blocks with persistent transmission was drawn up and implemented to tackle the ongoing transmission of poliovirus among migrant groups and in the most difficult-to-access areas head on. In Afghanistan and Pakistan, 2009 was marked by repeated military offensives that resulted in the mass movement of internally displaced people, in some cases hampering access to children and in others, opening up areas that had long been inaccessible. Persistent transmission of polio was restricted to 23 districts between the two countries -- emphasizing the value of new district-specific approaches. Of the 15 countries that experienced outbreaks of wild poliovirus in 2009, 10 had stopped transmission by the end of the first quarter of 2010. The 19-country coordinated campaigns in March and April, 2010, along the wild poliovirus 'importation belt" of sub-Saharan Africa, solidified a new approach -- a series of preplanned campaigns built on the back of a three-year immunization schedule to raise immunity as a multicountry block to levels required to end the current outbreak and prevent new ones. In the countries known to have re-established transmission, Chad and Angola, polio-focused staffing levels were escalated to a level matching the endemic countries, and aggressive advocacy efforts have led to a deeper understanding of the threat these nations pose to polio eradication. While by the first quarter of 2010 southern Sudan had not recorded any cases since June 2009, surveillance was intensified throughout 2009 to validate that progress. In July and August, an independent evaluation of the major barriers to interrupting poliovirus transmission took place, tasked with evaluating the primary challenges to achieving sufficient population immunity to interrupt poliovirus transmission and identifying area-specific strategies to overcome them. New approaches were proposed and evaluated, and while the Independent Evaluation urged against over-confidence, it found that if the managerial, security, and technical issues could be addressed, polio eradication could be achieved.
On cover: logos for World Health Organization, Rotary International, CDC (U.S. Centers for Disease Control and Prevention), UNICEF.
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