Global Polio Eradication Initiative; strategic plan, 2004-2008
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Global Polio Eradication Initiative; strategic plan, 2004-2008

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  • Description:
    By end-2003, poliomyelitis had been eliminated from all but 6 countries in the world as a result of the Global Polio Eradication Initiative, the largest international public health effort to date. Nearly 5 million children are walking who would otherwise have been paralyzed by polio and 1.25 million childhood deaths have been averted by distributing Vitamin A during the polio immunization campaigns. Once polio has been eradicated, the world will reap substantial financial, as well as humanitarian, dividends due to foregone polio treatment and rehabilitation costs. Depending on national decisions on the future use of polio vaccines, these savings could exceed US$ 1 billion per year. The Global Polio Eradication Initiative Strategic Plan 2004-2008 outlines activities required to interrupt poliovirus transmission (2004-2005), achieve global certification and mainstream the Global Polio Eradication Initiative (2006-2008), and prepares for the Global OPV Cessation Phase (2009 & beyond). This Plan reflects the major tactical revisions that were introduced in 2003 to interrupt the final chains of polio transmission, the revised timeframe for certification of eradication, and the decision to stop immunization with oral polio vaccine (OPV) globally as soon as possible after global certification Of the 4 objectives outlined in the Plan, the over-riding objective is the rapid interruption of polio transmission in the 6 remaining endemic countries. Eliminating these reservoirs during 2004-2005 is now an urgent international public health issue because the cessation of mass immunization campaigns in most polio-free countries has left the world increasingly vulnerable to importations of this disease. Objective 1 of the Plan details the supplementary immunization, routine immunization, and surveillance activities needed to finish the job of eradication and protect the investment made in polio-free areas. Particular attention is given to ‘intensifying’ supplementary immunization activities to improve quality and reach every child. The Plan highlights the 3 countries linked to over 95% of cases in 2003: Nigeria, India and Pakistan. It recognizes, however, that with the reduction in polio transmission in India and Pakistan in late 2003, the risks to global eradication are increasingly concentrated in Nigeria. The postponement of eradication activities in key areas of that country in 2003 led to a marked increase in the number of polio-paralyzed Nigerian children and the re-infection of at least 5 neighbouring countries. The narrow window of opportunity that now exists to eradicate polio can only be exploited if the leaders of the endemic areas ensure that every child is immunized during intensified supplementary immunization activities in 2004 (SIAs). Objectives 2 and 3 of the Plan outline activities for certifying the world polio-free and preparing for the Global OPV Cessation Phase that will follow. With the certification process and criteria having been validated in three WHO regions, Objective 2 focuses on improving surveillance quality (especially in the 19 countries yet to achieve certification-standard), reversing declines in surveillance sensitivity in the regions that have been certified, and completing Phase II of the Global Action Plan for the Laboratory Containment of Wild Polioviruses. Objective 3 outlines the implications of the 2003 decision to stop OPV after global certification. Although trivalent OPV will continue to be the vaccine of choice for routine immunization through 2008, the plan outlines the work required to develop the specific products needed to facilitate the safe cessation of OPV. These products include: a 3rd edition of the Global Action Plan for the Laboratory Containment of Wild Polioviruses (specifying the longterm requirements for wild poliovirus, vaccine-derived polioviruses and Sabin-strains), monovalent OPV (mOPV) stockpiles, IPV produced from Sabin strains (S-IPV), and appropriate IPV-containing combination vaccines. The plan also discusses the development of mechanisms to ensure that countries which desire or need these products have access to them by 2008. The fourth and final objective of the plan addresses the work required to integrate and/or transition the substantial human resources, physical infrastructure and institutional arrangements that were established for polio eradication into other disease control, surveillance and response programmes. This objective also details the programme of work to ‘mainstream’ those polio eradication activities that must be continued indefinitely (i.e. surveillance, stockpiles, containment) into existing national, WHO and UNICEF structures and mechanisms for managing other serious pathogens which are subject to high biosafety levels. The greatest risks to achieving the annual milestones of this plan are ongoing wild poliovirus transmission in any of the 6 remaining endemic countries and an increased frequency of polio outbreaks due to circulating vaccine derived polioviruses (cVDPVs). Implementing the full activities outlined in the Plan requires continued technical support from a strong polio eradication partnership, financing for the shortfall of US$ 150 million to interrupt poliovirus transmission, and identification of funding for the US$ 380 million budget to achieve global certification and mainstream the Global Polio Eradication Initiative. The Global Polio Eradication Initiative Estimated External Financial Resource Requirements 2004–2008 outlines the resources required to implement the Global Polio Eradication Initiative Strategic Plan 2004–20083 and the financial implications of the major risks to the annual milestones of the Plan.
  • Content Notes:
    World Health Organization ... [et al.].

    In the 15 years since the decision to eradicate polio, an extensive network of national governments, international agencies, private corporations, foundations, bilateral donors, humanitarian organizations, nongovernmental organizations (NGOs) and development banks have formed a "global polio partnership", spearheaded by the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC) and the United Nations Children's Fund (UNICEF).

    Includes bibliographical references.

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