Post on 07-May-2015
The Global Perspective &
The Polio Endgame
What's the Polio 'Endgame'?
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Polio
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Polio-paralyzed children, 1988-2012
Type 2 polio eradicated
Last type 2 wild poliovirus: 1999
however…..
Vaccine-derived polio outbreaks (cVDPVs) 2000-2013
Type 2 (478 cases)
Type 1 (79 cases)
Type 3 (9 cases)
Type 2Type 1
Type 3
The Endgame Goal: complete the
eradication of all wild & vaccine-related
polioviruses.
• Polio detection & interruption
• Systems strengthening, IPV intro. & OPV withdrawal
• Containment & Certification
• Legacy Planning
Endgame Plan, 2013-18
Bivalent OPV (bOPV)
Inactivated PoliovirusVaccine (IPV)
The 'endgame' approach
Strengthen routine immunization immediately
Introduce at least 1 dose of IPV by end-2015
Switch from tOPV to bOPV by mid-2016
The role of IPV
• Reduce risks of OPV2 withdrawal
• Help stop outbreaks if type 2 reintroduced
• Boost immunity against polio types 1 & 3
Inactivated Polio Vaccine (IPV)
The IPV challenge: not ‘business as usual’
IPV
Hep B
$5.0 B* pledged for Polio Endgame Plan
* including pledges received since the Summit
I s l a m i c A dv i s o r yGr ou p ( IA G)
Endgame Progress
27 March 201480% of world's population now certified polio-free!
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2007 2008 2009 2010 2011 2012 2013
Ca
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Polio, type 3 cases
Last type 3 case :
10 Nov 2012, Nigeria
Polio Cases, 2014
Type 1 Pakistan 71
Afghan 4
Cameroon 3
Eq Guinea 3
Nigeria 3
Iraq 2
Syria 1
Ethiopia 1
Somalia 1Polio 2014
IPV today71 countries already using IPV
85 have plan to introduce by end-2015
39 have not yet announced a plan
0 1,500 3,000750 Kilometers
Addressing Barriers
KANO, LQAs trend
BORNO, Access Trend
Mar100%
Dec14%
20143 cases
Est'd < 5 yr (2010
MoH)
Nov (MoH)
Dec (MoH)
Jan (all sources)
Feb (all sources)
Apr (all sources)
00.5
11.5
22.5
33.5
Children vaccinated (ml)
AUG SEP OCT
NOV DEC JAN
Accessible
Insecurity
Partiallyinaccessible
Inaccessible
HORN OF AFRICA outbreak
AFGHANISTAN• South: ongoing
indigenous virus
• East/North: cont'd importations
• new PM Polio Focal Point
• new security strategy KP
• Waziristan dialogue
• DG/WHO engaging PM
FATA, OPV trend
Imran Khan & Maulana Sami Ul Haq, Dec 2013
2013
Public Health Emergency of International Concern (PHEIC)
Temporary recommendations for all 'exporting countries'
Risks
Syria’s Polio Epidemic: The Suppressed Truth Annie Sparrow
Syria's Raging Health Crisis By ADAM P. COUTTS and FOUAD M. FOUAD
An Apolitical Virus: Strife Fuels Polio's Return to Middle East
By Christoph Reuter
Misinformation
The 'Red List' Countries
WestAfrica
Niger
Mali
Horn ofAfrica
Yemen
S. Sudan
MiddleEast
Leb, Jor
Tur, Irq
Central Africa
CAR
Chad
More 'Red List' Countries
Carry forward
Funding & Cash Gaps
2014 CASH GAP HEADLINES SINCE PREVIOUS VERSION
FRR
Funding Needs: Current Operational Budget 1,032.95$
less Operationalized Funding 690.64$
Cash Gap (Confirmed Only) 342.31$
less 75% Likely Funding 121.80$
Priorities
1. Nigeria (stop in 2014)
2. Outbreaks (stop in 2014)
3. Pakistan/Afghanistan
4. Red list countries
'Eradication
attacks inequities; the
ultimate in social
justice.'
circulating Vaccine-Derived Poliovirus Outbreaks (cVDPVs), 2000-2012
Type 2 (478 cases)
Type 1 (79 cases)
Type 3 (9 cases)
14 countries have had a
type 2 cVDPV
International Spread of Polio
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Endemic OutbreaksPolio cases:last 12 months
2012 2013
• SEARO certified polio-free (27 March)
• No type 3 virus globally for 16 months
• Most countries on track to stop type 1
Changes
• IPV (all endemics plan HR areas)
• IHR & polio vaccination (Apr 14)
• Access tracking & security group