Afghanistan, India, Nigeria and Pakistan: The four countries where polio is still endemic, where children and adults are still paralyzed by the vaccine-preventable disease. Not only has transmission never been eradicated in the countries, but the virus is now spreading to what were once polio-free areas.
To confront the problem, a broad range of stakeholders met in Geneva in June to launch the Global Polio Eradication Initiative’s new 2010–2012 strategic plan for eradicating wild poliovirus. Co-hosted by World Health Organization Director-General Margaret Chan, MD, MPH, and UNICEF Director Tony Lake, PhD, the meeting was held to build on positive gains made in 2010 and to discuss the implementation, monitoring, economics and financing of the new plan.
The plan — developed by WHO, UNICEF, the Centers for Disease Control and Prevention and Rotary International — builds on a 2009 plan that examined the major barriers to stopping wild polio transmission in the four remaining countries, worked to speed up the development and clinical trials of four new vaccines, and assessed new approaches to reaching children previously missed by vaccination efforts. The new 2010–2012 plan also builds on four major lessons learned since the global polio eradication initiative began more than two decades ago.
“The new plan has some very specific objective milestones,” said Carol Pandak, EdD, manager of Rotary International’s Polio Eradication Program. “(There are) rigorous processes for monitoring the milestones.”
The milestones — a new feature from previous polio strategies — are to be analyzed quarterly and are aimed at guiding work and keeping efforts on the right track. The milestones include cessation of all “re-established” polio transmission by the end of 2010 and cessation of all wild poliovirus transmission by the end of 2012.
Some of the lessons learned focus on improving program efficiency and developing district and population-specific strategies that tailor efforts to each country’s needs. Also, the four countries where polio is still endemic suffer from conflict and violence, which can pose a challenge when trying to immunize children.
“The four remaining endemic countries have their own particular challenges,” Pandak told The Nation’s Health. “Immunization activities are done on a rolling basis…(you) go into immunize children when you have the opportunity.”
Not only does the plan focus on eradicating polio in the four countries, but it has specific plans to give just as much attention to the areas where polio has reappeared.
“Common to all of these countries, or at least the areas with re-established transmission, was their recent emergence from conflict that contributed to particularly weak health systems, low routine immunization coverage and insufficient capacity to fully implement international outbreak response guidelines,” states the new plan. “Consequently, the Global Polio Eradication Initiative…will be substantially enhanced for these areas, to levels which are comparable to the Global Polio Eradication Initiative investment in endemic areas.”
In 1988, the same year that the Global Polio Eradication Initiative was created, polio was endemic in more than 125 countries. Since then, the virus has been eradicated in the majority of the world, with a 99 percent drop in the annual incidence of the disease globally. In 2006, about 2,000 cases of the disease were reported worldwide.
For more information and to view a copy of the strategic plan, visit www.polioeradication.org.
- Copyright The Nation’s Health, American Public Health Association
