Global Polio Eradication Initiative:

implementing the Polio Eradication and EndgameStrategic Plan 2013–2018

Progress in poliomyelitis (polio) eradicationPolio cases (n=416), 2013

Endemic countriesInfected countries

• No wild type-2 circulation since 1999• No wild type-3 circulation since

November 2012• Only wild serotype 1 currently in

circulation• Intensified efforts led to:

― reduced number of cases in endemic countries: Afghanistan and Nigeria

― strong outbreak response inHorn of Africa and Middle East

Progress in polio eradication

Endemic countriesInfected countries

Polio cases (n=171), 2014• No wild type-2 circulation since 1999• No wild type-3 circulation since

November 2012• Only wild serotype 1 currently

in circulation• Intensified efforts led to:

― reduced number of cases in endemic countries: Afghanistan and Nigeria

― strong outbreak response inHorn of Africa and Middle East

Current issues• End stage of eradication and increasing

number of countries with complex emergencies highlight urgency of stopping polio transmission in all infected areas

• Ban on vaccination and insecurity in parts of Pakistan

• Prevention of international spread

• Timely detection of and vigorous response to polio outbreaks

Afghanistan Nigeria Pakistan Outbreaks*0

50

100

150

200

250

300

37

103

55

614

53

93

256

8 6

138

19

2012 2013 2014* Cameroon, Equatorial Guinea, Ethiopia, Iraq, Somalia and the Syrian Arab Republic

Cases (n) Polio cases 2012–2014 to date

International spread of wild polioviruses

• International spread is a risk to polio eradication

• Public health emergency of international concern (PHEIC) declared by Director-General under the International Health Regulations on 5 May 2014, extended 31 July 2014

• Temporary recommendations according to whether a country exports poliovirus

• Affected States Parties’ application of the recommendations incomplete at end July

Member States currently exporting wild poliovirus

Member States with circulating wild poliovirus, but not currently exporting wild poliovirus

Syrian Arab Republic

PHEIC temporary recommendations

States currently exporting

Ensure that, prior to international travel, all residents or long-term visitors receive a dose of oral polio vaccines (OPV) or inactivated polio vaccine (IPV) (4 weeks–12 months before travel)

Ensure that polio vaccination is recorded on standard IHR vaccination certificate

States with circulating wild polio virus*

Encourage residents (or long-term visitors) to receive a dose of OPV or IPV (4 weeks–12 months before international travel)

* Including six-month monitoring period since last case/environmental isolation in non-endemic states.There are no recommendations for polio-free states. Full recommendations are available at Global Polio Eradication Initiative website (http://www.polioeradication.org/Infectedcountries/PolioEmergency.aspx).

Withdrawal of type 2 component from OPV and introduction of IPV

• End-game strategy: obligatory and synchronized

• Pivotal role of national regulatory authorities

• GAVI funding for IPV introduction for eligible countries

0 1,750 3,500875 Kilometers

Not available, not introduced /no plans (38 countries, 20%)

Not applicable

Intent to introduce in 2014–2015 (35 countries, 18%)

Formal commitment to introduce in 2014–2015(49 countries, 25%)

Introduced to date (72 countries: 37%)

Polio legacy planningMaintain the capacities and assets created for polio eradication to benefit other health priorities:

- surveillance for vaccine-preventable diseases, including laboratory capacity;

- strengthened routine immunization services in resource-poor settings;- planning and implementation of mass vaccination campaigns and work to reach

hard-to-reach groups;- outbreak detection and response; and- independent national processes of verifying/assessing status of communicable

disease control or performance of public health system.