Over the past three decades, the Global Polio Eradication Initiative (GPEI) has built a network of thousands of well trained staff and a massive surveillance, social mobilisation and vaccine delivery infrastructure, and has learned valuable lessons about reaching the most vulnerable and hard-to-reach populations on earth.This infrastructure already goes much further than polio eradication by supporting routine immunization, disease surveillance, and more.
National governments and the partners of the GPEI are acting now to plan for the future after polio. While some aspects of the infrastructure will be ramped down, others will be incorporated to help maintain a polio-free world. Some of the infrastructure already supporting other health programmes will be transitioned across, to reduce any risk from the closure of the polio eradication programme. And some assets will be used to help strengthen other health programmes so that the investments made in polio eradication can address other health needs for many years to come.
What Is Transition Planning?
There are three main objectives to post-polio transition planning:
By ensuring that crucial areas of work such as surveillance, containment and vaccination continue by mainstreaming them in to continuing systems.
Eradicating polio will be an incredible public health achievement, meaning that it can never return. Yet in the years immediately after eradication, some essential functions will need to continue in order to maintain a polio-free world and protect against any threats to a polio-free status. This includes immunization, surveillance, preparedness for outbreak response, and biocontainment in laboratories and vaccine manufacturing facilities. Stakeholders in polio eradication, driven by countries, must ensure these functions are mainstreamed into ongoing public health programmes so that they continue to sustain polio eradication after global certification.
Of the end of the Global Polio Eradication Initiative. Where staff, infrastructure and funding from the polio programme are supporting other health services, we need to plan now for the ramp down to reduce the impact.
The knowledge, skills and infrastructure built up over three decades to end polio are already having broader benefits for the health of communities. In some of the most vulnerable countries, polio staff provide technical assistance for routine immunization, surveillance for other diseases, and reach hundreds of millions of children with other health interventions alongside polio vaccines. When the polio eradication funding infrastructure ends, there will be the risk of losing momentum in these areas alongside the loss of staff, expertise and infrastructure.
If transition planning is not done properly, this loss of capacity could have adverse effects on other health programmes. The global health community must come together to transition some of the polio eradication assets providing most benefits to continuing health needs in countries so that they can continue to improve health sustainably for years to come.
So they can continue benefiting other health initiatives once eradication has been achieved.
This end of polio risk also presents an opportunity. The investments made in to stopping polio including funding, strong international commitment and an incredible social movement of more than 20 million people – have enabled the GPEI to amass a vast infrastructure of staff, surveillance networks, communication know-how, capacity building capabilities, laboratories, and logistic networks.
After polio eradication we have an opportunity to make these investments continue to go further to make a sustainable difference to other health goals. The GPEI is currently funding:
- Millions of community based health workers, social mobilisers and volunteers
- Thousands of skilled staff
- A global disease surveillance system and a network of 146 polio laboratories
- A far-reaching vaccine supply and logistics network
After polio eradication has been achieved and these assets and infrastructure are no longer needed by the GPEI, the questions will become:
How do we safeguard the polio-free world for the future?
How can we use these strong assets to strengthen health systems, contribute to global health security, ensure equitable immunization coverage, and more?
And what are the lessons learned through polio eradication that should be documented, shared with and used by other health programmes?
How to Transition the Polio Assets
To make the most of this opportunity for the polio eradication infrastructure to continue contributing to broader health goals, a wide variety of stakeholders from country governments, donors, civil society, other health programmes and the partners of the GPEI will need to work together to identify the areas of overlap between global and country health needs, and the assets that the GPEI has to offer.
Transitioning in countries with significant polio eradication infrastructure
Stakeholders such as Ministries of Health, GPEI and non-GPEI partners and other health programmes are mapping polio funded assets and country health needs to develop a strategy for how to responsibly transition the assets that are needed to maintain a polio-free world, to guard against the risks of the loss of the infrastructure and to seize the opportunity to make a sustainable difference to global health in the future.
Global transition planning
Not all of the assets that could be transitioned are at a country level. The partnership of the GPEI has been strong and effective; and while it will be scaled down, the close partnership between WHO, UNICEF, CDC, Rotary International and the Bill & Melinda Gates Foundation and many more should continue into the future to help meet other goals. Transition planning at the global level will work to ensure these relationships continue, and that new partners, including donors, are encouraged to join in partnership for the maximum global health benefits.
Aspects of the global transition planning process will include disease surveillance, outbreak response,global health security and routine immunization, so that the functions that need to be continued to safeguard eradication are mainstreamed into other global programmes.
Documenting and sharing lessons learned from polio eradication
Following three decades of efforts to eradicate polio, a key component of transition planning is capturing and sharing the lessons of polio eradication for the benefit of other health programmes.Transitioning the intellectual assets is just as important of a task as transitioning the people and infrastructure, since the polio programme has learned many lessons in reaching the hardest-to-reach, working in conflict affected areas, harnessing global commitment and in many other areas.