News Category: Financing and donors

H.E. Minister of Public Health of Afghanistan Mawlawi Noor Jalal Jalali chairs the TAG meeting in Afghanistan on 19 February 2025. ©WHO Afghanistan

The Technical Advisory Group (TAG) on polio eradication convened in Kabul on 19 and 20 February to review Afghanistan’s modified strategy for optimizing site-to-site vaccination campaigns and the challenges in interrupting wild poliovirus (WPV1) transmission. This marked the first in-country TAG meeting in seven years, highlighting the urgency of protecting hard-won gains and addressing ongoing risks. TAG welcomed the strong commitment of the Honorable Minister of Public Health, national leadership, and the entire Afghanistan polio eradication team.

TAG endorsed the programme’s ‘Strategic Reset’ to optimize site-to-site vaccination while stressing the need for stronger leadership, community acceptance, and broad government engagement. The group highlighted the importance of bringing vaccination services closer to communities, tracking and reducing missed children, and encouraging families to access vaccination sites through better community engagement. TAG also urged the full mobilization of government institutions to provide administrative and political support, while leveraging polio assets to strengthen routine immunization in high-risk areas.

Progress and challenges

Afghanistan remains one of the last two polio-endemic countries, with WPV1 transmission persisting in the southern corridor, a key epidemiological route where population movement between Afghanistan’s southern provinces and neighboring Pakistan continues to facilitate virus spread.

However, encouraging progress has been made in the eastern region, where sustained efforts have reduced cases and environmental detections. TAG highlighted this as a critical opportunity to stop endemic transmission in the East while calling for urgent measures to contain the outbreak in the South and prevent further spread.

The shift from house-to-house to site-to-site vaccination has increased the number of missed children, particularly in high-risk areas. Population movement, operational constraints, and limited community engagement have also posed challenges. TAG emphasized the need for stronger local leadership, consistent programme implementation across all provinces, and measures to prevent disruptions by local authorities.

TAG’s key recommendations

To ensure progress, TAG set clear epidemiological and operational targets. By mid-2025, the goal is to eliminate persistent virus lineages in the East, prevent new WPV1 cases in the East and South Regions, achieve a decline in environmental detections in the South, and prevent local transmission in other parts of the country.

Immediate actions in the South include full engagement of provincial and district governors, public health leaders, and religious figures to create an enabling environment. Community-based mobilization should track and reduce missed children, and a six-month plan to introduce ‘Pluses’ (such as soap and diapers) should be implemented to improve vaccine uptake. Additionally, vaccination campaigns must improve to ensure at least 80% of surveyed areas meet quality standards by June 2025. 

A critical moment for eradication

Despite the challenges, Afghanistan has a unique opportunity to end polio transmission by the end of 2025. However, success hinges on strong national and provincial leadership, sustained government commitment, and full coordination with regional partners, particularly Pakistan. TAG called for an ‘All of Government and All of Society’ approach to ensure uniform support and prevent funding shortages from undermining progress.

With continued effort and commitment, Afghanistan can move closer to a polio-free future. TAG urged all stakeholders to act decisively in this critical window of opportunity to protect every child from polio once and for all.

L-R: Dr. Sania Nishtar, CEO of Gavi, the Vaccine Alliance; Catherine Russell, Executive Director of UNICEF;  H.E. Dr. Abdullah al Rabeeah, Supervisor General of King Salman Relief and Humanitarian Centre, Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization;  Dr. Chris Elias, President of Global Development at the Gates Foundation and Chair of the Polio Oversight Board; and Aziz Memon, Pakistan Polio Plus Chair, Rotary International, on stage at the Riyadh International Humanitarian Forum.

RIYADH (24 February 2025) – The Kingdom of Saudi Arabia today reaffirmed its US$ 500 million pledge to the Global Polio Eradication Initiative (GPEI) in a signing event during the fourth Riyadh International Humanitarian Forum.

H.E. Dr. Abdullah al Rabeeah, Supervisor General of King Salman Relief and Humanitarian Centre, was joined by Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization; Catherine Russell, Executive Director of UNICEF; Dr. Sania Nishtar, CEO of Gavi, the Vaccine Alliance; Dr. Chris Elias, President of Global Development at the Gates Foundation and Chair of the Polio Oversight Board; and Aziz Memon, Pakistan Polio Plus Chair, Rotary International, to sign an agreement that will help the GPEI and its partners to reach 370 million children with polio vaccines each year and stop transmission of the virus for good. The funds were initially pledged in April 2024 at the first-ever World Economic Forum Special Meeting hosted in Riyadh.

“The world is on the path to eradicating polio once and for all, and the Kingdom of Saudi Arabia is proud to be part of this global initiative,” said H.E. Dr. Abdullah al Rabeeah. “The Kingdom’s contribution will go toward the important work of protecting the most vulnerable children of today so that the generations of tomorrow can live free from this preventable disease.”

As a result of decades of leadership from GPEI partners, generous support from donors and the commitment of affected countries, polio cases have fallen by over 99% since the GPEI was founded in 1988. More than 20 million people are walking today who would otherwise have been paralyzed by the virus. But fraught humanitarian crises – from parts of Pakistan and Afghanistan to Somalia and Yemen – have allowed the virus to continue paralyzing the world’s most vulnerable children. In 2024, the virus returned to Gaza in the occupied Palestinian territory after 25 years to paralyze a child, a cruel reminder that as long as polio exists anywhere, children everywhere will remain at risk.

“We have come so far in our shared mission to consign polio to history, but the last mile is the hardest,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Finishing the job requires unwavering determination, and this generous contribution from the Kingdom of Saudi Arabia will help us to reach children in conflict-affected and other difficult-to-reach areas as we work together to realize our vision of a polio-free world.”

“As we saw in Gaza last year, the hard-won gains of the global eradication effort are fragile if vaccination rates are allowed to drop. With the support of committed partners like the Kingdom of Saudi Arabia, we can better reach every child with life-saving vaccination and end polio, once and for all,” said UNICEF Executive Director Catherine Russell.

Today, governments and health workers, with support from the GPEI, are adapting to deliver polio vaccinations and other essential health services within humanitarian crises, while also strengthening health systems to bolster efforts in fragile contexts. Every commitment toward fully funding the GPEI’s extended 2022-2029 Strategy helps make this critical work possible.

“Just a few decades ago, polio paralyzed 350,000 children each year. In 2023, that number dropped to just 12 – a testament to the unwavering commitment of countries and partners worldwide. The world is at the brink of finally eradicating this deadly disease, but reaching the finish line will require continued global leadership and support,” said Bill Gates, chair of the Gates Foundation. “Thanks to this generous contribution from the Kingdom of Saudi Arabia, alongside long-standing efforts of many nations, we are one step closer to a polio-free world.”

Following the signing, H.E. Dr. Abdullah al Rabeeah will join GPEI and other global leaders and health advocates for a panel discussion on the importance of reaching all children with polio vaccines, eradicating the disease for good and improving global health security.

Additional partner quotes

Mike McGovern, International PolioPlus Chair, Rotary International: “Saudi Arabia’s $500 million contribution is a pivotal step in our mission to eradicate polio. This funding will enable Rotarians and health workers to intensify their efforts in reaching every child, ensuring that no one is left vulnerable to this preventable disease.”

Dr. Sania Nishtar, CEO, Gavi: “Strengthening global immunization efforts is crucial to protecting children from preventable diseases. By enhancing immunization, we can ensure that children everywhere are safeguarded against a range of illnesses, including polio, and move closer to a healthier, more resilient world.”

For media inquiries: Jacob Baskes (jbaskes@globalhealthstragies.com)

 

About the Global Polio Eradication Initiative (GPEI)

The Global Polio Eradication Initiative is a public-private partnership, spearheaded by national governments, WHO, Rotary International, the US Centers for Disease Control and Prevention, UNICEF, the Gates Foundation and Gavi, the Vaccine Alliance. Since its launch in 1988, this partnership has helped prevent more than 20 million cases of paralysis, prevented more than 1.5 million childhood deaths and reduced the incidence of wild poliovirus by 99.9 percent.


WHO Executive Board, Geneva, Switzerland, 7 February 2025 – Health ministries from around the world meeting at this week’s WHO Executive Board in Geneva expressed serious concern about increasing wild poliovirus transmission in the last two remaining endemic countries, Pakistan and Afghanistan, noting that extraordinary measures were going on in response.

The year 2024 saw an increase in virus transmission in both countries, which share the last remaining endemic wild poliovirus reservoir in the world.  WHO Member States commended the new emergency operational approaches being now implemented in both countries to turn the tide on this trend.  These approaches include identifying the different operational reasons why children are not being reached, area by area; increasing co-administration of inactivated polio vaccine (IPV) alongside oral polio vaccine (OPV); boosting overall immunity levels in children; and, improving access to more adequate sanitation infrastructures.

These measures reflect the unique environmental, geopolitical, programmatic and security challenges affecting both countries, which together essentially create an epidemiological ‘perfect storm’ for poliovirus transmission.  These approaches must be underpinned by strengthened surveillance activities not just in highest-risk areas, but comprehensively across all areas of both countries, and doing more to protect polio-free areas, particularly in critical border areas, and among highly mobile population groups, in particular in three clearly identified ‘virus transmission corridors’ affecting both countries.

Speaking on behalf of the Eastern Mediterranean Region, Regional Director Dr Hanan Balkhy said: “I assure you, on behalf of our Region and the leaders of both endemic countries, our commitment to eradicating this virus is stronger than ever.  We must reach and vaccinate every child and keep up a robust search for poliovirus, to stop further spread. Achieving this is far from simple. Pakistan and Afghanistan face immense geopolitical, infrastructural, environmental, and security challenges, creating what many describe as a ‘perfect storm’ for poliovirus transmission. Still, none of these challenges are insurmountable.”

“In Gaza,” Balkhy continued, “during a humanitarian pause last year, over 600,000 children were vaccinated against polio amid conflict – largely thanks to multi-actor, multi-level coordination and health and community workers’ grit. If it can be done there, it can be done everywhere.  Recently, leaders and experts from both endemic countries convened to develop emergency measures. Together, they outlined concrete steps to reach every child, no matter the obstacles, to tackle this virus resurgence and protect them. We deeply appreciate the international community’s steadfast support, and we ask for your continued assistance to get us across the finish line.”

Member States expressed concern about the ongoing variant poliovirus outbreaks (circulating vaccine-derived polioviruses) and urged intensified response to stop these outbreaks, including by maximizing the impact of novel oral polio vaccine type 2.  While the engines of transmission for such strains are now in clearly identified areas, namely northern Nigeria, eastern Democratic Republic of the Congo, south-central Somalia and northern Yemen, Member States underscored all countries remain at risk as evidenced by recent detection of such strains in environmental samples in five European countries.

“We all need to be very clear about one thing:  the global effort to eradicate polio is no longer a technical issue,” commented Dr Razia Pendse, WHO Chef de Cabinet to the Director-General.  “Medically and technically, we have everything we need to achieve success.  What we need, the only thing we need, is to be able to reach and vaccinate those last remaining children who are not yet fully vaccinated.  And the answer to achieving this is entirely geopolitical.”

The meeting also emphasized the importance of strengthening routine immunization services and disease surveillance everywhere, done in close coordination with all partners, including Gavi, the Vaccine Alliance.

Health authorities emphasized the importance of implementing all activities to not only achieve a polio-free world, but also to sustain it through integrating and successfully transitioning the polio assets, tools and infrastructure into existing national health systems and to help build strong, resilient and equitable health systems, and preparing for the post-certification era through intensified and accelerated containment activities and eventual cessation of oral polio vaccines use from routine immunization programmes. Successful development of an appropriate post-certification strategy will be critical to achieve this.

Closing the discussions, Rotary International, the civil society partner of the Global Polio Eradication Initiative, called for steadfast dedication to the effort.  “We have overcome every setback through collaboration and unity of purpose that is rare in our fragmented world,” said Dr Pierre Hoffmeyer, Rotary International representative to the United Nations in Geneva.  “Let us all remain united and unwavering in our commitment to end polio.”

Islamabad, Pakistan, 26 January 2025 – In the face of increasing wild poliovirus transmission in the last two remaining endemic countries, Pakistan and Afghanistan, global health experts gathered in Islamabad last week to evaluate measures to urgently reverse the epidemiological trend.  

The Technical Advisory Group (TAG) meeting on polio eradication came at a critical time for Pakistan, as the country faces a resurgence of wild poliovirus (WPV1) cases and a narrowing window to interrupt transmission by the end of 2025. With 73 WPV cases reported in 2024 compared to just six in 2023, and a significant increase in environmental detections across historic poliovirus reservoirs like Karachi, Peshawar, and Quetta, and beyond, the pressure to demonstrate results has never been greater. The meeting underscored the urgent need for extraordinary efforts and emergency operational measures to get the programme back on track and restore national and international confidence in the success of the longstanding effort.  

The Technical Advisory Group was convened by the WHO Regional Director for the Eastern Mediterranean Dr Hanan Balkhy on behalf of Member States and the GEPI partners. In her opening remarks, she emphasized the importance of reaching children being missed, particularly in insecure, underserved, high-risk areas and among migrant and mobile populations. 

Targeting persistent challenges 

The group highlighted the need to focus on areas where the virus has returned or continues to spread, particularly in parts of southern Khyber Pakhtunkhwa, central Pakistan, and urban centers. New approaches are required to ensure every child is reached, especially in areas where security issues and logistical challenges make vaccination campaigns difficult. While progress has been made in certain areas, more needs to be done to ensure high-quality vaccination campaigns and close gaps where children are being missed. 

Experts outlined specific milestones that must be achieved by mid-2025 to reverse the widespread poliovirus transmission: 

  • Interrupt polio transmission in the northern corridor (Peshawar Bloc), in the central Pakistan zone (northern Sindh, southern Punjab, eastern Baluchistan), and across Lahore, Rawalpindi and Islamabad. 
  • Substantially reduce the presence of the virus in environmental samples in Karachi, the Quetta Bloc and southern Khyber Pakhtunkhwa. 
  • Prevent further outbreaks in any areas that have recently detected or will detect poliovirus. 

The next six months are considered critical for making progress, with efforts focused on delivering effective vaccination campaigns and addressing challenges in hard-to-reach areas. 

Improving campaign quality to reach missed children 

To meet these ambitious targets, the quality of vaccination campaigns must improve to reach children who continue to be missed. Missing children repeatedly remains the single largest challenge for the programme. Pakistan’s current implementation of the “2-4-6 strategy” should continue focusing on strengthening programme management and accountability, enhancing the quality of Supplementary Immunization Activities (SIAs), and improving access to children in areas affected by insecurity. 

Significant interventions, innovations, and assessments have been introduced under this strategy. However, the improvements have not yet translated into better SIA quality. Ensuring access to all children, particularly in high-risk areas of Khyber Pakhtunkhwa, is essential to getting the programme back on track. Additionally, special attention must be paid to mobile and migrant populations (MMPs) and to maintaining high-quality immunization efforts in border districts where the virus risks being sustained. 

The TAG recommended specific benchmarks of quality and indicators of missed children that the programme must meet to achieve the recommended milestones for reversing poliovirus transmission trends by June 2025. 

Opportunities for progress 

Despite these challenges, there are significant opportunities for Pakistan to make strong progress in 2025. With committed political and administrative leadership, enhanced security support, and especially the Prime Minister’s regular Stock Takes, the programme can capitalize on this momentum to build a national movement for the “last push.” 

Other key areas of focus include improving the morale and motivation of frontline workers, expanding routine immunization coverage through the EPI, and leveraging the Big Catch Up campaigns to address gaps in immunization. 

A review in June 2025 will assess the programme’s trajectory and identify any urgent course corrections needed to sustain progress. The close interdependence between Pakistan and Afghanistan in eradicating polio further underscores the need for cross-border collaboration. As one country’s progress influences the other, maintaining high-quality efforts in border areas will be critical. The next TAG meeting for Afghanistan, planned for February, will further align strategies to tackle these shared challenges. 

At the TAG meeting, Madam Ayesha Raza Farooq, the Prime Minister’s Focal Person on Polio Eradication in Pakistan, emphasized the solidarity of the Global Polio Eradication Initiative (GPEI) with countries striving to protect future generations from polio. She highlighted the importance of collaboration among partners, governments, civil society, religious leaders, and frontline workers to overcome challenges and ensure that no child is left behind on the path to a polio-free Pakistan.

“Like the moon landing, polio eradication is a challenge that tests our collective resolve and compels us to achieve the extraordinary,” said Dr Mike Ryan, Executive Director of WHO’s Health Emergencies Programme and Deputy Director-General of WHO, speaking at the TAG meeting. “The last mile is the hardest. It’s the least crowded mile, full of risks and failures waiting to confront you. But it is also where true determination and resilience shine. I have every confidence that Pakistan, alongside Afghanistan, will achieve polio eradication. Together, you will land on the moon,” he added. 

A doctor and surveillance volunteer checks a child for signs of paralysis in a clinic in Shawalikot district, Afghanistan. ©WHO / Jawad Jalali
A doctor and surveillance volunteer checks a child for signs of paralysis in a clinic in Shawalikot district, Afghanistan. ©WHO / Jawad Jalali

The year 2024 has not been an easy one for polio eradication, with an increase in wild poliovirus transmission in the remaining two endemic countries and new and high-profile outbreaks including in Gaza. And yet global commitment to polio eradication remains as high as ever.

From community groups to G7 leaders, the determination to complete polio eradication goes beyond the health sector.  Political, multi-lateral fora including the Leaders and Health Ministers from the G7 and G20, and the Commonwealth, all underscored the opportunity we have in ridding the world of polio once and for all.  Countries, bilateral institutions and oversight and advisory groups, ranging from the World Health Assembly, to Regional Committees and the Eastern Mediterranean Regional Sub-committee for Polio Eradication and Outbreaks, to the African Regional Certification Committee for Poliomyelitis Eradication, all continue to voice their support to the global eradication effort.  Such support is echoed by civil society and communities, led by Rotary International and Rotarians from around the world.  Youth delegates at the inaugural in-person meeting of the Model WHO brought new generations to this quest.

G7 Leaders: “We recommit to ending… neglected tropical diseases and polio as public health threats…”

G7 Health Ministers: “We recommit to ending… polio. We also commend the Global Polio Eradication Initiative’s efforts to eradicate polio and call for keeping the efforts strong in order to reach eradication before 2030.”

Commonwealth Summit: “Heads urged for increased global and national efforts… to eradicate polio…”

G20 Leaders:  “We also reaffirm our commitment to ending the epidemics of AIDS, tuberculosis, malaria and for polio eradication.

G20 Health Ministers: “We also reaffirm our commitment to ending the epidemics of AIDS, tuberculosis, malaria and for polio eradication.”

Such political support across all levels is critical to securing success, as the challenges to global eradication are now primarily a geopolitical.  Medically and  technically, everything is in place to achieve success.  The key lies in reaching all remaining children who have not yet been fully vaccinated, and the answer to those challenges lies squarely in political will. As one delegate at the recently-held Model WHO said:  “Rain does not fall on a single house alone.  If we can reach children in Gaza given the current situation, we can reach children anywhere.”

On 13 November 2024, the GPEI held a virtual briefing with polio experts from around the world during which they discussed pressing challenges and inspiring progress toward ending polio everywhere. Over 250 attendees from 87 countries tuned in. You can watch the full recording of the event below.

 

WHO hosts the first in-person Global Model, a youth led simulation on the World Health Assembly, on 1 November 2024 at WHO Headquarters in Geneva, Switzerland.

Geneva, Switzerland, November 2024 – At the first in-person Global Model World Health Organization (GMWHO), held from 29 October to 1 November 2024 at WHO headquarters in Geneva, youth delegates in a simulated exercise representing Member States from around the world adopted a critical resolution laying out a clear roadmap to achieving and securing a polio-free world.  The GMWHO was jointly organized by WHO and the World Federation of United Nations Associations (WFUNA), to provide an authentic simulation of the World Health Assembly and the work of WHO for youth delegates from around the world.

Amid a myriad of global public health topics, youth delegates discussed the urgent need to eradicate polio, and adopted simulated resolution GMWHO WHA2.5 in Committee A5, focusing on the needs to overcome remaining geopolitical challenges to achieving and sustaining a polio-free world.  Youth delegates from across the world focused their discussions on the need to reach marginalized, vulnerable populations, ensuring sustained funding for the effort, strengthening disease surveillance, minimizing the risk of spread of both wild or variant polioviruses, and ensuring containment for polioviruses, among other aspects.  In particular, youth delegates called for the need for peace around the world, to reach some of the most marginalized communities with not just polio vaccine, but indeed broader public health interventions, quoting WHO Director-General Dr Tedros Adhanom Ghebreyesus that “peace is the best medicine.”

The resolution was unanimously adopted in Committee A5, by delegates representing about 50 Member States, on behalf of the entire GMWHO. Prior to formal adoption of the resolution, youth delegates from more than 30 Member States took to the floor to express support to achieving a world free of polio.  “There is a saying in our country:  rain does not fall on one roof alone,” said the distinguished delegate of Cameroon, speaking on behalf of the WHO African Region, meaning that achieving a global public good required the full engagement of every single country and government.

“The entire Global Model WHO was an amazing experience, both for myself as Chair of Committee A5, and more importantly, for our youth delegates from around the world,” said Caroline Knop, Chair of Committee A5 and medical student at Charité in Berlin, Germany.  “Everyone got a real sense of what it takes to achieve consensus for global health topics, and – more importantly – for what it takes to then implement this consensus.  It was a huge learning experience for all, and I think everyone very much appreciated the entire event.”

“On behalf of the GPEI, I would like to thank WHO, WFUNA and most importantly all youth delegates in making polio eradication a part of this exciting programme,” commented Dr Arshad Quddus, chief epidemiologist for polio eradication at WHO.  “I was extremely impressed by the level of knowledge and engagement youth delegates displayed, in clearly summarizing very complex challenges and solutions to achieving success, as illustrated in their adopted resolution.  The youth delegates collaborated closely together, working in the spirit of global solidarity and consensus.  The resulting resolution, even though of course simulated, actually very clearly outlines a roadmap to not only achieving a polio-free world, but indeed sustaining it.  As a global community, we should endeavour to fully implement this simulated resolution.  It was a pleasure engaging with this group, who are after all the future leaders of international development.  Clearly, our future is in very safe hands with these young and energetic professionals at the helm.”

View a video of the Model WHO.

The second round of the polio vaccination campaign in the Gaza Strip was completed yesterday, with an overall 556 774 children under the age of 10 being vaccinated with a second dose of polio vaccine, and 448 425 children between 2- to 10-years-old receiving vitamin A, following the three phases conducted in the last weeks.

Administrative data confirm around 94% of the target population of 591 714 children under the age of 10 years received a second dose of nOPV2 across the Gaza Strip, which is a remarkable achievement given the extremely difficult circumstances the campaign was executed under. The campaign achieved 103% and 91% coverage in central and southern Gaza, respectively. However, in northern Gaza, where the campaign was compromised due to lack of access, approximately 88% coverage was achieved according to preliminary data. An estimated 7000-10 000 children in inaccessible areas like Jabalia, Beit Lahiya and Beit Hanoun remain unvaccinated and vulnerable to the poliovirus. This also increases the risk of further spread of poliovirus in the Gaza Strip and neighbouring countries.

The end of this second round concludes the polio vaccination campaign launched in September 2024. This round also took place in three phases across central, south and northern Gaza under area-specific humanitarian pauses. While the first two phases proceeded as planned, the third phase in northern Gaza had to be temporarily postponed on 23 October because of intense bombardments, mass displacements, lack of assured humanitarian pauses and access.

After careful assessment of the situation by the technical committee, comprising the Palestinian Ministry of Health, World Health Organization (WHO), United Nations Children’s Fund (UNICEF), and the United Nations Relief and Works Agency for Palestine Refugees (UNRWA), the campaign resumed on 2 November. However, the area under the assured humanitarian pauses comprising the campaign was substantially reduced, compared to the first round, as the access was limited to Gaza City. Due to hostilities, more than 150 000 people were forced to evacuate from North Gaza to Gaza City, which helped in accessing more children than anticipated.

Despite these challenges, and thanks to the tremendous dedication, engagement and courage of parents, children, communities and health workers, the phase in northern Gaza was completed.

At least two doses and a minimum of 90% vaccination coverage are needed in each community to stop circulation of the polio strain affecting Gaza. Efforts will now continue to boost immunity levels through routine immunization services offered at functional health facilities and to strengthen disease surveillance to rapidly detect any further poliovirus transmission (either in affected children or in environmental samples). The evolving epidemiology will determine if further outbreak response may be necessary.

To fully implement surveillance and routine immunization services, not just for polio but for all vaccine-preventable diseases, WHO and UNICEF continue to call for a ceasefire. Further, apart from the attack on the primary healthcare centre, the campaign underscores what can be achieved with humanitarian pauses. These actions must be systematically applied beyond the polio emergency response efforts to other health and humanitarian interventions to respond to dire needs.

Jerusalem/Amman/Geneva/New York, 1 November 2024 - “A third phase of the polio vaccination campaign is set to begin tomorrow in part of the northern Gaza Strip after being postponed from 23 October 2024 due to lack of access and assured, comprehensive humanitarian pauses, intense bombardment, and mass evacuation orders. These conditions made it impossible for families to safely bring their children for vaccination and for perform their duties

“The humanitarian pause necessary to conduct the campaign has been assured, however, the area of the pause has been substantially reduced compared to the first round of vaccination in northern Gaza, conducted in September 2024. It is now limited to just Gaza City. Though in the past few weeks, at least 100,000 people have been forced to evacuate from North Gaza towards Gaza City for safety, around 15,000 children under ten years in towns in North Gaza like Jabalia, Beit Lahiya and Beit Hanoun still remain inaccessible and will be missed during the campaign, compromising its effectiveness. To interrupt poliovirus transmission, at least 90% of all children in every community and neighborhood must be vaccinated, which will be challenging to achieve given the situation.

“The final phase of the campaign had aimed to reach an estimated 119,000 children under ten years old in northern Gaza with a second dose of novel oral polio vaccine type 2 (nOPV2). However, achieving this target is now unlikely due to access constraints.

Despite the lack of access to all eligible children in northern Gaza, the Polio Technical Committee for Gaza, including the Palestinian Ministry of Health, World Health Organization (WHO), United Nations Children’s Fund (UNICEF), the United Nations Relief and Works Agency for Palestine Refugees (UNRWA) and partners has taken the decision to resume the campaign. This aims to to mitigate the risk of a long delay in reaching as many children as possible with polio vaccine and the opportunity to vaccinate those recently evacuated to Gaza City from other parts of North Gaza.

“To overcome challenges posed by the volatile security situation and constant population movement, robust micro plans have been developed to ensure the campaign is responsive to the significant population shifts and displacement in the north, following the first round in September. The campaign will be delivered by 216 teams across 106 fixed sites, 22 of which have been added to ensure increased availability of vaccination in areas where recently displaced people are seeking refuge. Two hundred and nine social mobilizers will be deployed to engage communities and raise awareness around vaccination efforts. The time period for the humanitarian pause has been extended by two hours and is expected to run from 6am to 4pm daily. As in the first two phases, vitamin A will also be co-administered to children between two to ten years in the north to help boost overall immunity.

“The campaign in northern Gaza follows the successful implementation of the first two phases of the second round in central and southern Gaza, which reached 451,216 children – 96% of the target in these areas. A total of 364,306 children aged between 2 and 10 years have received vitamin A so far in this round.

“Despite the challenges, WHO and UNICEF urge for the humanitarian pauses to be respected to ensure the successful delivery of this second round of the polio vaccination campaign. This is crucial to help curb the spread of polio in Gaza and neighboring countries.”

BERLIN 17 October 2024 – For more than three and a half decades, governments and health workers, with support from the Global Polio Eradication Initiative (GPEI), have made unprecedented progress toward the promise of a polio-free world. Thanks to these collective efforts, more than 20 million people are walking who would otherwise have been paralyzed by this dreadful disease. Billions of children have been protected with lifesaving immunizations. Five of the six World Health Organization Regions are free from wild poliovirus. 

The work of the polio program is now concentrated in some of the most complicated and fragile settings in which to deliver basic healthcare. Challenges to reaching all children with vaccines are serious, ranging from persistent violence to climate emergencies. The transmission of polio in conflict-affected areas in Gaza, Sudan, and Yemen is a stark reminder that where conflict debilitates health and sanitation systems, polio will inevitably appear unless we eradicate all forms of the virus.  

Recognizing remaining challenges, the GPEI’s Polio Oversight Board (POB) made the difficult but necessary decision in July to extend the timelines needed to achieve polio eradication—to the end of 2027 for wild poliovirus and the end of 2029 for type 2 variant poliovirus. That decision was informed by critical analysis and expert consultations, and extended timelines require additional financial resources to support ongoing eradication activities. 

Yesterday, the POB determined that the total funding needs of the extended 2022-2029 strategic period are US$6.9 billion, an increase from the US$4.8 billion projected for the 2022-2026 strategic period. To date, donors have already committed an incredible US$4.5 billion to the strategy, but US$2.4 billion more is urgently needed to overcome today’s challenges and make polio history. 

Critically, these funds will make possible the urgent and vital tactical shifts in the program’s approach that are necessary to deliver a polio-free world, allowing the GPEI to: 

  • Reach more children with polio vaccines by working with polio-affected country leaders to strengthen program implementation.  
  • Adapt to today’s challenges by deploying innovative tools like novel vaccines and surveillance methods to further strengthen outbreak response. 
  • Hold ourselves to the highest standard by improving accountability at all levels, from global leadership to field managers. 
  • Work with routine immunization programs by integrating polio services wherever possible. 
  • Deepen our relationships with the people we serve by strengthening community engagement. 

These shifts are being driven by the expertise of GPEI partners coupled with a program-wide commitment to double down on the toughest but most critical challenges standing between us and a future without polio. 

Shortcomings in funding or fully carrying out these efforts would come with serious consequences. Without dedicated eradication efforts, within a decade, many thousands of children around the world could once again be paralyzed or die from polio each year. This is an unacceptable future. More than ever, donor and polio-affected country governments must offer their renewed support to prioritize these efforts to reach all children with lifesaving vaccines and strengthen health systems along the way. 

With strengthened support and collaboration, together we can deliver a world where all children, families and communities are forever free from polio. 

 

 

About the Global Polio Eradication Initiative 

The Global Polio Eradication Initiative is a public-private partnership, spearheaded by national governments, WHO, Rotary International, the US Centers for Disease Control and Prevention, UNICEF, the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance. Since its launch in 1988, this partnership has helped prevent more than 20 million cases of paralysis, prevented more than 1.5 million childhood deaths and reduced the incidence of wild poliovirus by 99.9 percent, from more than 350,000 cases in more than 125 endemic countries to just two endemic countries in 2024. 

The Global Polio Eradication Initiative (GPEI) welcomes the 23rd report from the Independent Monitoring Board (IMB), which provides independent assessments of the program to help refine and improve the GPEI’s work. The report presents an analysis of the status of eradication efforts and suggests actions to help accelerate progress toward interruption of wild poliovirus type 1 and to stop all outbreaks of circulating vaccine-derived polioviruses.   

The IMB’s latest report notes the promising decline of types 1 and 2 variant poliovirus cases globally in the past year and the strong regional commitment to eradication throughout the Eastern Mediterranean Region. That said, the program agrees with the IMB’s assessment that progress against variant poliovirus to date is extremely fragile and variable across geographies, and that the recent rise in wild poliovirus detections in Pakistan and Afghanistan is of serious concern. The IMB also rightly recognizes the incredibly complex environments where the virus remains and the external factors impeding the program’s ability to consistently reach children in these places. The GPEI appreciates the board’s frank assessment of management and campaign quality challenges that the program is aware of and proactively working to address.  

As the IMB previews, the GPEI, after critical analysis and expert consultations, has decided to extend the timeline of certifying the eradication of wild polio to 2027 and certifying the elimination of type 2 variant polio to 2029. The GPEI will soon be releasing a document outlining the key tactical shifts that it will implement to enable stronger accountability and ownership across all levels of the program during this period. This also includes a more systematic approach to integrating polio activities with other health services and improving coordination with essential immunization programs to set the foundation to sustain a polio-free world.  

The polio program has successfully adapted and overcome challenges in its history and will continue to do so until polio everywhere is stopped. Since the IMB’s report was published, a coordinated vaccination campaign round reached approximately 560,000 children with the polio vaccine in Gaza. This was an incredible testament to the dedication and bravery of families and health workers and underscores the program’s ability, in coordination with its partners, to reach children with vaccine, even when facing immense obstacles.   

The GPEI appreciates the IMB’s continued scrutiny and shared commitment to achieving a polio-free world. As customary, the program is considering each recommendation carefully and will prepare a full response to be released soon. We will continue working closely with the IMB, polio-affected countries and partners to optimize the polio program’s work, improve vaccination campaigns and disease surveillance, strengthen broader health systems and ultimately ensure no child is paralyzed by polio again. 

23 September 2024 – The Government of Canada continues to demonstrate its commitment and leadership in the fight to eradicate polio, announcing a new contribution of CAN $151 million over the next three years to support the work of the Global Polio Eradication Initiative (GPEI). Canada’s Minister of International Development, the Hon. Ahmed Hussen, formally announced Canada’s next pledge to the GPEI at a Rotary regional conference in Toronto, Ontario on 20 September to an audience of Rotary club members and civic leaders from across Canada and the United States.

Canada has been a leading supporter of the global polio eradication effort since its inception and across successive governments, helping the GPEI reduce cases globally by over 99% and prevent more than 20 million cases of paralysis from polio. This most recent funding, which brings Canada’s total contributions to the GPEI to more than CAN $1 billion, will support the GPEI’s ongoing efforts in immunizing 370 million children annually. Canada’s overall contribution has also helped build and will ensure the continuation of increasingly important health infrastructure in some of the most vulnerable regions of the world. In addition to vaccinating children against polio, this infrastructure also delivers other essential health services, including critical surveillance and tracking systems.

“Building on Canada’s leadership in global health, today’s investment will strengthen our partnership with the Global Polio Eradication Initiative. By protecting children who are most at risk from this preventable disease and providing support for health workers at the forefront of this effort, we will be one step closer to eradicating polio,” said Ahmed Hussen PC MP, Minister of International Development for the Government of Canada.

“Rotary members in Canada and throughout the world are thrilled to welcome this new investment to the Global Polio Eradication Initiative,” said Jennifer Jones, a Canadian citizen who served as the President of Rotary International in 2022-23. “As a founding member of the GPEI, ending polio has been Rotary’s top priority since the very beginning, and the Canadian government has been with us every step of the way. With the finish line so close, every contribution to the global effort is a critical step towards a world without polio for children everywhere.”

Today, polio continues to spread in some of the most challenging places in the world to deliver health services, like Gaza, where variant poliovirus recently paralyzed a child for the first time in 25 years. The final two countries where the wild poliovirus remains endemic are Afghanistan and Pakistan. The GPEI is continuing to adapt its approach to reach every child with polio vaccines and other essential health services in these and other affected countries that are challenged by setbacks in routine immunization, security threats and climate catastrophes.

“We welcome this generous contribution from the Government of Canada towards our efforts to deliver a polio-free future,” said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “These funds will help the GPEI reach communities with polio vaccines, including in some of the most marginalized populations of the world, and bring us closer to our goal of eradicating this disease once and for all.”

“Canada’s support to GPEI is instrumental in protecting the lives of millions of children around the world against polio,” said Catherine Russell, Executive Director of UNICEF. “With the continuing commitment of our donors, and all partners in the polio program, we can deliver a world where no child has to live in fear of this disease.”

Ramesh Ferris, a polio survivor, Rotary member, Global Citizen, endurance athlete, and international immunization advocate, thanked Minister Hussen with a show of appreciation from Team End Polio—a world-class roster of athletes, global leaders, and polio eradication supporters united for a polio-free future.  “As a Canadian, I am thrilled to welcome Minister Hussen as a key supporter of Team End Polio,” Ferris said. “Teamwork makes the dream work. By continuing to work together on the same team to end polio, our global community will see the dream of a polio-free world become a reality.”

Later this week, the GPEI will recognize this contribution from Canada during a dialogue on equitable immunization on the sidelines of the 79th UN General Assembly, in front of an audience of GPEI partners, donors, and other leading voices in global health.

 

For media inquiries, please contact:

Rotary International: Jennifer Jones, +1 (519) 818-2255; JenniferJones@Rotary.org

Global Polio Eradication Initiative: Jacob Baskes, jbaskes@globalhealhstrategies.com

Global Affairs Canada: media@international.gc.ca

Over 187 000 children under ten years of age were vaccinated with novel oral polio vaccine type 2 (nOPV2) in central Gaza during the first phase of a two-round polio vaccination campaign, conducted between 1–3 September 2024. Vaccination coverage in this phase exceeded the initial estimated target of 157 000 children due to population movement towards central Gaza, and expanded coverage in areas outside the humanitarian pause zone.

To ensure no child is missed in this area, polio vaccination will continue at four large health facilities in central Gaza over the next few days. Vaccine doses have been supplied to these sites to meet any additional needs.

“It has been extremely encouraging to see thousands of children being able to access polio vaccines, with the support of their resilient families and courageous health workers, despite the deplorable conditions they have braved over the last 11 months. All parties respected the humanitarian pause and we hope to see this positive momentum continue,” said Dr Richard Peeperkorn, WHO Representative for the occupied Palestinian territory.

The first phase of the campaign was conducted by 513 teams, consisting of over 2180 health and community outreach workers. Vaccination was provided at 143 fixed sites, including hospitals, medical points, primary care centres, camps where displaced people are living, key public gathering spaces such as temporary learning spaces, food and water distribution points, and transit routes leading from central towards northern and southern Gaza. Additionally, mobile teams visited tents and hard to-reach areas to ensure they reached families who were unable to visit fixed sites. The presence of a substantial number of children eligible for vaccination who were unable to reach vaccination sites due to insecurity, necessitated special missions to Al-Maghazi, Al-Bureij and Al-Mussader – areas just outside of the agreed zone for the humanitarian pause.

Preparations are underway to roll out the next phase of the campaign, which will be conducted in southern Gaza from 5–8 September 2024, targeting an estimated 340 000 children below ten years of age. Some 517 teams, including 384 mobile teams, will be deployed. Nearly 300 community outreach workers have already begun outreach to families in southern Gaza to raise awareness about the campaign, while 490 vaccine carriers, 90 cold storage boxes, and other supplies have been transferred to Khan Younis for distribution to vaccination sites.

The third and last phase of the polio vaccination campaign will be implemented in northern Gaza from 9–11 September 2024, targeting around 150 000 children.

At least 90% vaccination coverage during each round of the campaign is needed to stop the outbreak, prevent the international spread of polio and reduce the risk of its re-emergence, given the severely disrupted health, water and sanitation systems in the Gaza Strip. Vaccination coverage will be monitored throughout the campaign, and, when necessary, vaccinations will be extended to meet coverage targets as part of flexible strategies to ensure every eligible child receives their vaccine dose.

The two-round campaign, being conducted by the Palestinian Ministry of Health (MOH), in collaboration with the World Health Organization (WHO) and United Nations Children Fund (UNICEF), the United Nations Relief and Works Agency for Palestine Refugees (UNRWA) and many partners, aims to provide two drops of nOPV2 to around 640 000 children during each round.

“The successful delivery of the first phase of the campaign in central Gaza is a culmination of immense coordination among various partners, including the Global Polio Eradication Initiative (GPEI) and donors, and underscores the importance of peace for the health and well-being of people in Gaza. We call on all parties to continue fulfilling their commitment to the humanitarian pauses as the second phase of the campaign begins tomorrow,” said Dr Peeperkorn.

Notes to editors

  • The campaign is part of an urgent response to prevent the spread of polio after circulating variant poliovirus type 2 (cVDPV2) was detected in Gaza, after 25 years of being polio-free. cVDPV2 has been detected in six environmental samples – or wastewater – collected from central Gaza in June 2024. Gaza has reported four cases of children with acute flaccid paralysis (AFP), including one case of confirmed polio in a child who tested positive for circulating variant poliovirus type 2 (cVDPV2). Two of the reported cases tested negative for poliovirus. Laboratory results are pending on samples from the fourth AFP case.
  • Novel oral polio vaccine (nOPV2) is a polio vaccine being used to stop transmission of variant poliovirus type 2 (cVDPV2), currently the most prevalent form of the variant poliovirus.
  • nOPV2 is safe and effective and offers protection against paralysis and community transmission. It is the vaccine globally recommended for variant type 2 poliovirus outbreaks – the type that has been found in the recent samples from Gaza.

It is with great sadness that we wish to inform you of the sudden and tragic passing of Mr Aidan O’Leary, Director for Polio Eradication at WHO.  Aidan passed away suddenly on the evening of Tuesday 6 August, while he was on holiday with his family.

Our thoughts and prayers are at this time with his family – we wish them strength and courage during this difficult period.

Aidan was a true leader, inspiring us all to strive to attain a better world.  Most recently, he was leading our global effort to eradicate polio as Director of the WHO Polio Eradication Programme. But already prior to that, he had been working tirelessly for the betterment of humanity.

Originally from Ireland, Aidan had a wealth of emergencies and public health experience.  Before starting with WHO, Aidan had been serving as Head of Office in Yemen  for the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), a role he had also previously held in Afghanistan and Iraq, as well as Head of OCHA’s Regional Office for the Syria Crisis.

Aidan also demonstrated his deep commitment to supporting some of the world’s most vulnerable people in other emergency settings. This included serving as Deputy Director of Operations for UN Relief and Works Agency for Palestinian Refugees in the Near East (UNRWA) based in Gaza, and Chief of Polio Eradication for UNICEF working in Pakistan and Afghanistan.

On a personal level, Aidan was an extremely personable, open and gentle friend and colleague.  He will be missed deeply both on a professional and on a personal level.

Aiden is survived by his wife and two children who he loved dearly.  On behalf of the GPEI, we wish to extend our heartfelt condolences to Aidan’s family, friends, and colleagues. He will be greatly missed.

As we keep Aidan and his family in our thoughts, our colleagues at CDC worked with the CDC Foundation to establish a dedicated page on which you can contribute to the Bob Keegan Polio Eradication Heroes Fund in Aidan’s memory.  Be sure to check the box where it says, “Dedicate my donation in honor or in memory of someone” and enter Aidan’s name.

Here is the page: Donate to CDC Foundation Impact Campaign

26 July 2024, Cairo, Egypt – Health ministers from across the Eastern Mediterranean Region have united to address the polio emergency in the occupied Palestinian territory. The urgent need for coordinated, collective regional action to combat circulating variant poliovirus type 2 (cVDPV2) in the Gaza Strip was the focus of the 11th meeting of the Regional Subcommittee on Polio Eradication and Outbreaks. WHO Regional Director for the Eastern Mediterranean Dr Hanan Balkhy convened the meeting, held virtually on 25 July 2024.

The confirmation of poliovirus adds to the multiple threats faced today by children in the Gaza Strip, who had access to robust routine vaccination services prior to the war – and raises concerns about the potential for widespread poliovirus transmission and paralytic polio. While an estimated 99% of children in the occupied Palestinian territory received their third dose of polio vaccine in 2022, this fell to 89% in 2023 according to the latest routine immunization estimates by WHO and the United Nations Children’s Fund (UNICEF).

Read more on the WHO EMRO website.

The Strategic Round Table “All for Health, Health for All: the WHO Investment Case, 2025-2028” at the 77th World Health Assembly on 28 May 2024 in Geneva, Switzerland.

Ministers of Health, policy makers and public health experts from around the world met this week at the annual World Health Assembly (WHA) in Geneva, Switzerland, to set global public health policy. Aiming to agree ways forward on issues ranging from reaching all children with vaccines during the year that the world celebrates the 50th anniversary of the EPI programme to dealing with growing antimicrobial resistance and reaching people living in areas of conflict with basic health services, delegates also discussed developments related to the Global Polio Eradication Initiative (GPEI). But why is this important? The decision to eradicate polio was taken long ago by the WHA – so why does it continue to feature on the agenda of the body that governs the World Health Organization?

While the GPEI is composed of six partners, the eradication effort and its strategy are fully owned and implemented by national governments, the Member States of the WHA. WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF, the Gates Foundation and Gavi, the Vaccine Alliance support the global eradication strategy, monitor and evaluate implementation and fine-tune approaches.  Between them, they provide expertise on the ground, scientific research, policy direction, financing, community engagement and advocacy. However, it is governments who are the primary owners of the global eradication effort, and communities who are the primary beneficiaries. All Member States and their populations will benefit equally from a polio-free world. The WHA is the primary convening mechanism for Member States, and the global ownership and decision-making related to polio eradication is taken by the WHA. In short, it is the ultimate and final oversight mechanism of the GPEI.

It started in 1988, when Member States adopted the goal of worldwide polio eradication. But that only marked the beginning of its oversight. Over the years, the WHA has adopted a number of strategic approaches to intensify the eradication effort, endorse new global vaccine solutions including the phased removal of oral polio vaccines (OPV), and to transition the polio assets, tools and knowledge to contribute to broader public health, agree on containment measures needed to safeguard a lasting polio-free world, address the need to minimize the international spread of polioviruses – which culminated in polio eradication being designated a Public Health Emergency of International Concern under the International Health Regulations.

Recognizing the unique nature of an eradication effort, the WHA has requested a comprehensive update on efforts to reach global eradication and to sustain a polio-free world at each annual WHA session (and via its Executive Board, typically held at the beginning of each year). This ensures that polio remains at the top of the global public health agenda, even as new global or regional public health threats emerge. In a demonstration of Member States holding one another accountable, the WHA expects the most up-to-date epidemiological and programmatic reports, a very clear picture of what challenges must be overcome, and who will be responsible to overcome them. This is particularly critical with a highly infectious disease that does not respect international borders.

So it is anything but ‘business as usual’, when Member States at the WHA examine the global polio situation and prospects for success. This year again, despite all the other critical public health issues being discussed, Member States spent time collectively reviewing the situation, examining challenges, celebrating successes and cautioning against complacence. Member States focused their discussions on the remaining endemic wild poliovirus type 1 (WPV1) strains in only a handful of districts of just two countries; reviewed the global emergency related to variant poliovirus type 2 outbreaks, limited to parts of a few countries with the most intense transmission; celebrated the African continent again becoming free of WPV1 following detection in 2022 of an imported poliovirus; called for bolstered integration efforts, and recognized recent announcements of new commitments by long-standing and new partners. Member States also discussed the new strategic framework for polio transition, which builds on lessons learned, and recognized the need for strong ownership and accountability during the polio post-certification era, to sustain a polio-free world.

Rotary International, representing its 1.2 million members worldwide as well as broader civil society, addressed Member States and reiterated its support to all countries in the effort.  Most importantly, Member States unanimously reaffirmed their collected resolve to achieve a lasting polio-free world and committed to fully implementing strategic approaches in all areas, by mobilizing strong support and necessary resources.

“Progress in reducing both wild and variant polio virus in 2023, renewed access in areas critical to polio eradication, and recent investments renew hope and confidence that we will achieve our goal.

We applaud increased collaboration among the GPEI, Gavi and EPI to protect all children from vaccine preventable diseases. Such collaboration is essential to overcome challenges and fulfill the promise of a polio free world while also providing broader essential immunizations and services,” said Professor Pierre Hoffmeyer, Rotary International Representative to the United Nations in Geneva, addressing the WHA.

As GPEI partners, we take this opportunity to express our sincere and deepest gratitude, on behalf of the children of the world, for the WHA’s unwavering commitment to polio eradication. We in turn commit to doing everything we can to support you, the Member States. Together, let us realise the dream first dreamed up by Rotary International, and ensure that no child anywhere will ever again be paralysed by poliovirus.

Brazzaville, May 14, 2024 – Following thorough assessments in Malawi and Mozambique, an independent Polio Outbreak Response Assessment Team (OBRA) today recommended the closure of the wild poliovirus type 1 (WPV1) outbreak in Malawi and Mozambique, marking a significant milestone in the fight against polio in the African region. 

The last WPV1 case in the African Region, linked to a strain circulating in Pakistan, was reported in Mozambique´s Tete Province in August 2022. A total of nine cases were detected in Mozambique and neighbouring Malawi, where the outbreak was declared in February 2022. In a coordinated response, more than 50 million children have been vaccinated to date against the virus in southern Africa. 

The meticulous evaluation carried out by the OBRA team included two in-depth field reviews and supplementary data review, concluding that there is no evidence of ongoing wild polio transmission. The assessment considered the quality of the outbreak response, including the overall population immunity, supplementary immunization campaigns, routine immunization coverage, surveillance systems, vaccine management practices, and the level of community engagement. 

The successful stopping of this outbreak reflects the unwavering commitment and collaborative efforts of African governments, health workers, communities and Global Polio Eradication Initiative (GPEI) partners, including Rotarians on the ground. Through robust surveillance, quality vaccination campaigns and enhanced community engagement, both countries have effectively controlled the spread of the virus, safeguarding the health and well-being of their children. 

“This achievement is a testament to what can be accomplished when we work together with dedication and determination,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “I commend the governments of Malawi and Mozambique, as well as all those involved in the response, for their tireless efforts to contain the outbreak. It is now imperative that we continue to strengthen our immunization systems, enhance surveillance, and reach every child with life-saving vaccines.” 

Health authorities, with high-quality technical support from GPEI, have put in place national prevention strategies in Malawi and Mozambique, as well as in all districts bordering other countries involved in the response. These include Tanzania, Zimbabwe and Zambia. 

To date, more than 100 million vaccine doses have been administered in the most at-risk areas. The strategy to get ahead of this outbreak and stop it before it got out of hand relied on detailed micro-planning, including mapping of cross-border communities, migratory routes, cross-border entry/exit points, and transit routes for each of the cross-border facilities. Synchronization and coordination of vaccination plans across five countries, as well as the monitoring of vaccination activities, proved key to identifying and reaching all eligible children in the cross-border areas, to avoid the risk of paralysis due to the virus. 

“The official closure of the outbreak is truly a success due to unfaltering determination and strong collaboration between the governments of Mozambique, Malawi and neighbouring countries, as well as between all partners and health workers. I want to particularly recognise the strong efforts of the vaccination teams working on the frontline to reach every last child,” said Etleva Kadilli, UNICEF Regional Director for Eastern and Southern Africa. “Going forward, routine immunisation must remain high up the priority list; no child is safe from polio until all children are vaccinated.” 

To enhance polio surveillance, over the past two years, 15 new wastewater surveillance sites were established in the affected countries. These sites have a critical role to play in detecting silent circulating poliovirus in wastewater, ensuring that quality samples are sent to laboratories for timely confirmation and response to poliovirus presence. 

Additionally, countries have scaled up efforts to protect children in high-risk areas by strengthening surveillance, and data and information management. World Health Organization (WHO) in the African Region’s Geographic Information Systems (GIS) Centre has analysed spatial and geographic data on visual maps, providing geographic real-time coverage information, including locating missing settlements, to improve vaccination coverage. 

“Closing polio outbreaks is possible when national governments, local health workers, community mobilizers, and global partners come together to prioritize a rapid and timely response to protect children from this devastating disease,” said Dr. Chris Elias, president of Global Development at the Bill & Melinda Gates Foundation. “Malawi, Mozambique, and the entire Southern-African region are setting the example for what it takes to urgently improve vaccination campaigns and disease surveillance systems. Commitments like these will help us achieve a world free of all forms of poliovirus.” 

Health experts, the OBRA team and GPEI coordinators on the ground underscored the pivotal role of enhanced polio surveillance, high quality community engagement in vaccination campaigns and timely outbreak response, including rapid deployment of experts and other field responders, to curb the virus. 

Note to editors: 

The notification of imported wild poliovirus in 2022 did not alter the certification of the African region as free of indigenous wild polio in August 2020, as the strain that was confirmed in southern Africa was imported. 

Polio has no cure and can cause irreversible paralysis. However, the disease can be prevented and eradicated through administration of a safe, simple and effective vaccine. 

As per the advice of an Emergency Committee convened under the International Health Regulations (2005), the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC). Countries affected by poliovirus transmission are subject to Temporary Recommendations. To comply with the Temporary Recommendations issued under the PHEIC, any country infected by poliovirus should declare the outbreak as a national public health emergency, ensure the vaccination of residents and long-term visitors and restrict at the point of departure travel of individuals, who have not been vaccinated or cannot prove the vaccination status. 

The Global Polio Eradication Initiative is spearheaded by national governments, WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF, the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance. Since 1988, the incidence of wild poliovirus has been reduced by more than 99%, from more 350,000 annual cases in more than 125 endemic countries, to four cases in 2024 from two endemic countries (Pakistan and Afghanistan). In 2023, only 12 cases of WPV1 were detected globally.

The fight against polio in Pakistan reaches a critical juncture as a high-level delegation from the Global Polio Eradication Initiative (GPEI) concludes their visit from April 30 to May 3, underscoring the urgency for innovative strategies to reach children not being vaccinated and enhanced political commitment to achieve eradication.

Led by Dr. Chris Elias, Chair of the Polio Oversight Board (POB) and President of Global Development at the Bill & Melinda Gates Foundation, the delegation engaged in discussions with Pakistan’s political and security leadership to address persistent challenges in the final stages of eradication efforts. The delegation also comprised of WHO Regional Director for the Eastern Mediterranean Region, Dr Hanan Balkhy, UNICEF South Asia Regional Director, Sanjay Wijesekera, CDC’s Polio Eradication Branch Chief, Dr Omotayo Bolu, and Trustee Rotary Foundation and National Polio Plus Committee Chair, Aziz Memon.

In Islamabad, they met with Prime Minister Shehbaz Sharif, Acting Foreign Secretary Rahim Hayat Qureshi, Coordinator to the PM on Health Dr Malik Mukhtar Ahmed Bharath and Pakistan Army’s Engineer-in-Chief Lt-Gen Kashif Nazir.

The POB is the highest decision-making and oversight body of the GPEI – the largest international public health initiative aiming to end polio globally. This was the first high-level GPEI visit to Pakistan since the formation of the new government in March. The focus of the visit was to strengthen political commitment in Pakistan to eradicate polio.

“During my time in Pakistan, I have once again been impressed by the commitment from the federal and provincial governments to stopping polio transmission. With continued commitment across the country from leaders, and at all levels, I know the final push to defeat polio will be possible,” said POB Chair Dr Chris Elias.

The delegation also visited Peshawar and Lahore where they held meetings with the provincial chief ministers of Khyber Pakhtunkhwa and Punjab as well as provincial health ministers and chief secretaries to discuss their respective provinces’ progress and challenges on polio eradication.

“Engaging with Pakistan’s new political leadership during this visit has demonstrated the commitment of all partners to polio eradication, but we must use the coming months to leverage this commitment wisely, or we risk losing the momentum and the confidence that we can get the job done,” Dr Hanan Balkhy, WHO’s Regional Director for the Eastern Mediterranean Region.

She added: “Pakistan has the real opportunity to stop the endemic strain of poliovirus that has been restricted to south Khyber Pakhtunkhwa province. Strengthening the tailored responses to the increased detections of the imported poliovirus in the historic reservoirs is going to be critical to prevent largescale outbreaks in the coming months.”

Pakistan is one of only two polio-endemic countries. The country has made significant progress in reducing polio cases and eliminating diverse poliovirus strains in recent years. However, several challenges persist in its last mile of eradication, including disruptions to vaccination campaigns caused by insecurity, children being missed in vaccine campaigns and community distrust.

“We know what to do; we know how to do it. It is incumbent on all of us – government, health workers, partners and communities – to work together determinedly to keep every child in Pakistan safe from this deadly and preventable disease,” said UNICEF Regional Director for South Asia Mr Sanjay Wijesekera.

Recognizing the significance of tailored strategies, the delegation highlighted the imperative of reaching migrant populations in infected and high-risk districts. Drawing from successful experiences in India, where vaccination efforts focused on thoroughly mapped migrant populations were pivotal, it was stressed that similar approaches are indispensable for further progress. The delegation also underscored the indispensable role of Routine Immunization (RI) in sustaining hard-won gains in polio eradication. Collaboration with the Expanded Programme on Immunization (EPI) was highlighted as paramount, particularly in areas with pressing health needs.

Stronger political commitment was identified as a linchpin for addressing legitimate demands of deprived communities for services and galvanizing health workers. The delegation advocated for leveraging influence and support to engage community influencers, ensuring comprehensive community participation in vaccination.

Aziz Memon, Trustee Rotary Foundation/National Chair, Pakistan PolioPlus Committee said: “Rotary International congratulates the Government of Pakistan on its progress in the fight against polio and encourages a renewed and urgent commitment to addressing the remaining challenges the Polio Programme faces.”

“Rotary has invested almost US$427 million in polio eradication efforts in the country and affirms our continued support to the Polio Programme until the goal is accomplished and all children in Pakistan are protected from polio,” he said.

The visit coincided with the ongoing immunization campaign from April 29 to May 6, aimed at vaccinating over 24.4 million children under the age of five in 91 districts. Amidst these efforts, the GPEI delegation’s engagement signifies a pivotal moment in Pakistan’s fight against polio, urging concerted action and unwavering commitment from all stakeholders.

Note:

Polio is a highly infectious disease caused by poliovirus mainly affecting children under the age of five years. It invades the nervous system and can cause paralysis or even death. While there is no cure for polio, vaccination is the most effective way to protect children from this crippling disease. Each time a child under the age of five is vaccinated, their protection against the virus is increased. Repeated immunisations have protected millions of children from polio, allowing almost all countries in the world to become polio-free, except for the two endemic countries of Pakistan and Afghanistan.

For further information, please contact: Ms Hania Naeem, Communications Officer, NEOC,

Contact No:+923431101988

Email:  hanianaim17@gmail.com

Islamic Development Bank Golden Jubilee, held in Riyadh, Saudi Arabia 28-04-24. © Tasneem Alsultan

On 28 April, the Islamic Development Bank (IsDB) and partners convened to celebrate the IsDB’s Golden Jubilee in Riyadh, Saudi Arabia. Over the last 50 years, the IsDB has been a leading partner in advancing health and development around the world, including through the polio eradication effort. Since 2013, the IsDB has provided US$ 587 million to the Global Polio Eradication Initiative (GPEI) and has been a key partner in promoting eradication and access to life-saving vaccines. To date, the IsDB is one of the largest providers of funding to the national polio eradication program in Pakistan – one of the last two countries where wild poliovirus remains endemic. 

The same day, Saudi Arabia announced US$ 100 million in new funding to support the second phase of the IsDB’s Lives and Livelihoods Fund (LLF), which was launched last May. The LLF aims to lift the poorest out of poverty across 33 IsDB member countries through investments in primary health care, preventing infectious diseases like polio, enhancing smallholder farming, and improving infrastructure.  This commitment follows a renewed pledge of US$ 50 million from the UAE to the LLF announced last week. To maximize the impact of every dollar, the Bill & Melinda Gates Foundation (BMGF) provides a 20% match of the total granted by donors to the LLF, up to US$ 100 million.  

These pledges were part of a broader partnership of more than US$ 620 million announced by Saudi Arabia and BMGF, which also included US$ 500 million from Saudi Arabia to support the GPEI. 

“The Islamic Development Bank warmly welcomes the Kingdom of Saudi Arabia’s generous contribution to the Global Polio Eradication Initiative. This vital support strengthens GPEI’s efforts to eliminate this devastating disease. We’re proud that IsDB and ISFD, our poverty alleviation arm, have been among the top financiers for Pakistan’s polio eradication efforts, providing over US$ 555 million since 2012,” stated Dr. Muhammad Al Jasser, IsDB President. 

“We also applaud the Kingdom of Saudi Arabia’s new funding for the Lives and Livelihoods Fund. This innovative initiative tackles poverty barriers faced by families, communities, and entire countries. We express our sincere gratitude to all partners, existing and new, for their continued collaboration and commitment. Together, through these concerted efforts, we can achieve the critical last-mile results needed to create a truly polio-free world,” added the IsDB President. 

“The fight to eradicate polio is a global effort, and it wouldn’t be possible without global partners. I’m grateful for the Islamic Development Bank’s ongoing support for polio eradication—through joint investments like the Lives and Livelihoods Fund, and particularly in Pakistan, one of only two countries where wild polio is still endemic. Eradicating polio is one of the most important legacies we can leave for future generations. And it will only be possible thanks to support from partners like the Islamic Development Bank,“ said Bill Gates, co-chair of the Bill & Melinda Gates Foundation. 

Today, wild poliovirus is now endemic in just two countries – Pakistan and Afghanistan – and most variant poliovirus cases are increasingly confined to high-risk areas in just four countries – Nigeria, the Democratic Republic of the Congo, Somalia, and Yemen. 

“The IsDB has played a key role in the fight against polio, helping the program reach millions of children with vaccines and strengthen health systems in the most critical areas to end this devastating disease.” said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, “We thank them for their partnership in global health over the past 50 years and look forward to many more.” 

“Communities all over the world are healthier today because of long-standing commitments to global health from partners, including the IsDB. Together, with donors, governments, and health workers, we can deliver a historic win for children and families everywhere and end polio for good,” said Catherine Russell, Executive Director of UNICEF. 

The GPEI has the tools and strategies needed to ensure children today and for generations to come are protected from paralysis or even death due to polio. But in many of the places where polio remains, there are complex challenges to reaching all children with vaccines and other life-saving interventions, including vaccine misinformation, political insecurity, environmental disasters, and broader humanitarian crises. Continued support from donors like the IsDB will be critical to help countries build better health systems and overcome the final obstacles to stop polio for good.  

“Raising funds to eradicate polio has been a long-standing mission of Rotary International, and we recognize the critical role every dollar plays in immunizing children. On behalf of the organization, I want to thank the Islamic Development Bank for their great partnership spanning 50 years in the fight against polio. We’ve come a long way in as many years, showing that together with full support and collaboration, we can overcome any obstacle in our path to achieve our promise to deliver a polio-free world to children everywhere,” said Mike McGovern, Chair of the International PolioPlus Committee at Rotary International. 

For more information on the IsDB and its Golden Jubilee celebrations, see here.  

About Islamic Development Bank (IsDB) Group 

Rated AAA by the major rating agencies of the world, the Islamic Development Bank is the premier multilateral development bank of the Global South that has been working for 50 years to improve the lives of the communities it serves by delivering impact at scale. The Bank brings together 57 Member Countries across four continents, touching the lives of nearly 1 in 5 of the world population. Its mission is to equip people to drive their own economic and social progress at scale, putting the infrastructure in place enabling them to fulfil their potential. Headquartered in Jeddah, Kingdom of Saudi Arabia, IsDB has regional hubs and centers of excellence in 11 of its Member Countries.  Over the years, the Bank has evolved from a single entity into a group comprising five entities: Islamic Development Bank (IsDB), the Islamic Development Bank Institute (IsDBI) tasked with research and training, the Islamic Corporation for the Insurance of Investment and Export Credit (ICIEC), the Islamic Corporation for the Development of the Private Sector (ICD), and the International Islamic Trade Finance Corporation (ITFC). 

RIYADH (28 APRIL 2024) – Today, at the first-ever World Economic Forum (WEF) Special Meeting hosted in Riyadh, the Kingdom of Saudi Arabia has pledged US$ 500 million over the next five years to support the work of the Global Polio Eradication Initiative (GPEI).

This announcement marks a significant increase in funding for the global effort to eradicate polio – a devastating virus that paralyzes and can be fatal for children but is preventable with vaccines. The funds announced today will enable GPEI partners – the Bill & Melinda Gates Foundation (BMGF), Gavi, the Vaccine Alliance, Rotary International, the United Nations Children’s Fund (UNICEF), the U.S. Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO) – spearheaded by national governments, to protect more than 370 million children with polio vaccines every year. It will also facilitate the delivery of other life-saving interventions like nutritional supplements and bed nets to underserved communities and strengthen health systems to better prepare countries for emerging health threats.

The commitment was made as part of a broader more than US$ 620 million partnership by Saudi Arabia and BMGF to support polio eradication and contribute to other global health initiatives, including the Lives and Livelihood Fund. The partnership was announced at the WEF Special Meeting by His Excellency Dr. Abdullah A. Al Rabeeah, Advisor to the Royal Court and Supervisor General of the King Salman Humanitarian Aid & Relief Centre (KSrelief) and His Excellency Fahad bin Abdurrahman Al-Jalajel, Minister of Health of the Kingdom of Saudi Arabia, in the presence of Dr. Tedros Adhanom Ghebreyesus, Director-General of the WHO, and Bill Gates, co-chair of BMGF.

H.E. Dr. Abdullah A. Al Rabeeah commented, “In Afghanistan and Pakistan, the last remaining polio-endemic countries, we have seen significant progress, yet work remains to be done as the world pushes towards making eradication possible. The pledge from Saudi Arabia today will enhance the innovation and collaboration needed to eradicate this disease. Together with our partners, the Bill & Melinda Gates Foundation, the Global Polio Eradication Initiative, the Islamic Development Bank and key countries across the region, our support will not only aim to end polio but to also strengthen health systems in these countries.”

“This investment towards global health isn’t just a good to have; it’s a strategic imperative for a thriving, more resilient future together,” said H.E. Fahad bin Abdurrahman Al-Jalajel, “the world faces many health challenges, and it is part of our responsibility and leadership to contribute with our partners in bridging the gaps, and through concerted efforts, we will be able to alleviate the suffering of many people.”

Thanks to decades of country leadership and global collaboration in delivering life-saving vaccines to billions of children, wild polio cases have fallen by 99.9% since the GPEI was founded in 1988 under the leadership of the World Health Assembly. More than 20 million people are walking today who would have otherwise been paralyzed by the virus. Just four cases of wild poliovirus have been recorded this year and 12 cases recorded last year in the remaining wild polio endemic countries of Pakistan and Afghanistan.

Meanwhile, outbreaks of variant poliovirus, which can emerge in places where not enough children are vaccinated against polio, are increasingly confined to high-risk areas in just four countries – Nigeria, the Democratic Republic of the Congo, Somalia, and Yemen. Still, in places where polio remains today, there are serious challenges to reaching all children with polio vaccines and other life-saving interventions, including vaccine misinformation, political insecurity, environmental disasters, and broader humanitarian crises.

“For decades, polio inflicted lifelong suffering on children and families. Today, we take another step toward finally eradicating it, thanks to the generous contributions of the Kingdom of Saudi Arabia. When we invest in eradicating polio, we make immunization and health systems more resilient, we equip nations to better respond to public health challenges, and most importantly, we ensure that more children will be able to live healthy lives,” said Bill Gates.

The announcement builds on a long history of support from Saudi Arabia and regional partners to the global polio eradication effort as well as across the Eastern Mediterranean – the last region where wild polio is endemic. For more than two decades, Saudi Arabia has not only financially supported the GPEI, but has also advocated for polio eradication and access to other life-saving vaccines in the Eastern Mediterranean and beyond. This support ranges from championing the cause among communities and religious leaders to advocating within major global convenings like the G20 and regional forums like the World Health Organization’s Eastern Mediterranean Regional Subcommittee for Polio Eradication and Outbreaks.

“Reaching all children with lifesaving vaccines is critical to ending polio and protecting children and communities everywhere from other preventable diseases and emerging health threats,” said Dr. Tedros Adhanom Ghebreyesus. “With this new funding, Saudi Arabia will help to protect children in even the hardest-to-reach areas, and move towards a healthier, polio-free world.”

“This important support will help bring us one step closer to eradicating polio once and for all,” said Catherine Russell, UNICEF Executive Director. “Together with communities, health workers, global partners, and donors like Saudi Arabia, we can help ensure that no child suffers from paralysis or dies from polio, and that more children have access to better health systems.”

To strengthen Afghanistan’s health systems and encourage a continued focus on achieving polio eradication in one of the world’s last polio-endemic countries, Saudi Arabia and the Gates Foundation have pledged US$ 3 million and US$ 15 million respectively over three years to support the Polio Legacy Challenge. This Challenge is a results-based financing initiative spearheaded by ministers of health in the region, including Saudi Arabia, the United Arab Emirates (UAE), and Qatar, under the auspices of the WHO EMRO Regional Subcommittee on Polio Eradication and Outbreaks.

Also today, as the Islamic Development Bank (IsDB) celebrates its 50th anniversary, Saudi Arabia announced US$ 100 million in new funding to support the IsDB’s Lives and Livelihoods Fund (LLF), which aims to lift the poorest out of poverty across 33 IsDB member countries through investments in primary health care, eliminating preventable infectious diseases like polio, supporting smallholder farming and rural agriculture, and improving basic infrastructure. This follows the UAE’s renewed pledge of US $50 million to the LLF announced earlier this week, continuing its support for the largest development fund in the region, which aids millions in low-income communities.

On the occasion, IsDB President Dr. Muhammad Al Jasser stated: “The Islamic Development Bank warmly welcomes the Kingdom of Saudi Arabia’s generous contribution to the Global Polio Eradication Initiative. This vital support strengthens GPEI’s efforts to eliminate this devastating disease. We’re proud that IsDB and ISFD, our poverty alleviation arm, have been among the top financiers for Pakistan’s polio eradication efforts, providing over US$ 555 million since 2012.”

“We also applaud the Kingdom of Saudi Arabia’s new funding for the Lives and Livelihoods Fund. This innovative initiative tackles poverty barriers faced by families, communities, and entire countries. We express our sincere gratitude to all partners, existing and new, for their continued collaboration and commitment. Together, through these concerted efforts, we can achieve the critical last-mile results needed to create a truly polio-free world,” added the IsDB President.

Additional quotes on the funding announcement:

Mike McGovern, Chair of the International PolioPlus Committee at Rotary International, said: “I extend heartfelt gratitude to Saudi Arabia for their commitment to the cause of polio eradication, which has been instrumental in advancing our collective mission towards a polio-free world. Together, we’ve witnessed the remarkable resilience of the polio eradication program, proving that with full support and collaboration, we can overcome any obstacle in our path. Let us continue to stand united in our efforts until polio is eradicated, ensuring a healthier, safer future for generations to come.”

Dr. Sania Nishtar, CEO of Gavi, the Vaccine Alliance, said: “This new commitment from the Kingdom of Saudi Arabia will not only help us achieve a polio-free world, it will help countries build stronger health systems, protecting families, communities and economies from other existing and emerging health threats.”

About the Global Polio Eradication Initiative

The Global Polio Eradication Initiative is a public-private partnership, spearheaded by national governments, WHO, Rotary International, the US Centers for Disease Control and Prevention, UNICEF, the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance. Since its launch in 1988, this partnership has helped prevent more than 20 million cases of paralysis, prevented more than 1.5 million childhood deaths and reduced the incidence of wild poliovirus by 99.9 percent, from more than 350,000 cases in more than 125 endemic countries, to twelve cases in two endemic countries in 2023.

Media Contact: Ally Rogers, Global Health Strategies (arogers@globalhealthstrategies.com)

About Islamic Development Bank (IsDB) Group

Rated AAA by the major rating agencies of the world, the Islamic Development Bank is the premier multilateral development bank of the Global South that has been working for 50 years to improve the lives of the communities it serves by delivering impact at scale. The Bank brings together 57 Member Countries across four continents, touching the lives of nearly 1 in 5 of the world population. Its mission is to equip people to drive their own economic and social progress at scale, putting the infrastructure in place enabling them to fulfil their potential. Headquartered in Jeddah, Kingdom of Saudi Arabia, IsDB has regional hubs and centers of excellence in 11 of its Member Countries. Over the years, the Bank has evolved from a single entity into a group comprising five entities: Islamic Development Bank (IsDB), the Islamic Development Bank Institute (IsDBI) tasked with research and training, the Islamic Corporation for the Insurance of Investment and Export Credit (ICIEC), the Islamic Corporation for the Development of the Private Sector (ICD), and the International Islamic Trade Finance Corporation (ITFC).

The President of the Republic of Madagascar, Andry Rajoelina, and the First Lady, Mialy Rajoelina, received a high-level delegation from the Global Polio Eradication Initiative (GPEI) on April 25, 2024 in Ambohitsorohitra palace in the capital, Antananarivo.

The delegation included the Regional Director of the World Health Organization (WHO) for Africa, Dr Matshidiso Moeti, the President of the Polio Oversight Board, Dr Chris Elias, the Regional Director of UNICEF for Eastern and Southern Africa, Etleva Kadilli, and the Director of Health Systems Strengthening and Immunization from Gavi, the Vaccine Alliance, Alex de Jonquieres.

To read more about the meeting, a press release is available here in French.

Adapted from the Annual Letter

The story of wild poliovirus is one powerful example of how philanthropy can catalyze progress. At one point, 7,000 children were paralyzed from wild poliovirus every week. Philanthropists, like Rotarians—who are able to take risks and dedicate resources that others could not—organized efforts to support eradication solutions, government efforts in polio-affected countries, and frontline heroes to reach children in even the most remote parts of the world. As a result of these global efforts, in 2023, the number of people infected by wild poliovirus dropped to 12 for the entire year.In the case of polio, philanthropy helped make the seemingly impossible possible. Many more of the greatest challenges that face our world today already have solutions—existing and emerging—that can save lives. As I share in my letter, philanthropy now has a chance to step forward and turn those solutions into real impact for people.There’s already so much generosity in the world, and together, we can tap into it and make certain everyone has the opportunity to live a healthy and productive life. Find out what we can achieve in my 2024 annual letter.

Mark Suzman,
CEO, Bill & Melinda Gates Foundation

Geneva, Switzerland, January 2024 – Convening this week at the World Health Organization (WHO) headquarters, global health leaders and Ministers of Health at the WHO Executive Board (EB) reaffirmed their commitment to eradicate polio once and for all and use the polio investments to build strong, equitable and resilient health systems.

Opening the EB amid a wide array of public health topics on the agenda, WHO Director-General Dr Tedros Adhanom Ghebreyesus told assembled delegates:  “We continue to intensify our efforts to eradicate polio. Last year, six cases of wild poliovirus were reported in Pakistan, and six in Afghanistan, the second-lowest number of cases reported in a calendar year. Our target is to interrupt transmission of wild poliovirus this year.”

Member States noted the unique opportunity to eradicate remaining wild poliovirus type 1 endemic transmission, which is now limited to just a handful of areas of eastern Afghanistan and three districts of southern Khyber Pakhtunkhwa, Pakistan, and urged for continued intensified efforts to reaching all remaining un- or under-immunized children in those areas.  Delegates also reiterated the importance of intensifying efforts to combat variant poliovirus outbreaks (circulating vaccine-derived polioviruses), including through strengthened outbreak response and the continued roll-out of novel oral polio vaccine type 2, which became the first vaccine used under Emergency Use Listing (EUL) to be pre-qualified by WHO.  The engines of transmission for such strains are in clearly-identified and known most consequential geographies, namely north-western Nigeria, eastern Democratic Republic of the Congo, south-central Somalia and northern Yemen.

Speaking on behalf of WHO Regional Director for the Eastern Mediterranean Dr Ahmed Al Mandhari, Dr Hamid Jafari, Director for Polio Eradication in the Eastern Mediterranean said:  “In Afghanistan and Pakistan, the national programmes deployed innovative strategies and strengthened partnerships with humanitarian actors to reach more children. And across the region, the programme also identified pathways for sustaining essential polio functions, through integration with existing programmes. In particular, I am proud of the work of the Regional Subcommittee for Polio Eradication and Outbreaks that we started back in 2021. Their advocacy and support have successfully carved out clear pathways towards protecting children in the Region from polio and other vaccine-preventable diseases.”

Within this context, delegates thanked current Regional Director Dr Ahmed Al Mandhari, for his personal engagement and leadership in bringing the region to the threshold of success; and welcomed his successor, Dr Hanan H Balkhy, who committed to leading the region across the finish line.

“On behalf of the core partners of the Global Polio Eradication Initiative, Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF, the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance, we would like to thank all Member States for their tremendous efforts,” said Aidan O’Leary, WHO Director for Polio Eradication and Chair of the Global Polio Eradication Initiative Strategy Committee.  “Last year, thanks to your efforts, upwards of 800 million children were immunized, many in areas with protracted and complex emergencies.  The reality is that it is precisely in such areas of complex emergencies where polio persists, and unfortunately those emergencies are becoming even more complex.  We need the continued political will of Member States to overcoming whatever geo-political challenges might currently stand in the way of reaching that remaining last unreached child in these areas.  Be assured that together with our partners, we stand ready to support you in your incredible efforts.”  Underscoring WHO’s commitment to the effort, O’Leary reminded the EB that WHO now considered the effort to eradicate polio as its only Public Health Emergency of International Concern (PHEIC), under the International Health Regulations (IHR).

O’Leary also reminded delegates of our collective duty to prepare for a lasting polio-free world. He referenced specifically the new approach to polio transition, which draws upon lessons-learned, and puts countries at the forefront, as solutions need to be country-specific, tailored to each country’s own context.  Within that context, delegates emphasized the importance of implementing all activities to not only achieve a polio-free world, but also to sustain it through strengthening essential immunization, surveillance, integration and transition, reiterating their support and commitment to fully finance the Global Polio Eradication Initiative Strategy and the WHO base budget.

Speaking on behalf of Rotarians around the world and civil society as a whole, Judith Diment of Rotary International’s PolioPlus Committee, congratulated delegates on ongoing efforts to protect children from devastating diseases such as polio.  “The Global Polio Eradication Initiative is closing in on zero, with fewer cases in fewer places in 2023, reaching more children through tailored approaches to increase public demand and identifying missed children.  We applaud the use of targeted, integrated activities.”

In late December 2023, the World Health Organization issued its first-ever prequalification approval for a vaccine being used under its Emergency Use Listing (EUL) regulatory pathway – novel oral polio vaccine type 2 (nOPV2). Since rollout of this next-generation vaccine began in March 2021, the Global Polio Eradication Initiative (GPEI) has administered nearly 1 billion doses of nOPV2 across 35 countries, protecting millions of children against illness and paralysis. Prequalification will enable additional countries to access the vaccine more easily for more sustainable response to outbreaks of type 2 variant poliovirus (cVDPV2). 

“This is a historic milestone for polio eradication and for public health,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Novel oral polio vaccine type 2 has blazed a trail for other new vaccines that address critical health emergencies, and its use demonstrates the utility of the EUL mechanism in helping to rapidly get new products to where they’re needed most.” 

The EUL to PQ pathway 

WHO EUL is reserved for the use of yet-to-be-licensed vaccines, medicines and diagnostic tools during public health emergencies like polio outbreaks. Following rigorous assessments of existing quality, safety and efficacy data from completed clinical trials, the pathway enables expedited availability of products to the places impacted by these emergencies. The vaccine’s manufacturer, Bio Farma Indonesia, has been instrumental in ensuring supply and enabling nOPV2 to earn full licensure from the Indonesian regulatory authority, Badan POM. WHO Prequalification (PQ) is the final step of the process, allowing for streamlined regulatory approval for nOPV2 use in countries that need it. 

“This key step illustrates how innovation can help protect children against the variant poliovirus type 2, with thanks to the support of donors and partners, and the commitment of governments and community health workers,” said UNICEF Executive Director Catherine Russell. “UNICEF is committed to helping ensure the safe and adequate supply of vaccines to countries, while working with communities to build trust in vaccines. We need to keep going till we reach every child, and eradicate polio once and for all.”

nOPV2’s performance and the power of innovation 

To date, nOPV2 has been used in 35 countries under EUL, predominantly in the African region which is most affected by cVDPV2 outbreaks. Throughout its clinical development and field use, nOPV2 has proven to be as safe to use and effective at stopping outbreaks as its predecessor, monovalent type 2 oral vaccine (mOPV2), but, importantly, is more genetically stable. After nearly three years of use, estimates show that nOPV2 is 80% less likely to seed new variant polio outbreaks, making it the tool of choice to stop these outbreaks for good.  

Nigeria has played an outsized role in nOPV2 rollout in the leadup to WHO Prequalification, administering nearly half a billion doses to children across the country to date. The vaccine has helped bring about an 85% reduction in variant poliovirus cases in Nigeria since 2021, and its impact is visible through this and other data in a new story from the GPEI. 

Development of the vaccine began in 2011 through a consortium of experts led by the Bill & Melinda Gates Foundation, including the UK National Institute for Biological Standards and Controls (NIBSC), the U.S. Centers for Disease Control and Prevention (US-CDC), the US Food and Drug Administration, PATH and the University of California at San Francisco. 

“Supporting the development of new vaccines is one of the most important investments we can make to protect people against preventable diseases like polio,” said Mark Suzman, CEO of the Bill & Melinda Gates Foundation. “With easier access to nOPV2 for more countries, this vaccine will keep even more children safe in areas still grappling with poliovirus. We look forward to working with partners across sectors to support more groundbreaking innovations.” 

Next steps in the fight against type 2 variant poliovirus 

As of 3 January 2024, 325 cases of cVDPV2 had been reported in 2023, compared to 689 cases in 2022. While nOPV2 has played a key part in this reduction, its success, like any polio vaccine, depends on the ability to rapidly implement high-quality immunization campaigns that reach every child.   

To overcome the final challenges that remain in polio eradication, the GPEI is finding new ways to access children living in hard-to-reach areas, promote community acceptance of vaccines, and improve early detection and response to outbreaks. These efforts are being prioritized in the places where children are at the highest risk of encountering and spreading the virus. 

“It is critical to protect all children against polio with timely administration of vaccines. Along with our global partners, CDC is committed to ensuring rapid detection of type 2 polio outbreaks and response with the novel oral vaccine,” said Dr. Mandy Cohen, Director of the US-CDC.  

A prequalified nOPV2 will help to make important headway against cVDPV2 outbreaks, and with renewed support from global partners, donors and leaders of polio-affected countries to fully implement the program’s strategy, we can stop all forms of polio for good. 

 

END 

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About the GPEI:
The Global Polio Eradication Initiative is a public-private partnership led by national governments with six partners – the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC), the United Nations Children’s Fund (UNICEF), Bill & Melinda Gates Foundation and Gavi, the vaccine alliance. Its goal is to eradicate polio worldwide.

For media enquiries:
WHO
For prequalification specific enquiries:
Sarah Sheppard – Communications Officer sheppards@who.int
For polio and nOPV2 enquiries:
Joseph Swan – Communications Officer swanj@who.int

UNICEF
Helen Wylie, Communications Specialist hwylie@unicef.org

Bill & Melinda Gates Foundation
Amber Zeddies, Senior Program Officer amber.zeddies@gatesfoundation.org

US CDC
Chelsea Toledo, Health Communications Specialist rnv8@cdc.gov  

The Global Polio Eradication Initiative has two goals laid out in its current strategy: to interrupt all remaining transmission of endemic wild poliovirus type 1 (WPV1) and to stop all outbreaks of variant poliovirus type 2 (cVDPV2). 2023 was a critical year for progressing on each of these, and while our urgent and diligent work to end polio must continue into 2024, the GPEI achieved incredible things in the past twelve months.

Continuing work in endemic countries

Despite significant geo-political and environmental challenges in the two remaining WPV1-endemic countries, Pakistan and Afghanistan, the polio programme has continued to reach greater numbers of children with polio vaccines.

WHO Representative in Afghanistan, Dr. Luo Dapeng, vaccinating children against measles in a mobile clinic in Baba Wali Village of Kandahar province. © WHO/Afghanistan

Wild polio transmission was beaten back to just a handful of districts in eastern Afghanistan and the southern area of Khyber Pakhtunkhwa province in Pakistan. In both countries, efforts are increasingly focused on reaching and vaccinating the last remaining ‘zero dose’ children – children who have received no vaccines of any kind. The number of these missed children continues to dwindle, with the success of improved collaboration with the national immunisation program, new efforts like Pakistan’s Nomad Vaccination Initiative and focused vaccination activities at border crossings between the two countries. Just one family of the virus remains endemic in each country, and coupled with this increasing geographic restriction, the situation resembles the end of wild polio eradication efforts in former virus hotspots like India, Nigeria and Egypt.

In addition, after a wild poliovirus outbreak that was confirmed in southeast Africa in early 2022, neither Malawi nor Mozambique has reported a WPV case since August 2022 thanks to a concerted subregional emergency response across five neighbouring countries. We are hopeful that this outbreak will be officially closed in the coming months, affirming that countries have what it takes to protect children from this devastating disease and keep wild polio out of Africa.

Progress on variant polio outbreaks

Thanks to the novel oral polio vaccine type 2 (nOPV2), strong political commitment and community-based efforts to reach more children with the vaccine, the number of cases of variant poliovirus type 2 (cVDPV2) continued to decline in 2023.

Nearly 1 billion doses of nOPV2, a comparably safe, effective, but more genetically stable version of the existing type 2 oral polio vaccine (mOPV2), have now been administered across 35 countries, protecting millions of children from illness and paralysis.

Emergency response to variant polio outbreaks is continuing, notably in the most consequential geographies for the programme—where children are at the highest risk of encountering and spreading poliovirus. In northern Nigeria, for example, variant polio cases have fallen by 90% since a peak in 2021, thanks to concerted commitment from government, unique community programs to improve the reach of vaccines and the extensive rollout of nOPV2. Across these consequential geographies, the programme will continue to focus on increasing access, acceptance and campaign quality, which have helped make incredible progress in Nigeria, and continue to innovate until we end polio for good everywhere.

Finally, In September 2023, after a massive vaccination response in the shadow of ongoing war, Ukraine officially stopped its outbreak of type 2 variant polio that began in 2021. New York, London and Jerusalem, where high-profile outbreaks began in 2022, have not detected the virus in recent months. Still, the emergence of polio in these areas is a reminder that as long as poliovirus exists anywhere, it is a threat to people everywhere.

nOPV2 Vaccination at Guilding Angel School Tunga, Minna, Niger. © WHO/AFRO

A global effort

Most importantly, thanks to the efforts of the GPEI and its partners, health workers vaccinated more than 400 million children in 2023, preventing an estimated 650,000 cases of paralysis from polio and saving the lives of up to 60,000 children. Building full, healthy futures was at the core of Rotary International’s mission when it began this fight to end polio for good in 1985, and when the GPEI was launched in 1988—35 years ago.

This year, the Independent Monitoring Board (IMB) conducted a rigorous mid-term review of the GPEI’s progress towards its strategic goals. This welcome counsel is already helping inform and guide the GPEI’s own ongoing analysis and strengthening of its strategic approaches to achieve a polio-free world, as the programme published its initial response to the mid-term review, under the guidance of the Polio Oversight Board (POB).

Achieving and sustaining a polio-free world has proven harder – and taken longer – than anyone could have imagined. But making history is never easy, and we are confident that together we can eradicate a second human disease from this earth, and build stronger, more resilient health systems along the way.

2023 has firmly set the stage for success. With the complexities of the world today, this programme still inspires to bring about the very best in our humanity.

Thank you to all who have contributed to this effort so far and continue to do so. Let us double down and make the dream of a polio-free world a reality.