With polio at the lowest levels in history in Pakistan, the country is about to launch an all-out and hopefully final assault on the disease in 2018. To help these emergency efforts, the Government of Germany announced today an additional € 2 million in financial support, to Pakistan’s national emergency action plan. Germany is a longtime supporter of the Global Polio Eradication Initiative (GPEI) with contributions totaling more than US$ 550 million to the effort, not including a recently announced additional pledge of € 19.9 million to Nigeria’s polio eradication effort for 2018. For its engagement in polio eradication, including in fostering global commitment, Germany has on numerous occasions been internationally recognized at the highest levels. Chancellor Angela Merkel is a past recipient of Rotary International’s prestigious Polio Champion Award.
The Global Polio Eradication Initiative partners would like to extend their profound gratitude to both the Government of Pakistan and Germany for their collaboration and for their tremendous support and engagement in the effort to eradicate polio globally.
Italy has provided €4.5 million to support efforts to reach and vaccinate all children under five years of age in Pakistan and Afghanistan – the only two countries worldwide that have reported polio cases this year.
In Afghanistan, the contribution will be used to support and train vaccinators and social mobilizers in generating demand for vaccination, the delivery of vaccines and monitoring whether vaccination activities are well-implemented. In Pakistan, the contribution will support vaccination campaigns in the most challenging areas of the country, as well as the immunization of communities that are at particularly high risk due to their mobility, through tactics such as giving vaccine established transit points.
The Bill & Melinda Gates Foundation have matched Italy’s contribution, doubling its impact to €9 million.
Polio is a highly infectious but entirely preventable disease which remains endemic in only three countries – Afghanistan, Pakistan and Nigeria. When the polio eradication effort was launched in 1988, there were 350,000 cases of polio every year across 125 polio-endemic countries. In 2017, there are 13 cases to date globally – 8 cases in Afghanistan and 5 in Pakistan, with Nigeria not recording any cases for more than 12 months.
This remarkable progress is thanks to the tireless work of committed front line health workers, governments and the five partners of the Global Polio Eradication Initiative: UNICEF, WHO, Rotary International, the US Centers for Disease Control and Prevention, and the Bill & Melinda Gates Foundation.
“The Italian Minister of Foreign Affairs, Angelino Alfano, underlined Italy’s commitment to a polio-free world for all future generations. “Italy is proud to support this immunization initiative which will not only rid the world of this devastating disease but improve children’s health and bring health returns and productivity gains for communities and countries’ economies,” Minister Alfano said.
UNICEF Director of Polio Eradication Akhil Iyer said that the funding would support efforts to generate community demand for vaccination and deliver vaccines in high-risk polio-endemic areas. “Italy’s contribution is critical in helping us to reach every last child in some of the world’s most challenging contexts, and to help us prove that we can live in a world where no child need be left behind,” Mr Iyer said.
WHO’s Director of Polio Eradication, Michel Zaffran, said new funding such as Italy’s was essential to ensure all children were covered during immunization campaigns. “As we reach the endgame of the polio eradication effort, the vaccination of what we call mobile populations – communities which are migrant or on the move – is essential to ensure all children are protected and the virus cannot spread from one area to another. This funding will directly help us reach and protect those most vulnerable populations,” Mr Zaffran said.
At a meeting of the Group of 7 on 5-6 November 2017 in Milan, Ministers of Health reiterated the importance of sustaining commitment to polio eradication as part of their broader commitment to strengthen health systems. They also recognized… “the importance of continuing our efforts to succeed and keep the world sustainably polio‐free, and, of the opportunity to leverage and transition polio assets and resources that have generated major and broader health benefits, including strengthened health systems.”
At the meeting, entitled “United towards Global Health: common strategies for common challenges”, Ministers discussed key global health challenges guided by the G7 Taormina Leaders’ Communiqué. Their statement on polio was aligned with previous G7 and G20 commitments and with the Sustainable Development Goals.
The attention given to polio eradication by the Ministers forms an integral part of their broader commitment to … “the importance of strengthening health systems through each country’s path towards Universal Health Coverage, leaving no one behind, and of preventing health systems from collapsing during humanitarian and public health emergencies and effectively mitigating health crises”.
Under Japanese and Italian Presidencies in 2016 and 2017, the importance of the global effort to eradicate polio and the opportunity to transition polio-funded assets for Universal Health Coverage and Global Health Security after eradication have been highlighted several times. Such high-level political support for the initiative is critical to maintain the momentum needed for success.
In 2018, Canada, a longstanding GPEI donor, will hold the Presidency of the G7, 16 years after it placed polio eradication on the agenda of the G7 for the first time.
Thanks to global commitment to end polio, children in countries like Nigeria will be able to grow up free from the threat of this debilitating disease. WHO/L.Dore
The United Kingdom is helping make history by eradicating a human disease for just the second time ever, after smallpox. On August 4, Secretary of State for International Development, Priti Patel announced £100 million in new funding to the Global Polio Eradication Initiative, which will help to give the world’s children protection against this crippling disease.
“Polio has no place in the 21st Century,” said Priti Patel. “This devastating and highly infectious disease causes painful paralysis and is incurable – trapping the world’s poorest people in a cycle of grinding poverty. The UK has been at the forefront of fighting global health threats, including polio, and our last push towards eradication by 2020 will save 45 million children from contracting this disease. The world is closer than it ever has been to eradicating polio for good, but as long as just one case exists in the world, children everywhere are still at risk. Now it is time for others to step up, follow Britain’s lead and make polio history.”
British aid has made up 10% of global contributions to the GPEI over the last 30 years. Thanks to UK aid, 1.6 million people are walking who could have been paralysed for life had they not been vaccinated against polio. While case numbers are at a historic low and wild poliovirus restricted to just three countries (Afghanistan, Nigeria and Pakistan), children continue to be paralysed. DFID and British taxpayers are helping to ensure that no child is ever again paralysed by polio, with 80 children a minute receiving the polio vaccine thanks to this new funding.
More than 50 000 Rotarians across the UK and even more across the globe have been instrumental in this effort. Rotary brought the partners of the Global Polio Eradication Initiative together to start this fight, and continues to drive the effort forward through advocacy and fundraising.
The few remaining places where polio is present are some of the most challenging environments in the world. The UK’s commitment to tackling extreme poverty, helping the most vulnerable and strengthening health care in fragile states is crucial to addressing the challenges standing in the way of a polio-free world.
At the Rotary Convention in Atlanta in June, public health leaders from both donor and endemic countries, as well as the private sector, pledged US$ 1.2 billion to polio eradication against the additional US$ 1.5 billion needed to achieve eradication. The UK’s contribution is crucial in filling the remaining gap.
Ambassador Lanteri has handed over to Ambassador Shino as co-chair of the Polio Partners Group. WHO.
The movement to eradicate polio is a global effort that has attracted support from the highest level from country governments, formed partnerships and relied upon millions working on the frontline. This network is making history as part of the biggest public health programme in the world, which has the opportunity to eradicate a disease for only the second time in history.
The Polio Partners Group (PPG) serves as the voice of many of these committed stakeholders to give input into the work being done by the Global Polio Eradication Initiative and to bring together polio-affected countries, donors and other partners to ensure that the GPEI has the necessary political and financial resources to end polio.
At the group’s latest meeting in June, Ambassador Carole Lanteri of the Permanent Mission of Monaco ended her time as Co-Chair after two years fostering the PPG’s engagement in-depth and high-level dialogue on key programmatic issues with the Initiative’s stakeholders. Monaco is a key partner and donor of the global effort, providing financial and political support. Ambassador Lanteri handed over to Ambassador/Deputy Permanent Representative Mitsuko Shino of the Permanent Mission of Japan.
Japan, the fifth largest donor government to the Initiative, recently reaffirmed its commitment at the Rotary Convention in Atlanta where global health leaders came together to pledge US$ 1.2 billion to polio eradication efforts.
Michel Zaffran, Director of Polio Eradication at WHO, thanked Monaco for their support, noting that “Ambassador Carole Lanteri has brought the highest levels of political commitment to the PPG meetings. With thanks to her continued leadership, we have seen Ambassadors and senior representatives from endemic and donor countries and partners engaging in very technical discussions on the programme. This is testament to the extraordinary convening power of Ambassador Lanteri. She has forged a partnership of political will among diplomats and stakeholders in Geneva, all determined to work for a polio-free world.”
As the PPG thanked Ambassador Lanteri for her service and leadership, a warm welcome was extended to the new Co-Chair, Ambassador/Deputy Permanent Representative Mitsuko Shino of the Permanent Mission of Japan. As a new co-chair, Ambassador Shino will bring her long standing experience and passion in the field of human rights to polio eradication. “Polio is about equity, reaching every child with safe vaccines to realize a world in which no child is left suffering from this preventable disease. It would be a great honor for us to witness the realization of human and child rights to enjoy healthy lives.”
New funding and political commitment will enable the GPEI to protect 450 million children from polio every single year. WHO/L.Dore
Atlanta, USA, 12 June – Public health leaders gathered at the Rotary Convention in Atlanta to unite in their commitment to securing a polio-free world. Endemic countries and donors together pledged US$ 1.2 billion to finance the polio endgame.
The Global Polio Eradication Initiative was launched in 1988, spearheaded by Rotary International. For the past three decades, Rotary has brought political commitment, funding and energy to the fight against polio. At this pledging event, Rotary committed a further US$ 150 million to the cause.
At a time when polio eradication has never been closer, new funding and political commitment is more important than ever. The poliovirus has been cornered to just three remaining countries – Afghanistan, Nigeria and Pakistan – but this progress is fragile. While polio continues to exist anywhere in the world, children everywhere remain at risk. Each year, the GPEI reaches 450 million children to vaccinate them against the virus, in polio endemic countries and elsewhere, and maintains disease surveillance systems in more than 70 countries to find and stop every last virus.
Today, 16 million people are walking who would have been paralysed if they had not been protected against polio thanks to the extraordinary efforts of public health workers. This new injection of funding and commitment will ensure that in the future, no child will ever again suffer from the consequences of this incurable, but preventable, disease.
G20 Health Ministers’ meeting in Berlin, Copyright: BMG/photothek/Inga Kjer
20 May 2017, Berlin, Germany – The first-ever G20 Health Ministers’ meeting has issued a declaration on global health, including recognition of the historic opportunity that exists to contribute to global polio eradication, and the important role played by polio-funded assets in achieving broader health goals. The declaration also called for the timely and effective application of these assets to other programmes once eradication is achieved, to help countries maintain their ability to meet their obligations under the International Health Regulations (2005).
This is the first time that public health has been included on the G20 agenda, in recognition that health security contributes to socio-economic stability and sustainable development. The inclusion of polio in the inaugural Health Ministers’ declaration is symbolic of the global effort to stop polio and how close we are to achieving our historic goal, as well as the contribution the programme makes towards many other areas of public health.
This declaration comes ahead of discussions on the status of global polio eradication efforts, and polio transition planning at the World Health Assembly later in the month.
The G20’s acknowledgement of polio eradication and transition planning efforts comes off the back of sustained political commitment and financial support from the governments of the three remaining polio-endemic countries – Nigeria, Afghanistan and Pakistan – as well as the long-term commitment and support of G20 members Australia, Canada, the European Union, France, Germany, India, Indonesia, Japan, Republic of Korea, Russia, Kingdom of Saudi Arabia, Turkey, the United Kingdom, and the United States of America.
G7 leaders meet later this month in Italy. In 2016, in continuation of the G7 Ise-Shima Summit, the Ministers of Health and high representatives of the G7 “reaffirmed [their] commitment to achieve polio eradication… and recognize the significant contribution that the polio-related assets, resources and infrastructure will have on strengthening health systems and advancing universal health coverage.”
More on polio eradication and transition planning
Nigerian Minister of Health (left) and EU Ambassador signing the documents for the €70 million grant
At an event in Abuja on 16 February 2017, the Government of Nigeria and the European Union signed a historic partnership to support health systems and polio eradication efforts in the country. Attended by key ministries and partners such as WHO and UNICEF, a €70 million grant agreement was signed targeted at improving maternal, newborn and child health, strengthening Nigeria’s health system and supporting ongoing efforts to eradicate polio.
The project is the first phase of support from the European Union to the Nigerian health sector under the 11th European Development Fund, and will be jointly implemented by United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) in partnership with the Federal Government of Nigeria and key target states in the country.
Fifty million euro of the grant aims to ensure that by 2020, Adamawa, Bauchi and Kebbi states of Nigeria have functional primary health care centers, providing round-the-clock services to three million children under the age of five years as well as to almost a million pregnant women and lactating mothers.
Twenty million euro, to be dispersed by WHO, will go specifically towards health systems strengthening to achieve universal health coverage and support the push to eradicate polio from Nigeria for good. The grant comes at a critical time for polio eradication in Nigeria, with emergency efforts underway to stop the virus in the last remaining polio reservoir on the African continent.
Michel Arrion, the EU Ambassador to Nigeria and ECOWAS, said at the event, “The European Union is working together with the Nigerian authorities to address developmental challenges in key priority areas under its 11th European Development Fund. This project will help to improve access to effective health and nutrition in the prioritized states and support the final push to eradicate polio in Nigeria”.
The EU has been major supporter of polio eradication efforts worldwide and in particular Nigeria, providing €45 million to the country between 2011 and 2017. Additionally, the EU has provided significant emergency funding to help successfully stop past outbreaks in the Horn of Africa and the Middle East, and supported the eradication effort in other parts of the world.
Thanking the EU for on-going commitment, Dr Wondimagegnehu Alemu, WHO Country Representative, said, “Our partnership with the EU will enable the organization to continue providing the necessary technical support to the government of Nigeria towards strengthening health systems and enhancing timely interventions during supplemental immunization activities, including reaching children in areas with insecurity in the northeast.”
Polio eradication efforts have always played an important role in health systems strengthening. The polio network routinely conducts surveillance for other diseases of public health importance, including measles, yellow fever, neonatal tetanus and avian influenza. With local knowledge of communities, health systems and government structures, the polio network’s technical capacity in disease surveillance and planning of large-scale operations often helps sustain international and national relief efforts. At the country level, polio staff spend, on average, 50% of their time working on broader public health efforts, over and beyond polio eradication, providing a critical contribution to strengthening of health systems.
A US$ 33.3 million grant from the Government of Japan in humanitarian emergency funding to UNICEF was announced this week and will help to protect millions of children from polio in Nigeria and the Lake Chad region.
In response to the urgent need to rapidly raise immunity to polio virus in the region, Japan has generously provided exceptional funding from their supplementary budget envelope to purchase polio vaccines, conduct house-to-house polio campaigns and support communication efforts to mobilize communities for vaccination in Nigeria, Chad, Niger, Cameroon and the Central African Republic.
The detection of wild poliovirus in north-eastern Nigeria occurred in August 2016 following the large-scale movement of families affected by conflict in Borno State out of areas inaccessible to health services. National Governments, in collaboration with the Global Polio Eradication Initiative (GPEI), comprising the World Health Organization, UNICEF, Rotary International, CDC and the Bill & Melinda Gates Foundation (BMGF), have implemented emergency vaccination campaigns throughout the region to rapidly raise childhood immunity to the polio virus and guard against further spread.
UNICEF Director of Polio Eradication Mr Reza Hossaini said the Japanese funding was gratefully received and filled an urgent need. “This additional funding is very timely to support the ongoing polio vaccination campaigns and give Africa the very real opportunity to be completely polio-free,” Mr Hossaini said. “These campaigns aim to not only stop transmission of polio in north-eastern Nigeria but protect its neighbours against the spread of the virus through provision of vaccines and targeted social mobilization activities.”
Japan remains one of the champion donors to the GPEI and the Global Health agenda in general, with contributions to polio eradication through UNICEF since 2002 totalling more than US$ 333 million. This funding – and the leadership provided by both the Tokyo International Conference on African Development (TICAD) process and the Japan International Cooperation Agency (JICA)’s innovative soft loan in partnership with BMGF in Nigeria and Pakistan for polio eradication – has proven instrumental in the historic reduction of wild poliovirus transmission globally.
In 2016, wild poliovirus transmission was limited to just 37 cases globally in the three remaining polio-endemic countries – Nigeria, Pakistan and Afghanistan. This year, to date, only two cases have been recorded worldwide, in Afghanistan. However, while the opportunity to finally eradicate polio is real, the risk remains: as long as one child is infected, every child remains at risk. It is critical that all countries continue to maintain high immunity to polio until the virus is eradicated, once and for all.
Today, Bill and Melinda Gates released their Annual Letter. This year the letter is addressed to Warren Buffett, who donated the bulk of his fortune to the Bill & Melinda Gates Foundation 10 years ago, and focuses on the gains that have been made since then to improve health of children around the world.
Bill and Melinda use the letter to highlight numbers that tell a story of how the world is doing in several different areas – 48 million children saved since 2000, 300 million women in the developing world who use contraceptives. But they say there is one number they work toward every day: zero.
As Bill and Melinda explain in their letter, the “magic number is zero” when thinking about many of the health challenges we face today – ending malaria, TB, HIV – and polio is the closest to reaching this goal. Bill and Melinda discuss the persistence and dedication of health workers around the world and Rotary International in achieving this magic number.
It is in part because of the contributions from Warren and other generous donors that the world has made this incredible progress – and now zero is in sight.
Hear from Ann Lee Hussey, a polio survivor and volunteer for Rotary International, as she shares her story of living with polio. Her experiences drive her commitment to reach zero and end the disease once and for all.
140th session of WHO Executive Board, Geneva, Switzerland. Photo: WHO/C.Black
27 January 2017, Geneva, Switzerland – Ministries of health gathering at this week’s Executive Board of the World Health Organization (WHO) reviewed the latest global poliovirus epidemiology and concluded that the world has never had a better chance to complete the job. Amid discussions on Ebola, Zika and pre-elections for the new WHO Director-General, delegates stressed the urgent need to secure a lasting polio-free world, by fully implementing the Global Polio Eradication Initiative (GPEI) Polio Eradication Endgame Strategic Plan.
Endemic polio is now restricted to a handful of areas of Pakistan, Afghanistan and Nigeria, all of which are implementing regionally-coordinated emergency plans to reach and vaccinate the remaining pockets of under-immunized children.
Despite more children being reached in these traditional ‘reservoir’ areas for the virus, delegates cautioned that risks remained, as underscored by the detection of polio cases in Borno state of Nigeria, the first in two years anywhere in Africa. Countries are now focusing on making sure there are no surveillance gaps at a subnational level so that virus cannot circulate undetected, while working to increase population immunity levels.
Delegates commended the successful global switch from trivalent oral polio vaccine (OPV) to bivalent OPV in 2016, and emphasized that strong surveillance to detect any type 2 poliovirus from any source is now critical. A global stockpile of monovalent OPV type 2 (mOPV2) remains on hand for potential response as needed. A critical global supply shortage of inactivated polio vaccine (IPV) continues to pose a risk, but is being managed by prioritizing available supply to high-risk areas and implementing new measures to stretch available supply, notably use of fractional IPV, as recommended by the Strategic Advisory Group of Experts on immunization (SAGE).
At the same time, countries expressed appreciation at the ongoing efforts to fully implement global laboratory containment activities. They also encouraged plans to transition the infrastructure of the GPEI for the long-term, to ensure the assets and infrastructure established to eradicate polio will continue to benefit broader public health efforts even after the disease is gone. At the World Health Assembly in May, the GPEI will present a strategic roadmap towards polio transition and the development of a post-certification strategy.
With all technical and programmatic building blocks in place to achieve success, ministries urged all stakeholders to ensure that the necessary financial resources to fully implement the Endgame Plan are rapidly mobilized.
Closing the discussion, partners from civil society addressed the ministries through Rotary International with a clear call to action: “We must protect hard won gains by sustaining immunity levels and careful monitoring of virus transmission. An additional US$1.3 billion is needed through 2019 to reach more than 400 million children in up to 60 countries and to ensure high quality surveillance. The eradication of polio will be a monumental achievement by a global partnership. Such achievements exemplify what we can do when united for a common purpose. Together we can end polio and forever build a better future for all children.”
Polio is highly infectious, and can easily fly undetected with a child from one country to another. But when anyone flies from the Republic of Korea, they are directly supporting the effort to ensure this disease never travels again at all.
An innovative financing mechanism titled the ‘‘Global Disease Eradication Fund” air-ticket solidarity levy means the Government of Korea collects 1,000 South Korean Won (about US$0.85) from each international passenger departing Korea’s airports. This week, the Government of Korea announced it was giving US $4 million of those funds to UNICEF and WHO to support disease surveillance and a rapid outbreak response wherever it occurs.
This contribution has been generously matched by the Bill & Melinda Gates Foundation, doubling its impact to $8 million and reducing the polio eradication funding need, which is currently estimated at $1.3 billion for 2016-2019.
This unique new funding agreement was made possible through the committed work of Korean Rotary members, who used the global stage of their Rotary International Convention in Seoul in May to highlight the opportunity for Korea to support polio eradication.
Michael K. McGovern, the Chair of Rotary’s International PolioPlus Committee, expressed his thanks to the Government of Korea for its support. “We are getting closer to our goal of a polio-free world, but we’re not done yet,” Mr McGovern said. “This new funding from Korea will help ensure the right financial resources are in place to get the world to the finish line: a future where no child has to suffer the devastating effects of polio.”
UNICEF and WHO welcomed the funding, which will be used to detect and respond to any potential outbreak of polio. UNICEF received $3 million, with WHO receiving $1 million of the funds.
UNICEF Director of Polio Eradication Reza Hossaini said the funding would be utilized for rapid outbreak response. “UNICEF is responsible for supply and demand in an outbreak response – the rapid supply of safe and effective vaccines, and generating the demand in the community to ensure they seek the vaccine and can quickly protect their children from the virus.”
WHO’s Director of Polio Eradication, Dr Michel Zaffran, said the funding would support the roll-out of effective disease surveillance globally. “To eradicate poliovirus, we must know where it is,” Dr Zaffran said. “Korea’s contribution is key to ensuring that we can find poliovirus anywhere it still survives through sensitive disease surveillance mechanisms.”
WHO Afghanistan/S.Ramo
The borders between Afghanistan and Pakistan are porous, with populations moving fluidly between the two countries despite challenging terrain. With both countries continuing to find cases of polio, ensuring that every child crossing the border receives polio vaccines is important to stop the virus in its tracks. Following a decision to repatriate Afghan refugees from Pakistan, the numbers of people moving across the border has risen dramatically in the last year.
WHO Afghanistan/S.Ramo
Children arriving from Pakistan are at risk of communicable diseases such as polio, pertussis and measles and many suffer from acute respiratory infections due to colder weather conditions. Many are also at risk of malnutrition. Afghanistan remains a polio-endemic country; this year there have been 12 confirmed polio cases to date in Afghanistan from the eastern, southern and south-eastern regions.
WHO Afghanistan/S.Ramo
Polio vaccinators climb onto a truck to vaccinate a child at the Torkham border in Nangarhar, the busiest border crossing in Afghanistan. Over 50,000 children have been vaccinated with the oral polio vaccine (OPV) at this border crossing since July this year by vaccination teams supported by the Ministry of Public Health, WHO and UNICEF.
Currently polio teams are working at 17 cross-border points to ensure that all children entering Afghanistan get immunized against polio. Over 280 Permanent Transit Teams (PTTs) vaccinate children who travel in and out of security-compromised areas and children traveling to other destinations to ensure that every child on the move receives two drops of the oral polio vaccine to grow up healthy.
WHO Afghanistan/S.Ramo
Polio social mobilizers talk to women who have just arrived from Haripur, Pakistan, about the different kinds of vaccinations children need and the benefits of immunization. They also describe to them the symptoms of acute flaccid paralysis (AFP), the symptoms of polio, asking the women to bring their children to the nearest health centre if they suffer from any floppy weakness of the limbs.
WHO Afghanistan/S.Ramo
Elina prepares the inactivated polio vaccine (IPV) to administer to Maryam, a three-year-old refugee, at the UNHCR encashment centre in east Kabul. “I am a mother of three daughters and really enjoy my job as a nurse and vaccinator. I want to help our children and make sure all Afghan children can be spared from polio paralysis by giving them the polio vaccine.”
WHO Afghanistan/S.Ramo
Wali Mohammad has lived in Pakistan for 25 years and is now returning with his seven daughters and five sons. He holds his 3-year-old-daughter Amina on his lap at an IOM transit centre near the border in Nangargar as she is given vaccines to protect her against measles and polio.
WHO Afghanistan/S.Ramo
Sardar has been a polio vaccinator for five years. “We vaccinate hundreds of children every day by giving them two drops of the oral polio vaccine. We often climb into the trucks as they cross the border if the children don’t come down. This way we know we reach all children,” said Sardar, one of the vaccinators immunizing children at the Torkham border crossing in eastern Nangarhar province. “I want to help our children. Our country needs to finish polio for good.”
WHO Afghanistan/S.Ramo
Razi Khan holds his daughter Asma as she gets the injectable inactivated polio vaccine (IPV) at the IOM transit centre near the Torkham border. Razi Khan has five daughters and four sons and he has lived in Pakistan for the last 30 years after moving there from Laghman province. Receiving IPV alongside OPV boosts immunity against polio.
WHO Afghanistan/S.Ramo
Vaccinator Jawad calls out for children under the age of 10 at the Torkham border to get a polio vaccination if they have not yet received it from teams climbing into trucks.
With transmission limited to small geographic areas this year, Afghanistan is closer to stopping the circulation of wild poliovirus than ever before. To eradicate the debilitating disease for good, vaccination teams must continue to reach every single child, everywhere.
In the last stages of polio eradication, a sensitive surveillance system that can detect every single poliovirus is indispensable to find it in its last hiding places. In Pakistan, surveillance for cases of acute flaccid paralysis (AFP), subsequent testing and supplementary environmental sampling from the environment are informing the progress made towards eradication.
The poliovirus has proven to be a constant and resilient foe, continuing to show up in several areas of Pakistan. However, transmission is the lowest it has ever been. So far in 2016, fewer children have been paralysed by polio than at any other year in history, with the virus limited to a few areas in just three countries – Pakistan, Afghanistan and Nigeria. Pakistan has made strong progress in identifying and vaccinating missed children in the country’s most challenging areas, resulting in historical low numbers of cases this year. This remarkable achievement is especially visible in the core reservoir districts where persistent transmission has been the norm.
Training surveillance officers
The training of dedicated surveillance officers is key to ensuring Pakistan’s surveillance system is built strongly for eradication. A recent training for 32 district surveillance officers from across Pakistan highlighted the importance of effective AFP and environmental surveillance in tracking down the virus. World Health Organization’s National Surveillance Coordinator, Dr Tahir Malik said the training is essential to ensure surveillance officers down to the district level are highly skilled in identifying and investigating cases. “This is critical not only to orient new surveillance officers but also for old officers to bring alignment in surveillance procedures”. He further explained, “After training we expect from the participants to fully understand poliovirus epidemiology, AFP surveillance, but also in detail its components and mechanics in Pakistan.”
“The training, which also covered specifics on the role of laboratory, surveillance indicators, healthy children sampling and environmental surveillance, aims to bring all officers on one page in terms of programme priorities,” Dr Tahir said.
Constantly improving
Supported by contributions from the Canadian Government, the training is part of the programmes surveillance improvement plan that was recommended by the Technical Advisory Group (TAG) for Polio Eradication in Pakistan, to place a greater emphasis on disease surveillance including scaling up the workforce of dedicated staff, realigning environmental surveillance sites and ensuring surveillance targets are met by including private and informal health sectors, pushing for timely investigation, and reprioritizing reporting sites to focus on silent UCs and Tehsils.
The Chairman of the TAG Jean-Marc Olive, who was visiting Pakistan during the training, addressed the Surveillance officers from Punjab, Balochistan, FATA and KP. “Make the paediatrician your friend, talk continuously to the community, walk, move, sensitise, orient, visit facilities and care providers. Surveillance is not beautiful graphs on a laptop, it is hard field work,” he said. “Be proud of what you do for the children of Pakistan.”
The 2016-2017 National Emergency Action Plan for polio eradication also highlights the intensification of surveillance as a critical activity so that virus signal are picked up as early as possible and response initiated rapidly and aggressively. In response, the programme is working to engage private clinics, traditional healers and pharmacies to make it more likely that all cases of polio will be reported and immediate case response can be launched when needed.
Environmental surveillance
In addition, there has been an increase in the work being done for environmental surveillance. The number of sites that test for presence of the virus in sewage water has been increased to 43 sites across Pakistan’s highest risk areas and environmental samples are being taken more frequently, which is proving to support the programme to detect and track the virus, a critical step as the country edges closer to stopping transmission.
Leaving no stone unturned
Once Pakistan is able to demonstrate that no poliovirus is present, both from AFP surveillance and supplementary environmental surveillance, for three consecutive years, the country will be declared polio-free. Until that time Pakistan will continue to leave no stone unturned in pursuit of the virus and no child unvaccinated and vulnerable.
Rotarians partner together on National Immunization Day in Moradabad, India.
The award honors organizations that show philanthropic commitment and leadership through financial support, innovation, encouragement of others, and involvement in public affairs.
“We are honored to receive this recognition from the AFP, which gives us even more reason to celebrate during our Foundation’s centennial year,” says Rotary Foundation Trustee Chair Kalyan Banerjee. “The continued strong support of Rotary members will help us keep our promise of a polio-free world for all children and enable the Foundation to carry out its mission of advancing world understanding, goodwill, and peace. We look forward to another 100 years of Rotary members taking action to make communities better around the world.”
The world is in a better position than ever to finish the job on polio. To bring us over the finish line, Global Citizens, engaged citizens from all around the world, have signed petitions, tweeted, emailed, and even called their leaders asking them to fill the funding gap needed to achieve full eradication by 2019. In the lead up to this year’s Global Citizen Festival held on 24 September, individual Global Citizens took 134 470 actions to end polio leading Prime Minister Muscat of Malta and Prime Minister Bettel of Luxembourg to announce new funding commitments of $30,000 and at least 2 million euros until 2019, respectively, for polio eradication.
Canadian Prime Minister Justin Trudeau also encouraged Global Citizens to email world leaders on polio; instead, they took it one step further and called him, by the thousands. He received the message and responded to Global Citizens (and Rihanna) in a video message, showcased at the Global Citizen Festival, with Usher:
“Lately my office has been flooded with phone calls and tweets from many of you. Thanks Rihanna! I’ve heard your voices loud and clear on a whole range of issues – from supporting the eradication of polio, to ensuring every girl everywhere has the chance to go to school. Canada has long supported efforts to fight polio, which is now 99.9 % eliminated. And we will be a strong partner through to the end. Thank you for keeping these issues on our global agenda. Keep calling, keep tweeting, keep lighting up our switchboards. We’re listening, and we’re taking action. You’ve shown to the world that change starts with you. Together, we will end it for good.” – Justin Trudeau, Prime Minister of Canada
Global Citizens are holding Prime Minister Trudeau to his promise. They will continue to call on Canada, UK, and other countries to fully fund efforts to end polio. Together, we can make polio the second disease to be eradicated within our lifetimes.
About Global Citizen: Global Citizen is a campaigning and advocacy organization that is catalyzing a movement to end extreme poverty by 2030. As one of its longest running campaigns, Global Citizen has campaigned to bring about the end of polio by raising public awareness and campaigning towards government funding of the Global Polio Eradication Initiative. To learn more: https://www.globalcitizen.org/en/
One year into the implementation of the 2030 Agenda for Sustainable Development, global leaders reconfirmed their full commitment to implementing ensuring healthy lives and well-being for all, including ending polio.
Health Ministers and high representatives of Canada, France, Germany, Italy, Japan, the United Kingdom, the United States and the European Commissioner for Health and Food Safety gathered in Kobe on 11 – 12 September, in continuation of the G7 Ise-Shima Summit in May to address major global health challenges.
In a statement released following the meeting, the leaders called for commitments from all stakeholders in the polio eradication programme to ensure that every last child is reached with polio vaccines. They particularly emphasised the need to fill the programme’s funding gap in order to ensure the achievement of this global good.
As well highlighting the importance of going above and beyond to reach children even in the most challenging environments, the G7 leaders also looked to the future, stating that polio assets have the potential to contribute to strengthening health systems if transitioned to other programmes once polio eradication has been achieved.
In 2013, a group of Dutch Rotarians began selling boxes of tulip bulbs, with proceeds going to EndPolioNow, as part of Rotary’s fight against polio. In that year alone, tulips found their way to Rotarians across the Netherlands. Since then the tulip initiative has spread, with 4500 boxes sold in 2015, raising more than €45,000. This was tripled by the Bill and Melinda Gates Foundation resulting in a donation of $144,727 for the End Polio Now fund.
In 2016 the campaign has committed to committed to selling at least one box of Rotary tulip bulbs per Rotarian in the Netherlands, with over 18,000 members in the country. The campaign has also grown to become international in scope, with tulips sold across, Germany, Switzerland and the United States of America.
Rotary’s work
The EndPolioNow tulip campaign is just one example of efforts made by Rotarians across the world to end polio for good. Through its PolioPlus programme, established in 1985, Rotary was the first to have the vision of a polio-free world. More than one million Rotary members have volunteered their time and personal resources to polio eradication in nearly every country. Rotary members also provide valuable field support during National Immunization Days through social mobilization and by administering the oral polio vaccine to children.
It is thanks to the dedicated work of Global Polio Eradication Initiative partners such as Rotary International and Rotarians across the globe that we are now closer than ever to eradicating polio for good.
Learn more about Rotary’s work to eradicate polio here.
The United Arab Emirates (UAE) has provided more than 116 million units of polio vaccine for Pakistani children between January 2014 and the end of May 2016 through the Emirates Polio Campaign. This commitment has played an important role in the progress seen in Pakistan in recent years, as highlighted by the recent meeting of the Technical Advisory Group (TAG) Islamabad.
In May, Rotary recognized five members of Congress for their support of the humanitarian service organization’s top priority to eradicate polio, a vaccine-preventable disease that still paralyzes children in parts of the world today.
The following lawmakers were presented with Rotary’s Polio Eradication Champion Award during an event at the Capitol Building in Washington, D.C. on May 11, 2016: Sen. Roy Blunt (MO.), Sen. Jeff Merkley (OR.), Sen. Brian Schatz (HI), Rep. Tom Cole (OK), and Rep. Dave Reichert (WA).
These five lawmakers serve as advocates for securing U.S. government funding for polio eradication activities through the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Agency for International Development (USAID). As key allies, they influence both their constituents at home and congressional colleagues to support a polio-free world.
As the world’s largest funder of polio eradication, the U.S. government has contributed more than $2.8 billion since the mid-1980s. To support the final push to end polio, Rotary and its partners are asking for $234 million in U.S. funding in 2017 through the CDC and USAID.
Rotary established the Polio Eradication Champion Award in 1995 to recognize heads of state, health agency leaders and others who have made a significant contribution to polio eradication.
Past recipients of the Rotary award include Angela Merkel, Chancellor of Germany; Prime Minister David Cameron of the United Kingdom, United Nations Secretary-General Ban Ki-moon, and 43 current members of the 114th Congress previously recognized by Rotary as Champions.
At the 42nd G7 Summit presided by Japan on 26 – 27 May, G7 leaders reaffirmed their continued commitment to reaching polio eradication targets. Courtesy G7
Related
WHO
Last week, global political commitment to eradicating polio was affirmed at the World Health Assembly (WHA) in Geneva. During the polio agenda item, member states discussed progress made in the last year and the remaining hurdles that stand in the way of polio eradication.
In her opening address to the WHA, Dr Margaret Chan, Director General of WHO, said polio eradication has never been so close to the finish line. “During the short span of 2 weeks in April, 155 countries successfully switched from trivalent to bivalent oral polio vaccine, marking the largest coordinated vaccine withdrawal in history. I thank you and your country teams for this marvellous feat,” she said.
Member states reviewed the latest global epidemiology, noting the strong progress made across Africa with no case of wild poliovirus in approaching two years. Delegates from Afghanistan and Pakistan, the final remaining polio endemic countries, outlined the steps they are taking to ensure that transmission is interrupted as a matter of urgency. With fewer missed children than ever before and just 74 cases across the two in 2015, achieving eradication has never appeared to be such an achievable target.
Many member states spoke to reaffirm their commitments to fulfilling the objectives of the resolution passed at the last WHA to commit to ending polio once and for all. Michel Zaffran, Director of Polio Eradication at WHO, stated that strong progress had been made against all four objectives of the Polio Eradication and Endgame Strategic Plan.
Delegates also commended the historic achievement of the switch, warning that shortages of the inactivated polio vaccine and potential outbreaks of type 2 vaccine-derived polioviruses would be some of the major challenges of the coming year. They also expressed appreciation for the global contingency plans put in place to adequately manage the risks associated with the supply shortage, notably the availability of the stockpile of monovalent oral polio vaccine type 2.
Gavi, the Vaccine Alliance, supported the interjections of several member states highlighting the importance of ramping up transition planning in countries to prepare for the end of the polio infrastructure after eradication. “To be sustainable, the decision on which polio assets to sustain must be fully led and driven by countries themselves, based on national ownership, national plans and investments,” said the Gavi spokesperson.
Rotary international spoke to affirm that their 1.2 million volunteers worldwide remain fully committed to polio eradication. “We have three key challenges remaining,” said the Rotarian speaker. “First, we have to interrupt polio in Pakistan and Afghanistan. Second, we must avoid complacency. An additional US $1.5 billion is needed through 2019 to sustain high levels of immunity, repeatedly reaching more than 400,000,000 children in up to 60 countries and carrying out high quality surveillance to protect progress. Finally we must fully leverage the physical and intellectual assets of polio eradication so that they can benefit broader public health priorities.”
The Government of Canada announced a Can$19.9 million contribution to Nigeria’s polio programme yesterday to help keep the country free from the debilitating virus, as part of its Can$ 250 million commitment to polio eradication for 2013-18. The announcement was made by Canada’s Minister for International Development, Hon. Marie-Claude Bibeau at the global Women Deliver conference in Copenhagen. This high-level event focused on the Sustainable Development Goals and developing solutions to the health, economic and social challenges facing girls and women around the world today.
Through WHO’s ‘Sustaining Polio Eradication Through Strengthened Routine Immunization project’, the additional funding will help to immunize more than 13 million children against polio in 11 high-risk Nigerian states, and train upwards of 150,000 vaccinators. It complements Canada’s polio eradication support for the Hard-to-Reach Project through UNICEF, an initiative to bring polio vaccines to the most vulnerable and remote communities alongside other health interventions such as routine vaccines, maternity care, deworming tablets and Vitamin A supplements.
“Polio will be eradicated in a few years,” said Minister Bibeau in a press statement. “Consider the powerful impact of such a statement. It can happen with a sustained effort aimed at immunizing every child. Our aim is to help reduce the burden of diseases affecting mothers and children, and eradicate polio from Nigeria for good.”
Citing the conference as an opportune time to make the announcement, WHO thanked the Government of Canada for its continuous support to polio eradication efforts in Nigeria and beyond.
“We are grateful for Canada’s leadership and significant support to polio eradication and its commitment to keep Nigeria polio free,” said Dr Flavia Bustreo, WHO Assistant Director General for Family, Women’s and Children’s Health. “Given the leadership role that women play in polio eradication worldwide, it is particularly meaningful that this announcement is made at Women Deliver,” she added. “As the caretakers in many families, women are well placed to convince families to accept vaccination. Thanks to the critical action of women as community mobilizers and vaccinators, the programme is reducing the number of chronically missed children by building community trust.”
Nigeria successfully removed itself from the list of polio endemic countries in 2015 with its last case in July 2014, a remarkable achievement for a country that for decades struggled to stamp out the virus. Although now polio-free, like many other countries, it remains at significant risk of poliovirus importation.
“Polio is still endemic in Afghanistan and Pakistan, and so long as transmission occurs in these countries, we are not out of the woods,” said Joseph Swan, Communications Officer for WHO’s polio hub based in Amman, Jordan, who attended the conference. “WHO and partners continue to work closely with governments of countries like Nigeria to enhance immunization coverage and improve surveillance systems to detect polio, should it reappear. We mustn’t be complacent. We must continue to innovate to reach every last child in the poorest and most underserved communities of the world. Because until polio transmission is stopped for good, no country is safe from outbreaks,” he said.
Women are increasingly empowered with new roles to serve their communities, which could have lasting changes on societies. A new strategy to employ local women to administer the vaccine and make regular house visits in some of the highest risk areas is being implemented in high-risk areas of Pakistan. Female teams are now covering nearly 40% of Karachi’s 2.2 million children younger than five, and the initiative will be scaled up.
The Women Deliver conference brought together more than 5000 participants, from policymakers to activists, youth leaders, and members of civil society and the corporate sector, as well as partners of the Global Polio Eradication Initiative.
The Canadian announcement comes weeks after its Can$40 million contribution to aid eradication efforts in Pakistan.
