Sixty-fifth World Health Assembly: daily notes on proceedings
– Notes: Friday, 25 May 2012
Intensification of the global polio eradication initiative
Committee A today approved a draft resolution (EB130.R10) which declares the completion of poliomyelitis eradication a programmatic emergency for global public health. India was once again congratulated for stopping indigenous wild poliovirus circulation. However, three countries still face endemic transmission of wild polio virus; unless poliovirus transmission is stopped in these countries, there will be a global resurgence of the disease with a real risk of severe outbreaks in areas that have long been polio-free. The approved resolution requires the full implementation of current and new eradication strategies, the institution of strong national oversight and accountability mechanisms for all areas infected with poliovirus, and the application of appropriate vaccination recommendations for all travellers to and from areas infected with poliovirus.
Member States with poliovirus transmission are urged to declare such transmission to be a “national public health emergency”, requiring the development and full implementation of emergency action plans. Pakistan, Nigeria and Afghanistan have already established national emergency plans for polio eradication and shifted their national polio eradication initiatives to an emergency status, with an all-of-government and society approach to ensure all children are reached and vaccinated. During the discussion, partners reiterated their support to the polio eradication initiative and the importance of treating polio eradication as a programmatic emergency, and urged all partners to be fully committed in their action and their financing.
SIXTY-FIFTH WORLD HEALTH ASSEMBLY (Draft) A65/55
26 May 2012
Third report of Committee A
Committee A held its eighth, ninth and tenth meetings on 25 May 2012. These meetings were held under the chairmanship of Mr Herbert Barnard (Netherlands) and Dr Zangley Dukpa (Bhutan).
It was decided to recommend to the Sixty-fifth World Health Agenda item 13.10
Poliomyelitis: intensification of the global eradication initiative
The Sixty-fifth World Health Assembly,
– Having considered the report on poliomyelitis: intensification of the global eradication initiative;
– Recalling resolution WHA61.1 on poliomyelitis: mechanism for management of potential risks to eradication, which, inter alia, requested the Director-General to develop a new strategy to reinvigorate the fight to eradicate poliovirus and to develop appropriate strategies for managing the long-term risks of reintroduction of poliovirus and re-emergence of poliomyelitis, including the eventual cessation of use of oral poliovirus vaccine in routine immunization programmes;
– Recognizing the need to make rapidly available the necessary financial resources to eradicate the remaining circulating polioviruses and to minimize the risks of reintroduction of poliovirus and reemergence of poliomyelitis after interruption of wild poliovirus transmission;
– Noting the finding by the Independent Monitoring Board of the Global Polio Eradication Initiative finding in its report of October 2011 that “polio simply will not be eradicated unless it receives a higher priority – in many of the polio-affected countries, and across the world”1 and its recommendation in its April 2011 report that the World Health Assembly “considers a resolution to declare the persistence of polio a global health emergency”;
– Noting the report of the meeting in November 2011 of the Strategic Advisory Group of Experts on immunization at which it stated “unequivocally that the risk of failure to finish global polio eradication constitutes a programmatic emergency of global proportions for public health and is not acceptable under any circumstances”;
– Recognizing the need for Member States to engage all levels of political and civil society so as to ensure that all children are vaccinated in order to eradicate poliomyelitis;
– Having noted the current high cost and limited supplies of inactivated polio vaccine that are hampering the introduction and scaling-up of inactivated polio vaccine, resulting in major programmatic and financial implications to developing countries;
– Noting that the technical feasibility of poliovirus eradication has been proved through the full application of new strategic approaches;
– Noting that continuing poliovirus transmission anywhere will continue to pose a risk to
poliomyelitis-free areas until such time as all poliovirus transmission is interrupted globally;
1. DECLARES the completion of poliovirus eradication a programmatic emergency for global public health, requiring the full implementation of current and new eradication strategies, the institution of strong national oversight and accountability mechanisms for all areas infected with poliovirus, and the application of appropriate vaccination recommendations for all travellers to and from areas infected with poliovirus;1
2. URGES Member States with poliovirus transmission to declare such transmission to be a “national public health emergency” making poliovirus eradication a national priority programme, requiring the development and full implementation of emergency action plans, to be updated every six months, until such time as poliovirus transmission has been interrupted;
3. URGES all Member States:
(1) to eliminate the unimmunized areas and to maintain very high population immunity against polioviruses through routine immunization programmes and, where necessary, supplementary immunization activities;
(2) to maintain vigilance for poliovirus importations, and the emergence of circulating vaccine-derived polioviruses, by achieving and sustaining certification-standard surveillance and regular risk assessment for polioviruses;
(3) to make available urgently the financial resources required for the full and continued implementation, to the end of 2013, of the necessary strategic approaches to interrupt wild poliovirus transmission globally, and to initiate planning for the financing to the end of 2018 of the polio endgame strategy;
(4) to engage in multilateral and bilateral cooperation, including exchanging epidemiologic information, laboratory monitoring data, and carrying out supplementary immunization activities simultaneously as appropriate;
4. REQUESTS the Director-General:
(1) to plan for the renewed implementation through 2013 of the approaches for eradicating wild polioviruses outlined in the Global Polio Eradication Initiative Strategic Plan 2010–2012 and any new tactics that are deemed necessary to complete eradication, including the enhancement of the existing global polio eradication initiative within the Organization;
(2) to strengthen accountability and monitoring mechanisms to ensure optimal
implementation of eradication strategies at all levels;
(3) to undertake the development, scientific vetting, and rapid finalization of a
comprehensive polio eradication and endgame strategy and inform Member States of the potential timing of a switch from trivalent to bivalent oral poliovirus vaccine for all routine immunization programmes; and includes budget scenarios to the end of 2018 that include risk management;
(4) to coordinate with all relevant partners including vaccine manufacturers, to promote the research, production and supply of vaccines, in particular inactivated polio vaccines, to enhance their affordability, effectiveness and accessibility;
(5) to continue mobilizing and deploying the necessary financial and human resources for the strategic approaches required through 2013 for wild poliovirus eradication, and for the eventual implementation of a polio endgame strategy to the end of 2018;
(6) to report to the Sixty-sixth World Health Assembly and the subsequent two Health Assemblies, through the Executive Board, on progress in implementing this resolution.
1 International travel and health. Geneva, World Health Organization, 2012 edition.