POLIO [to 19 December 2015]

POLIO [to 19 December 2015]
Public Health Emergency of International Concern (PHEIC)

GPEI Update: Polio this week as of 15 December 2015

:: The report on the September 2015 meeting of the Strategic Advisory Group of Experts on immunization (SAGE) was published this week, confirming that the globally coordinated withdrawal of the type 2 component in oral polio vaccine (OPV), also referred to as the ‘tOPV to bOPV switch’, should occur in April 2016.

:: Looking back at 2015 and ahead at 2016: a wrap-up of the year shows fewer cases in fewer places than ever before. The report on the status of polio eradication to WHO’s Executive Board also summarizes the progress on the Polio Endgame Plan, and on Resolution WHA68.3, adopted by the World Health Assembly (WHA) in May 2015.
[No new cases identified in Country-level reports in this week’s Update]


Poliomyelitis – Report by the Secretariat
WHO Executive Board 138 Session Provisional Agenda item 8.6
EB138/25 11 December 2015
Excerpts – Editor’s text bolding
1. At the time of writing (November 2015), strong progress continues to be made towards each of the four objectives of the Polio Eradication and Endgame Strategic Plan 2013–2018 (the Endgame Plan). With only Afghanistan and Pakistan remaining endemic for poliomyelitis, wild poliovirus transmission is at the lowest levels in history, with the fewest-ever reported cases from the fewest-ever affected countries. In resolution WHA68.3 on poliomyelitis, adopted in May 2015, the World Health Assembly recognized progress made towards interrupting transmission and towards the phased removal of oral polio vaccines, and urged Member States to fully finance and implement the Endgame Plan.

2. The declaration of international spread of wild poliovirus as a Public Health Emergency of International Concern and the temporary recommendations promulgated under the International Health Regulations (2005) remain in effect. In September 2015, the Polio Oversight Board of the Global Polio Eradication Initiative reviewed progress and concluded that wild poliovirus transmission is more likely to be interrupted in 2016 than in 2015. This delay shifts the target date for certification of global polio eradication to 2019 and increases the cost of completing polio eradication by US$ 1500 million. In October 2015, WHO’s Strategic Advisory Group of Experts on immunization confirmed its recommendation that the withdrawal of oral polio vaccines containing the type 2 component should occur during the period 17 April–1 May 2016 in all countries that are using trivalent oral polio vaccine through a globally-coordinated replacement of this vaccine by the bivalent oral polio vaccine. The Group also reaffirmed that, in preparation for this global event, it is crucial that countries meet established deadlines to identify facilities holding wild or vaccine-derived poliovirus type 2, destroy all type 2 poliovirus materials and, only where necessary, appropriately contain type 2 poliovirus in essential poliovirus facilities…

Strengthening routine immunization
15. The Global Polio Eradication Programme initiated a joint programme of work with the GAVI Alliance and other partners to support efforts to strengthen routine immunization in 10 “focus” countries with significant polio resources. Six of these countries – Chad, Democratic Republic of the Congo, Ethiopia, India, Nigeria and Pakistan – have developed annual national immunization plans that build on polio assets to improve broader immunization goals, resulting in as much as a 22% reduction in unimmunized children in some areas, in 2014 compared to 2013.1 Polio staff in these countries spend as much as 50% of their time on broader immunization and public health issues.

16. In 2015, pursuant to resolution WHA68.3, the Global Commission for the Certification of the Eradication of Poliomyelitis and the Strategic Advisory Group of Experts on immunization urged accelerated implementation of the WHO Global Action Plan to minimize poliovirus facility-associated risk after type-specific eradication of wild polioviruses and sequential cessation of oral polio vaccine use (GAP III). Specifically, all Member States should complete Phase I (Preparation for containment of poliovirus type 2) which includes establishing an inventory of facilities holding polioviruses, destroying all wild poliovirus materials by the end of 2015 and destroying all Sabin type 2 poliovirus materials by July 2016. Any type 2 poliovirus materials not destroyed should be securely contained in designated “poliovirus essential” facilities. For implementation of Phase II (Poliovirus type 2 containment period) Member States hosting essential poliovirus facilities (vaccine production, research and repositories) should designate a national containment authority, establish biorisk management regulations aligned with GAP III, and certify secure containment of poliovirus materials. The Secretariat is supporting Member States in implementing the global action plan…

Circulating vaccine-derived poliovirus – Lao People’s Democratic Republic
Disease outbreak news
15 December 2015
On 8 December 2015, the National IHR Focal Point of Lao People’s Democratic Republic (PDR) notified WHO of 2 additional VDPV1 cases. These cases are from Xaisomboun, a previously unaffected province. To date, the total number of confirmed cVDPV1 cases in this outbreak is 5…

IS Hinders Polio Eradication Efforts in Afghanistan
Noor Zahid, Zabihullah Ghazi
Voice of America December 11, 2015 4:40 PM
Polio vaccinations for tens of thousands of Afghan children are being delayed because health workers are unable to access remote regions controlled by Islamic militants including the Islamic State group.

Gula Khan Ayub, a Ministry of Public Health official, said around 100,000 children could not get vaccinated in a recent four-day polio vaccination campaign carried out in 14 eastern and southern provinces of Afghanistan due to militants’ threats.

The militants are blocking polio vaccination campaigns, saying the Afghan government and the West are using health workers for intelligence-gathering purposes, VOA correspondent Zabihullah Ghazi reports…