Public Health Emergency of International Concern (PHEIC)
Polio this week as of 16 August 2017 [GPEI]
:: Marking Pakistan’s Independence Day this week, Canadian Prime Minister Justin Trudeau paid tribute to both countries’ ongoing collaboration, including on the effort to eradicate polio.  “Our two countries established a diplomatic relationship shortly after Pakistan was declared a sovereign nation in 1947. We continue to work together to advance shared priorities, including governance and democracy, regional security, poverty reduction, polio eradication, trade, defense, and the fight against climate change.”

:: The 14th Emergency Committee for polio eradication under the International Health Regulations met on 3 August and has made its recommendations to the WHO Director-General, who has accepted them.  The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC), and recommended the extension of revised Temporary Recommendations for a further three months.  The key change is the inclusion of DR Congo and Syria in the category ‘States infected with cVDPV2s, with potential risk of international spread’.

:: Long-time polio eradicator Iris Tetford retires:  the partners of the Global Polio Eradication Initiative (GPEI) wish Iris Tetford a well-deserved and happy retirement.  For years, Ms Tetford has been an integral part of the polio eradication team at WHO in Geneva.  She contributed substantially to the creation of the weekly global update, and continuously close coordinated with regional and country counterparts to manage the weekly data analysis and public reporting process.  Many thanks for your tremendous engagement and contribution to the global eradication effort, Iris!  We wish you all the best for your well-deserved retirement.

:: Summary of newly-reported viruses this week:  Afghanistan:  one new wild poliovirus type 1 (WPV1) case; Pakistan:  one new WPV1-positive environmental sample; Syrian Arab Republic:  three new circulating vaccine-derived polio type 2 (cVDPV2) from Syria, two from Deir-Ez-Zour and one from Homs governorates…

Statement of the 14th IHR Emergency Committee regarding the international spread of poliovirus
WHO statement
3 August 2017
[Excerpts; Editor’s text bolding]]
The fourteenth meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) regarding the international spread of poliovirus was convened by the Director General on 3 August 2017 at WHO headquarters with members, advisers and invited member states attending via teleconference.

The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine derived polioviruses (cVDPV). The Secretariat presented a report of progress for affected IHR States Parties subject to Temporary Recommendations. The following IHR States Parties presented an update on the current situation and the implementation of the WHO Temporary Recommendations since the Committee last met on 24 April2017: Afghanistan, Democratic Republic of Congo (DR Congo), Nigeria, Pakistan and Syria….

The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC), and recommended the extension of revised Temporary Recommendations for a further three months…

Additional considerations
The Director-General Dr Tedros attended the Emergency Committee and listened to the recommendations of the committee. He thanked Committee Members and Advisors for their advice, and noted that in the context of polio eradication, even one case of polio should be treated as an emergency. He noted that in all the geographic areas reviewed by the committee at the meeting, a sub-regional or multi-country coordinated response greatly improved the chance of success, and that to achieve the final goal of zero cases, the world may need to respond even more aggressively. He affirmed that he was personally committed as Director-General to providing any support needed to reduce the risk of the international spread of polio recommended by the committee.

The Committee strongly urged global partners in polio eradication to provide optimal support to all infected and vulnerable countries at this critical time in the polio eradication programme for implementation of the Temporary Recommendations under the IHR, as well as providing ongoing support to all countries that were previously subject to Temporary Recommendations (Somalia, Ethiopia, Iraq, Israel and Equatorial Guinea).

The Committee urged all countries to avoid complacency which could easily lead to a resurgence of polio. Surveillance particularly needs careful attention to quickly detect any new transmission, and careful assessment of where insecurity and inaccessibility impact on surveillance was needed. Similarly, there needs to be tracking of populations where there are high proportions of unvaccinated children due to inaccessibility, and requested the secretariat to include a report on this issue at its next meeting.

Based on the current situation regarding WPV1 and cVDPV, and the reports made by Afghanistan, DR Congo, Nigeria, Pakistan, and Syria, the Director-General accepted the Committee’s assessment and on 3 August 2017 determined that the situation relating to poliovirus continues to constitute a PHEIC, with respect to WPV1 and cVDPV


Situation reports on the polio outbreak in Syria
Situation update 8 August 2017
Three (3) new cases of cVDPV2 were reported this week from 3 new districts: 1 case from Deir Ez-Zor district, Deir Ez-Zor governorate; 1 from Boukamal district, Deir Ez-Zor governorate; and 1 from Tadmour district, Homs governorate.

Five districts in 3 governorates are now infected.

The total number of cVDPV2 cases is 33 (this includes the previously reported 29 cases from Mayadeen district, Deir Ez-Zor governorate, and 1 case from Tell Abyad district, Raqqa governorate). All confirmed cases to date have had onset of paralysis before 11 July 2017.
Final laboratory results for an additional 9 poliovirus type-2 (PV2) isolates from Deir Ez-Zor are pending.

Discussions around expanding the scope of the immunization response to include accessible areas of a Tadmour sub-district in Homs, bordering Deir Ez-Zor, will be held in light of the confirmation of the cases in this area.

Raqqa governorate commenced its first immunization round on 12 August (Raqqa and Thawra districts) and 13 August (Tell Abyad district). The immunization round aims to reach 120 000 children under 5 years of age. Preliminary information suggests the rounds are reaching children in all three districts.

Preparations continue for the second round in Deir Ez-Zor governorate, scheduled for 19-23 August. IPV for use in the second rounds in Deir Ez-Zor and Raqqa governorates has arrived in Damascus.

The total number of AFP cases detected in Deir Ez-Zor governorate since the beginning of 2017 is 113 (83 from Mayadeen, 11 from Deir Ez-Zor, and 19 from Boukamal districts). Raqqa governorate has reported 16 AFP cases (5 from Raqqa, 10 from Tell Abyad, and 1 from Thawra districts). Homs governorate has reported 26 AFP cases (11 from Homs city, 12 from Rastan, 1 from Tadmour and 2 from Talkalakh districts).

The Eradication and Outbreak Management Group (EOMG) has approved the release of additional doses of IPV to cover high-risk population groups in northwest Syria, Turkey and Lebanon. Lebanon requested 144 000 doses and has begun to implement IPV campaigns across the country.


WHO Grade 3 Emergencies  [to 19 August 2017]
::  Cholera count reaches 500,000 in Yemen  14 August 2017

The Syrian Arab Republic
:: Situation reports on the polio outbreak in Syria  8 August 2017
 [See Polio above for more detail]

:: WHO and partners take on malaria: the top killer in north-eastern Nigeria
August 2017
WHO estimates up to 10 000 lives could be saved by November through malaria prevention and control, if more funds are secured

WHO Grade 2 Emergencies  [to 19 August 2017]
:: Reaching key populations to prevent the spread of disease in Ethiopia  10 August 2017
:: Community engagement contributes to control of acute watery diarrhea in Ethiopia’s Somali region  2 August 2017

:: World Humanitarian Day: WHO urges more health aid to address Ukraine’s humanitarian crisis  18 August 2017

UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
:: Iraq: Mosul Humanitarian Response Situation Report No. 41 (27 July to 8 August 2017)

Syrian Arab Republic
:: 19 Aug 2017   One Syrian doctor’s determination in the face of violence and displacement

:: 17 Aug 2017  Statement by the Humanitarian Coordinator in Yemen Mr. Jamie McGoldrick on Shrinking Humanitarian Space in Yemen [EN/AR]
:: 13 Aug 2017  Yemen Humanitarian Bulletin Issue 26 | 14 August 2017
:: Revised 2017 Yemen Humanitarian Response Plan (YHRP)


UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
:: Ethiopia Weekly Humanitarian Bulletin, 7 August 2017

:: United in the fight against sexual violence in North Kivu 12 Aug 2017
   The widespread use of sexual violence in North-Kivu

:: Horn of Africa: Humanitarian Impacts of Drought – Issue 9 (10 Aug 2017)
:: Statement by the UN Deputy Humanitarian Coordinator for Nigeria, Peter Lundberg – Press Conference, 12 August 2017
…Responding to the humanitarian needs of millions of people in the northeast remains our priority and our focus, each and every day. The fact remains that the humanitarian crisis in Nigeria’s north-east and the Lake Chad region – now in its eighth year – is one of the most severe in the world today, with 8.5m people in need of humanitarian assistance in 2017 in the worst-affected states of Borno, Adamawa and Yobe, and 6.9m targeted for humanitarian assistance in these three states.
Civilians continue to bear the brunt of a conflict that has resulted in widespread forced displacement – today more than 1.8 million are internally displaced – and violations of international humanitarian and human rights law, severe protection concerns and a food and nutrition crisis of massive proportions.
Women and girls are also disproportionately affected by this…

Editor’s Note:
We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.

MERS-CoV [to 19 August 2017]
21 July 2017   WHO/MERS/RA
Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia
17 August 2017
Between 4 July and 12 August 2017, the national IHR Focal Point of Saudi Arabia reported 26 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection including six deaths, and two deaths among previously reported cases…Globally, 2066 laboratory-confirmed cases of infection with MERS-CoV including at least 720 related deaths have been reported to WHO..