Public Health Emergency of International Concern (PHEIC)
Polio this week as of 3 April 2018 [GPEI]
:: New on www.polioeradication.org: Bill Gates and Aliko Dangote support polio eradication efforts in Nigeria. We talk with Professor Rose Leke, Chair of the African Regional Certification Commission, and with Dr Ondrej Mach, who explains why we are developing new polio vaccines for the post-eradication era.
:: The report following the February meeting of the Global Commission for Certification of Poliomyelitis Eradication (GCC) is now published and available here. The GCC came together to review the criteria that will need to be met to achieve global certification of eradication.
:: In Kenya, advance notification of a circulating vaccine-derived poliovirus type 2 (cVPDV2) detected from an environmental sample is being investigated (to be officially reflected in next week’s global data). A cVDPV2 was isolated from an environmental sample collected on 21 March 2018 from Nairobi, linked to the cVDPV2 confirmed from Mogadishu, Somalia. No cases of paralysis associated with this virus have been detected, however a risk assessment is ongoing as is planning for a potential regional response.

Summary of newly-reported viruses this week:
Afghanistan: Two new wild poliovirus type 1 (WPV1)  positive environmental samples have been reported in Kandahar province.
Pakistan: One new wild poliovirus type 1 (WPV1)  positive environmental sample has been reported in Sindh province

Global Commission for the Certification of the Eradication of Poliomyelitis – Report from the Seventeenth Meeting
Geneva, Switzerland, 26 – 27 February 2018 :: 23 pages
The Global Commission for the Certification of Poliomyelitis Eradication (GCCPE/GCC) met in February 2018. It noted that although no WPV paralytic cases had been reported in Pakistan since November 2017 and fewer cases were being reported from Afghanistan for comparable periods in earlier years, considerable numbers of positive environmental samples were being reported from both countries implying that there was still significant ongoing transmission. This circulation of WPVs has implications for the commencement and conclusion of the process of certification of interruption of transmission.

The GCC has previously asked for development of a risk assessment tool that can be used by National Certification Committees and Regional Certification Commissions allowing the GCC to compare risks and their mitigation between countries and across Regions. The GCC noted the progress being made with this tool and hopes that it will be introduced shortly in all Regions.

The GCC considered the possibility that there may still be cVDPV outbreaks in the approach to certification and agreed conditions for the process of certification in such circumstances. The GCC also reviewed the surveillance standards that it will require countries to fulfil according to the systems in place (AFP, environmental and enterovirus surveillance or combinations of these). The GCC’s Terms of Reference were reviewed since it had been many years since this was last done. The GCC has previously recommended that countries should undertake outbreak simulation exercises and proposed that the GCC should undertake a certification exercise. This could be done using the example of certification of WPV3 eradication. Finally, the GCC asked for a time line for its activities to be presented regularly and updated as circumstances on the interruption of transmission and containment change.

The GCC will meet next in approximately six months.
Prof. David M. Salisbury CB
Chair, GCC


WHO Grade 3 Emergencies  [to 14 April 2018]

WHO concerned about suspected chemical attacks in Syria
11 April 2018 – WHO is deeply alarmed by reports of the suspected use of toxic chemicals in Douma city, East Ghouta.

WHO Grade 2 Emergencies  [to 14 April 2018]

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. 
Syrian Arab Republic
:: Syrian Arab Republic: Response to the East Ghouta Crisis in Rural Damascus Situation Report No. 3 (3 April – 11 April 2018) 11 Apr 2018
:: Turkey | Syria: Situation in North-western Syria – Situation Report No.2 (as of 10 April 2018)

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 Humanitarian Bulletin Issue 50 | 26 March – 08 April 2018

Rohinga Refugee Crisis 
:: ISCG Situation Report: Rohingya Refugee Crisis, Cox’s Bazar | 12 April 2018
Editor’s Note:
We will cluster these recent emergencies as below and continue to monitor the WHO webpages for updates and key developments.

Yellow Fever  [to 14 April 2018]
:: Nearly one billion people in Africa to be protected against yellow fever by 2026  10 April 2018
[See Milestones/Perspectives above for more detail]