The Global Perspective
&
The Polio Endgame
What's the Polio 'Endgame'?
0
100
200
300
400
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005...
Last type 2 wild poliovirus: 1999
however…..
Vaccine-derived polio outbreaks (cVDPVs)
2000-2013
Type 2 (478 cases)
Type 1 (79 cases)
Type 3 (9 cases)
Type 2
Type 1
Typ...
The Endgame Goal: complete the
eradication of all wild & vaccine-related
polioviruses.
• Polio detection &
interruption
• Systems strengthening, IPV
intro. & OPV withdrawal
• Containment &
Certification
• Lega...
Bivalent OPV
(bOPV)
Inactivated Poliovirus
Vaccine (IPV)
The 'endgame' approach
Strengthen routine immunization immediately
Introduce at least 1 dose of IPV by end-2015
Switch fro...
The role of IPV
• Reduce risks of OPV2 withdrawal
• Help stop outbreaks if type 2 reintroduced
• Boost immunity against po...
The IPV challenge: not ‘business as usual’
IPV
Hep B
$5.0 B* pledged for Polio Endgame Plan
* including pledges received since the Summit
I s l a m i c Ad v i s o r y
G r o u p ( I AG )
Endgame Progress
27 March 2014
80% of world's population
now certified polio-free!
0
250
500
750
1000
1250
2007 2008 2009 2010 2011 2012 2013
Cases
Polio, type 3 cases
Last type 3 case :
10 Nov 2012, Niger...
Polio Cases, 2014
Type 1 Pakistan 71
Afghan 4
Cameroon 3
Eq Guinea 3
Nigeria 3
Iraq 2
Syria 1
Ethiopia 1
Somalia 1Polio 20...
IPV today
71 countries already using IPV
85 have plan to introduce by end-2015
39 have not yet announced a plan
0 1,500 3,...
Addressing
Barriers
KANO, LQAs trend
BORNO, Access Trend
Mar
100%
Dec
14%
2014
3 cases
0
0.5
1
1.5
2
2.5
3
3.5
Est'd < 5
yr (2010
MoH)
Nov
(MoH)
Dec
(MoH)
Jan (all
sources)
Feb (all
sources)
Apr (all
sources)
...
AUG SEP OCT
NOV DEC JAN
Accessible
Insecurity
Partially
inaccessible
Inaccessible
HORN OF AFRICA outbreak
AFGHANISTAN
• South: ongoing
indigenous virus
• East/North: cont'd
importations
• new PM Polio Focal Point
• new security strategy KP
• Waziristan dialogue
• DG/WHO engaging PM
FATA, OPV trend
Imran Kha...
2013
Public Health Emergency of
International Concern (PHEIC)
Temporary recommendations for all 'exporting countries'
Risks
Syria’s Polio Epidemic: The
Suppressed Truth
Annie Sparrow
Syria's Raging Health Crisis
By ADAM P. COUTTS and FOUAD M. FOU...
The 'Red List' Countries
West
Africa
Niger
Mali
Horn of
Africa
Yemen
S. Sudan
Middle
East
Leb, Jor
Tur, Irq
Central
Africa
CAR
Chad
More 'Red List'...
Carry
forward
Funding & Cash Gaps
2014 CASH GAP
FRR
Funding Needs: Current Operational Budget 1,032.95$
less Operationaliz...
Priorities
1. Nigeria (stop in 2014)
2. Outbreaks (stop in 2014)
3. Pakistan/Afghanistan
4. Red list countries
'Eradication attacks
inequities; the ultimate
in social justice.'
circulating Vaccine-Derived Poliovirus
Outbreaks (cVDPVs), 2000-2012
Type 2 (478 cases)
Type 1 (79 cases)
Type 3 (9 cases)...
International Spread of Polio
0
50
100
150
200
250
Endemic Outbreaks
Polio cases:
last 12 months
2012 2013
• SEARO certified polio-free (27 March)
• No type 3 virus globally for 16 months
• Most countries on track to stop type 1
Changes
• IPV (all endemics plan HR areas)
• IHR & polio vaccination (Apr 14)
• Access tracking & security group
Polio Update part 2
Polio Update part 2
Polio Update part 2
Polio Update part 2
Polio Update part 2
Polio Update part 2
Polio Update part 2
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Polio Update part 2

  1. 1. The Global Perspective & The Polio Endgame
  2. 2. What's the Polio 'Endgame'?
  3. 3. 0 100 200 300 400 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Poliocases(thousands) Polio-paralyzed children, 1988-2012 Type 2 polio eradicated
  4. 4. Last type 2 wild poliovirus: 1999 however…..
  5. 5. Vaccine-derived polio outbreaks (cVDPVs) 2000-2013 Type 2 (478 cases) Type 1 (79 cases) Type 3 (9 cases) Type 2 Type 1 Type 3
  6. 6. The Endgame Goal: complete the eradication of all wild & vaccine-related polioviruses.
  7. 7. • Polio detection & interruption • Systems strengthening, IPV intro. & OPV withdrawal • Containment & Certification • Legacy Planning Endgame Plan, 2013-18
  8. 8. Bivalent OPV (bOPV) Inactivated Poliovirus Vaccine (IPV)
  9. 9. The 'endgame' approach Strengthen routine immunization immediately Introduce at least 1 dose of IPV by end-2015 Switch from tOPV to bOPV by mid-2016
  10. 10. The role of IPV • Reduce risks of OPV2 withdrawal • Help stop outbreaks if type 2 reintroduced • Boost immunity against polio types 1 & 3 Inactivated Polio Vaccine (IPV)
  11. 11. The IPV challenge: not ‘business as usual’ IPV Hep B
  12. 12. $5.0 B* pledged for Polio Endgame Plan * including pledges received since the Summit
  13. 13. I s l a m i c Ad v i s o r y G r o u p ( I AG )
  14. 14. Endgame Progress
  15. 15. 27 March 2014 80% of world's population now certified polio-free!
  16. 16. 0 250 500 750 1000 1250 2007 2008 2009 2010 2011 2012 2013 Cases Polio, type 3 cases Last type 3 case : 10 Nov 2012, Nigeria
  17. 17. Polio Cases, 2014 Type 1 Pakistan 71 Afghan 4 Cameroon 3 Eq Guinea 3 Nigeria 3 Iraq 2 Syria 1 Ethiopia 1 Somalia 1Polio 2014
  18. 18. IPV today 71 countries already using IPV 85 have plan to introduce by end-2015 39 have not yet announced a plan 0 1,500 3,000750 Kilometers
  19. 19. Addressing Barriers
  20. 20. KANO, LQAs trend BORNO, Access Trend Mar 100% Dec 14% 2014 3 cases
  21. 21. 0 0.5 1 1.5 2 2.5 3 3.5 Est'd < 5 yr (2010 MoH) Nov (MoH) Dec (MoH) Jan (all sources) Feb (all sources) Apr (all sources) Children vaccinated (ml)
  22. 22. AUG SEP OCT NOV DEC JAN Accessible Insecurity Partially inaccessible Inaccessible HORN OF AFRICA outbreak
  23. 23. AFGHANISTAN • South: ongoing indigenous virus • East/North: cont'd importations
  24. 24. • new PM Polio Focal Point • new security strategy KP • Waziristan dialogue • DG/WHO engaging PM FATA, OPV trend Imran Khan & Maulana Sami Ul Haq, Dec 2013
  25. 25. 2013
  26. 26. Public Health Emergency of International Concern (PHEIC) Temporary recommendations for all 'exporting countries'
  27. 27. Risks
  28. 28. Syria’s Polio Epidemic: The Suppressed Truth Annie Sparrow Syria's Raging Health Crisis By ADAM P. COUTTS and FOUAD M. FOUAD An Apolitical Virus: Strife Fuels Polio's Return to Middle East By Christoph Reuter Misinformation
  29. 29. The 'Red List' Countries
  30. 30. West Africa Niger Mali Horn of Africa Yemen S. Sudan Middle East Leb, Jor Tur, Irq Central Africa CAR Chad More 'Red List' Countries
  31. 31. Carry forward Funding & Cash Gaps 2014 CASH GAP FRR Funding Needs: Current Operational Budget 1,032.95$ less Operationalized Funding 690.64$ Cash Gap (Confirmed Only) 342.31$
  32. 32. Priorities
  33. 33. 1. Nigeria (stop in 2014) 2. Outbreaks (stop in 2014) 3. Pakistan/Afghanistan 4. Red list countries
  34. 34. 'Eradication attacks inequities; the ultimate in social justice.'
  35. 35. circulating Vaccine-Derived Poliovirus Outbreaks (cVDPVs), 2000-2012 Type 2 (478 cases) Type 1 (79 cases) Type 3 (9 cases) 14 countries have had a type 2 cVDPV
  36. 36. International Spread of Polio 0 50 100 150 200 250 Endemic Outbreaks Polio cases: last 12 months 2012 2013
  37. 37. • SEARO certified polio-free (27 March) • No type 3 virus globally for 16 months • Most countries on track to stop type 1
  38. 38. Changes
  39. 39. • IPV (all endemics plan HR areas) • IHR & polio vaccination (Apr 14) • Access tracking & security group

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