Progress Toward Ending Polio in Afghanistan and Pakistan
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Presentation delivered by Chris Maher, Manager, Polio at the 62nd session of the Regional Committee for the Eastern Mediterranean Region
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Progress Toward Ending Polio in Afghanistan and Pakistan
- 1. The status of polio eradication: progress and challenges Agenda item 2(b) 62nd session of the Regional Committee for the Eastern Mediterranean 58 October 2015 1 10/7/2015
- 2. Polio eradication and end game strategic plan 20132018 Objectives • Detect and interrupt all polio transmission • Strengthen routine immunization, introduce one dose of inactivated polio vaccine and withdraw oral polio vaccine • Contain poliovirus and certify the interruption of transmission • Plan polio legacy 2 10/7/2015 The status of polio eradication: progress and challenges
- 3. Wild poliovirus cases, 30 March 29 September 2015 3 The status of polio eradication: progress and challenges The best ever opportunity to stop wild poliovirus transmission; only one serotype in limited areas of two remaining endemic countries
- 4. 0 5 10 15 20 25 30 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 0 10 20 30 40 50 60 70 80 90 100 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 4 20112012 Monthly distribution of wild poliovirus cases, 20112015 WPV type 1 WPV type 3 2011 2012 2014 2013 Numberofwildpolioviruscases Numberofwildpolioviruscases Data in WHO as of 8 September 2015 2015 The status of polio eradication: progress and challenges
- 5. Distribution of WPV in the Region, 2014Sep 2015 5 # # # # # # # # # # # # # # ## # # # # # ## # ## # # # # # # # # # # # # # # # # # # # # # # ## ## # ## # # # ## # # # # # # # # # # # # # # # # # # # # # # # # # ## # # # # ## # # ### # # # # ## # # # # # # # ## # # # # # # # # # # # # # # # # # # # # # # # # # # ## # # # # # # # # # # # # ## # # # # # # # # # # # # # # # # # # # # # ### # # # # # # # # ## # # # # # ## # # # # ## ## # # # # ## # # # # # # # ## # # # # # ## # # # ## # # # # ### # # # # ## # ## # # # # # # # # # ## # # # # # # ## ## # # ## # # # # # ## # # # # # # # ### # # # # ## # # # # # # # # # # # # # # # # # # # # # # # # # ### # ## # ## # # # # # # # # # # # # # # # Horn of Africa outbreak last WPV 11 August 2014 Middle East outbreak last WPV 7 April 2014 Pakistan total WPV=32 last WPV 22-Aug-15 Afghanistan total WPV=12 last WPV 6-September-15 2014 WPV=342 2015 up to 29 September WPV=44 Afghanistan total WPV=28 Pakistan total WPV=306 # # # ## # # # # # # # # # # # # ## # ## # # # # # # # # # # # ## # # The status of polio eradication: progress and challenges
- 6. In 2015, all of the global wild polio burden is in Pakistan and Afghanistan 6 10/7/2015
- 7. Are we making progress? Polio cases in 2014–2015 as at 29 September 7 0 20 40 60 80 100 120 140 160 180 200 Afghanistan Pakistan 2014 2015 The status of polio eradication: progress and challenges
- 8. WPV distribution 2014 and 2015 8 # # # # # # # # # # # # # # # # # # # # # # ## # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # ## # # # # # # # # # ## # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # ## # # # # # # # # # # # # # # # # # # # # ## # # # # # # # # # # # # # # # # # # # # ## # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # ## # # # # # # # # ## # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # ## ## # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # ## # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # 2014 2015 The status of polio eradication: progress and challenges
- 9. Declining active WPV genetic clusters, 2010–9/2015 87% reduction in the circulating clusters, 16 in 2010 to 2 in 2015 9
- 10. However there are still risks… • Travelers from Pakistan and Afghanistan (especially from polio endemic areas) travel to and work in countries all over the world • If transmission continues there is a risk that wild poliovirus from Pakistan or Afghanistan will re-infect other countries 10 The status of polio eradication: progress and challenges
- 11. Cumulative score, 16 November 2014High Medium Low Not Included Non EMR countries Risk interpretation (score) High ( <50%) Medium (50–74%) Low ( ≥75%) Cumulative score, 2 August 2015 Subnational risk assessment, August 2015 11 The status of polio eradication: progress and challenges
- 12. Vaccination status of 659 month-old non-polio AFP cases in focus countries, 20142015 12 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 2014 2015 2014 2015 2014 2015 2014 2015 2014 2015 2014 2015 0 1-3 4-6 7+ doses AFG IRQ PAK SOM SYR YEM The status of polio eradication: progress and challenges
- 13. Priorities for the upcoming 6 months 13 # # # ## # # # # # # # # # # # # ## # ## # # # # # # # # # # # ## # # Stop polio tranission Consolidate improving immunization coverage and surveillance All countries: Enhance preparedness and response plans, and prepare for tOPV-bOPV switch The status of polio eradication: progress and challenges
- 14. What can Member States do? • Support Pakistan and Afghanistan to stop polio virus transmission • Improve immunization coverage of high risk areas/populations: slums, IDPs, migrants • Enhance sensitivity of surveillance systems to enable early detection and response to any poliovirus importation or emergence of VDPVs • Field test preparedness and response plans • Prepare for the switch from tOPV to bOPV 14 The status of polio eradication: progress and challenges
- 15. Summary • We are in the best position we have ever been to eradicate polio globally within 69 months • To achieve our goal, the national emergency action plans for polio eradication in Afghanistan and Pakistan have to be fully implemented • The actions of all Member States is crucial in these final stages of global eradication to support Pakistan and Afghanistan and to keep the Region polio-free 15 The status of polio eradication: progress and challenges