Transcript Document

Global Polio Eradication Initiative
UNICEF
CDC
(US, Federal Govt)
Vaccine
Procurement,
Communication
and Social
Mobilization
Funding and
Surveillance
Surveillance,
Operation and
Monitoring
WHO &
GOVT.
Advocacy, Funding
& Social
Mobilisation
ROTARY
GLOBAL POLIO CASES
Global Polio Cases :
Year 2000 = 719
Year 2001 = 483
Year 2002 = 1918
Year 2003 = 784
Year 2004 = 1255
Year 2005 = 1979
Year 2006 = 1998
Year 2007 = 1315
Year 2008 = 1651
Year 2009 = 1604
Year 2010 = 1352
Year 2011 = 650
Year 2012 = 223
Year 2013 = 400
Year 2014 = 11
Data as on 12/02/2014
Country or territory
Indonesia
India
Yemen
Nigeria
Ethiopia
Benin
Bangladesh
Pakistan
Somalia
Nepal
Niger
DRC
Angola
Car
Syrian Arab Republic
Sudan
Afghanistan
Chad
Burkina Faso
Ghana
Mali
Kazakhstan
Togo
Russian Federation
Cote d'lvoire
Guinea
Liberia
Sierra Leone
Burundi
Mauritania
Senegal
Tajikistan
Turkmenistan
Ghana
Namibia
Congo
Myanmar
Kenya
Uganda
Gabon
China
Cameroon
Other
Total
No. of Countries
Non-endemic country
2000
0
265
0
28
3
1
1
199
46
4
2
28
55
3
2001
0
268
0
56
1
0
0
119
7
0
6
0
1
0
2002
0
1600
0
202
0
0
0
90
3
0
3
0
0
0
2003
0
225
0
355
0
2
0
103
0
0
40
0
0
1
2004
0
134
0
782
1
6
0
53
0
0
25
0
0
30
2005
303
66
478
830
22
0
0
28
185
4
10
0
10
0
2006
2
676
1
1123
17
0
17
40
36
5
11
13
2
0
2007
2008
2009
2010
2011
874
559
741
42
1
285
798
3
6
388
21
32
8
5
11
41
8
0
117
89
144
6
12
5
29
3
15
3
29
14
4
27
4
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
22
2
0
0
0
1
11
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
10
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
25
11
8
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
127
4
24
9
0
19
0
0
0
17
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
26
31
37
6
8
1
0
3
0
1
0
0
0
0
0
0
0
0
45
38
64
15
2
0
6
0
27
42
11
11
2
13
0
0
0
5
18
460
3
0
0
441
0
0
0
0
0
10
1918
9
2
26
784
15
13
73
1255
18
19
8
0
0
3
4
0
0
0
13
483
15
0
31
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
19
0
0
2
0
0
0
2
0
1998
17
1
17
22
0
0
0
86
719
23
27
9
2
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
1979
16
1604
23
1352
20
0
0
0
0
0
0
0
0
0
0
0
0
0
0
11
0
0
0
0
1315
12
1651
18
2012
2013
2014
62
122
53
9
0
0
198
58
93
190
9
0
5
93
5
4
1
23
0
14
2
14
0
4
0
400
8
4
11
2
0
20
6
2
100
33
25
26
80
132
4
1
7
37
5
14
36
3
2
1
1
1
1
21
650
17
223
5
INDIA POLIO STATUS SINCE THE BEGINNING
OF THE PROGRAMME…
500 PER DAY
BUT NOW…
0 in 2014
WILD POLIO CASES IN INDIA
Data as on 14.02.2014
Rotary’s India National PolioPlus Committee
The India National PolioPlus Committee in india plays the following roles:
 Advocacy




Political
Bureaucratic
Religious
Corporate
 Financial
 Social Mobilisation
 Operational support
Financial Contribution towards GPEI
US$
1.2
billion
Worldwide
Contributions
US$ 9
billion
Raised From
Donors
US$ 178
Million
INDIA
CONTRIBUTION
POLIO ERADICATION STRATEGY
ROUTINE OPV
IMMUNISATION
MOPPING UP
OPERATIONS
IN HIGH RISK
AREAS
4 PILLARS
PPI
NID/SNID
REPORTING ALL
AFP CASES
(Surveillance)
# Each of these components is essential for the complete eradication of Polio.
Mop Up Immunization

Outbreak Response Immunization (ORI)
Acute Flaccid Paralysis (AFP) Surveillance

The number of AFP cases reported each
year is used as an indicator of a country’s
ability to detect polio-even in countries
where the disease no longer occurs. A
country’s surveillance system needs to be
sensitive enough to detect at least one case
of AFP for every 100 000 children under
15 – even in the absence of polio.
Reaching every child during mass polio vaccination
campaigns
250 2013
500
2013
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2014
2015
Nationwide
campaigns
Sub-national
campaigns
Routine Immunization
• Current level of Routine Immunization is
60-61%. To protect our children against
wild polio virus it is more important to
increase the vaccine of Polio under R.I.
High risk areas identified in India, April 2012
411,000
HRAs
Migrant sites
= 10 Migrant sites
~ 257,000 Migrant sites
High risk areas in
settled population
= 10 HR sites
~ 154,000 HR areas in settled population
Intensification of Routine Immunization
• 9 priority states & 239 districts with weak RI identified for focused attention
HR Districts (based on
Full Imm. <50% in DLHS3)
Strengthening Routine Immunization
• Fourth pillar for polio eradication - Helps sustain
population immunity against polio – reduces risk
of circulation of poliovirus
• Important component of the polio endgame
strategy before & after withdrawal of OPV
• Protects children
preventable diseases
against
other
vaccine
Preparing for India to be
Certified as Polio Free
Certification Process
The Goal of the GPEI is the Global Certification
of the eradication of polio.
Global certification of eradication will be reached
when all countries demonstrate the absence of
wild poliovirus transmission for at least three
consecutive years in the presence of excellent
surveillance.
Certification Committee Structure
• Global Commission for the Certification of
the Eradication of Poliomyelitis
• Six Regional Certification Commissions for
Polio Eradications
• Every country has a National Certification
Committee for Polio Eradication (NCCPE)
India NCCPE established on Aug 7, 1998
Process of Regional Certification
• NCCPEs to prepare detailed documentation as per
standard format.
• These are reviewed by the regional Commission and it
will recommend to the Global Commission
• Only Global Commission can certify a region as polio
free
Only WHO regions and NOT individual
countries certified as polio free
(26-27 March, 2014)
3 of the 6 WHO Regions Already Certified Polio
Free
• 1994 - North, Central and South America (PAHO
region)
• 2000 - Western Pacific region (that includes China)
• 2005 - European region in 2005.
2014 –WHO South East Asia region that includes
India is the next region to be certified as polio free.
Preparations are underway
Importation
• Recently Govt of India has issued the
notification:
• A dose of oral polio vaccine (OPV) for all
travellers to and from India from polio
endemic countries : Afghanistan, Nigeria
and Pakistan and countries with poliovirus
circulation following importation : Ethiopia,
Kenya, Somalia and Syria. In the absence of
which VISAS will not be issued.
• Govt of India has set up immunisation
booths across borders.
The geographical distribution of children with poliomyelitis associated with wild-type
poliovirus shown by serotype for 2012 and (inset) the total number of children with
poliomyelitis globally by serotype reported each year during 2001–2012.
93 polio cases in Pakistan, 53 in Nigeria and 14 in Afghanistan . The Horn of Africa – Somalia-190, Kenya14, Ethiopia-9 , Cameroon-4 and An outbreak of cases in Syrian Arab Republic – 23 (Syria reported polio case
after 1999) in the year 2013. Still Pakistan is reporting fresh cases of Polio during the current year numbering
Continuous vaccination of children at border
crossing points
5 vaccination posts
along Indo-Pak border
since Sep 2011
88 vaccination posts
along Indo-Nepal border
since Apr 2011
PAKISTAN
NEPAL
INDIA
BANGLADESH
MYANMAR
Vaccination post
2 vaccination posts along Indo-Bangladesh border since Mar 13
2 vaccination posts along Indo-Myanmar border since April 13
Lessons
• Its not over until its over
everywhere
• 'The price of freedom is
eternal vigilance'
Challenges
•
•
•
•
•
•
Maintaining immunity
Maintaining surveillance
Readiness to respond
Reducing risk
Building on polio
Preparing for the endgame
POLIO NOW A PUBLIC
HEALTH EMERGENCY
• 194 member states to fully fund the GPEI & fill
$945M gap in budget for 12-13.
• All remaining infected countries to declare
polio to be a NATIONAL PUBLIC
HEALTH EMERGENCY requiring the
implementation of emergency action plans
monitored at the highest levels
POLIO A PUBLIC HEALTH
EMERGENCY
• New approaches to tackle persistent
challenges and improve polio vaccination
campaign performance
• Heightened accountability, coordination,
and oversight to ensure success at every
level of government and within every
partner agency and organization
POLIO A PUBLIC HEALTH
EMERGENCY
• A surge of technical assistance and
social mobilization capacity
• If any child in the world is
permanently paralysed by Polio it is
now a Global Emergency
• If any child in the world is not
reached by Oral Polio Vaccine it is
now an emergency.
Emergency Preparedness and Response Plan 2011
The Govt. of India has constituted a “Central Emergency
Preparedness and Response Group” to ensure adequate
preparedness for a rapid response and manage the actual response
to the detection of a wild poliovirus anywhere in India.
Rotary’s Role in Emergency Preparedness and
Response Plan
Advocacy at state and district levels for quaility implementation of
polio eradication activities.
Support IEC/Social mobilization activities & media management
in coordination with Govt.. UNICEF and NPSP.
Any other essential emergency support activities.
Emergency Preparedness &Response
Switch Over- Preparing for Polio Endgame
Strategy
• Withdrawal of oral polio vaccine to minimize risks
associated with use of OPV in the post eradication phase
• Switch from tOPV to bOPV in 2016
• Withdraw all OPV from programme in 2018/2019
• Before switch over IPV will be introduced in 2015. The
introduction will also protect the occurrence of vDPV
cases.
End Game Strategic Plan 2013-18
Funding Gap
• The Total funding requirement from 2013-2018 is $ 5.5
billion.
• Committed
-
$ 4 billion
• Deficit
-
$ 1.5 billion
World Polio Day 24 October 2013
India on World Polio Day illuminated iconic sites across the country including historic
monuments India Gate, Red Fort with End Polio Now message.
India Gate
Red Fort
India Celebrated 3 years of last case
reported in the country on 13 January 2014
India Gate
Red Fort
Celebrations on India’s Victory over Polio on 11
February 2014 in New Delhi by Govt of India
Towards a polio-free India
Rukhsar. Let's
ensure she is
the last polio
case in India!
Rotary’s Continued Engagement
Very Crucial.
• Thank and appreciate those who have been
working so hard.
• Continued advocacy in high risk areas against
complacency
• Respond to local problems with local solutions
You started the race and so you better be there
at the finishing line when celebrations start