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Appeals & Funding
Ministers of Health from around the world will convene next week at WHO’s Executive Board meeting, to set global public health policies. Among other topics, representatives are expected to review the current polio epidemiology and global preparedness plans for the phased removal of oral polio vaccines. A report has been prepared, to facilitate discussions, available here.
The year ends with real – and fragile – progress: the longest stretch in history without wild poliovirus in Africa, large outbreaks stopped in the Middle East and the Horn of Africa, a certified polio-free South East Asia and no wild poliovirus type 3 for over 2 years. This will be the last weekly update of 2014.
In response to the outbreak of circulating vaccine-derived poliovirus (cVDPV) in South Sudan, over 19,000 children were vaccinated last week in Bentiu Poc, where the two cases were reported. Outbreak response plans are in place to hold three rounds of supplementary immunization activities (SIAs) in high risk areas to stop transmission of the virus.
In Madagascar, a circulating vaccine-derived poliovirus type 1 (cVDPV1) has been confirmed. The virus was isolated from one case of acute flaccid paralysis (AFP) with onset of paralysis on 29 September, and from three healthy contacts. An estimated more than 25% of children remain under-immunized against polio in the country. Madagascar was previously affected by a cVDPV2 outbreak in 2001/2002 (resulting in five cases) and in 2005 (resulting in three cases). Emergency outbreak response is being finalized, with campaigns to be held in December and January.
The 67th World Health Assembly, the WHO’s highest decision-making body, is meeting this week in Geneva. The report of the polio eradication programme to the Assembly is available here, and is scheduled to be discussed on Friday. On the sidelines of WHA, Bruce Aylward, WHO Assistant Director-General for Polio and Emergencies, discussed polio eradication at the World Health +SocialGood digital event on Monday. The recorded discussion can be watched here (start at 1:04:00).
The data table below is as of 22 January 2014
The first four cases wild poliovirus cases type 1 (WPV1) have been reported for 2014. All cases were reported from North Waziristan, FATA, Pakistan. North Waziristan is the district with the largest number of children being paralyzed by poliovirus in the world. As long as polio still exists in reservoirs like North Waziristan, the world will always be at risk of outbreaks.
Last week, 20,000 Rotarians from 160 countries gathered in Lisbon, Portugal for the annual Rotary International Convention. Rotary and the Bill and Melinda Gates Foundation announced an extension of their existing fundraising partnership that could generate up to US$525 million for polio eradication. The Bill and Melinda Gates Foundation will match two dollars for every new dollar Rotary commits to polio eradication, up to US$35 million per year, through 2018. More.
In Pakistan, the WPV1 outbreak in Bara in Khyber Agency (Federally Administered Tribal Areas – FATA), is continuing. Seven cases have now been reported since end-April. This outbreak is the major WPV reservoir in all of Asia, and is threatening progress achieved elsewhere in the country and in neighbouring Afghanistan. See ‘Pakistan’ section below for more.
Polio this week - As of 19 June 2013
Polio this week - As of 12 June 2013
At last week’s World Health Assembly (WHA) in Geneva, Switzerland, health ministers from around the world acknowledged the progress achieved in the past year in bringing polio to its lowest ever levels, thanks to actions of Member States in placing polio eradication on an emergency footing. Delegates endorsed the new Polio Eradication and Endgame Strategic Plan 2013-2018 to secure a lasting polio-free world and urged for its full implementation and financing.
A wild poliovirus type 1 (WPV1) case has been confirmed in Kenya, the first WPV in the country since July 2011, with onset of paralysis 30 April. The location is a refugee camp in the Dadaab area, close to the border with Somalia, where a child was paralysed by polio near the capital Mogadishu on 18 April. Outbreak response activities are being planned. See ‘Horn of Africa’ section for more.
Two new wild poliovirus (WPV) cases are officially reported this week, both from Nigeria, bringing the total number of WPV cases in 2013 to 26 (compared to 53 at this time last year). Additionally, a new circulating vaccine-derived poliovirus type 2 (cVDPV2) case is reported in Pakistan. Please see country-specific sections below, for more information.
Multi-country immunization campaigns took place this week (26-29 April) across West Africa. Benin, Burkina Faso, Côte d’Ivoire, Guinea, Liberia, Mali and Sierra Leone all participated, aiming to reach nearly 30 million children under the age of five years with oral polio vaccine (OPV).
As does the risk of a mass polio outbreak
28 March 2013 - The harvest has come and gone but the Sahel region of west and central Africa remains in crisis. OCHA estimates that more than 10 million people will remain food insecure throughout 2013, including 1.4 million children under five suffering from acute malnutrition. At the same time, insecurity in Mali is pushing people to flee their homes and their country; and for those that remain (particularly in the North), the price of food is rapidly rising.
Next week, the Strategic Advisory Group of Experts on immunization (SAGE) will meet in Geneva, Switzerland, from 9-11 April. Among other immunization topics, SAGE is expected to review the global polio situation. The draft agenda of the SAGE meeting is available at http://www.who.int/immunization/sage/en/.
- In the Democratic Republic of Congo, all samples from 2012 AFP cases have now been fully cleared, and confirm that the country has not reported a WPV case in over one year (the last reported WPV case had onset of paralysis on 20 December 2011).
- Islamic scholars call for urgent action to complete polio eradication in Muslim communities: “Crippled children lead to a crippled Muslim Ummah” warned the Grand Imam of Al-Azhar, at a meeting in Cairo this week of Muslim scholars from several countries.
- In Somalia, a new circulating vaccine-derived poliovirus type 2 (cVDPV2) from January 2013 was reported.
- This latest case is confirmation that the cVDPV2 outbreak from 2011 in south-central Somalia is ongoing. In 2012, this outbreak had also spread across the border into neighbouring Kenya. Outbreak response continues to be implemented. See ‘Horn of Africa’ section below for more.
Intense virus transmission in northern Nigeria, large-scale population movements and lack of funds make for dangerous situation
West Africa just comes off the heels in stopping a multi-country polio outbreak that affected 12 countries from 2009 to 2011, caused 281 cases and cost US$94 million to control. But the threat of a renewed outbreak now looms as large as ever.