Syria/Iraq: Polio Outbreak - Oct 2013
On 28 Oct 2013, the Minister of Health of the Syrian Arab Republic announced that, after a 15-year absence, polio had returned to the Middle East. Thirteen cases were confirmed from Syria's Deir Al Zour province. The occurrence of an outbreak reflects declining immunization rates due to the severe interruption of public health services and to the conditions in which the people are living. A comprehensive outbreak response will need to be implemented across the region, with seven countries and territories to conduct mass polio vaccination campaigns targeting more than 22 million children aged under 5 years. (Strategic Plan for Polio Outbreak Response in the Middle East)
As of 8 Feb 2014, 17 confirmed polio cases had been reported from Syria's Deir ez-Zour Governorate, three from Aleppo Governorate, one from Al. Hasakeh Governorate and two from Idleb Governorate (WHO/UNICEF, 8 Feb 2014).
By 20 Mar, a total of 37 cases had been reported: 25 cases by the Syrian Arab Republic Ministry of Health, and 12 cases from contested areas (Aleppo, Edleb and Deir Al Zour) not yet reflected in official figures. The most recent case had onset of paralysis on 17 Dec 2013. Further evidence of regional spread was confirmed by notification of a case from Iraq, the first polio case in the country since 2000. The case, a six-month old boy from Baghdad who had not been immunized, developed paralysis on 10 Feb 2014. Genetic sequencing indicates the virus is most closely related to virus detected in the Syrian Arab Republic. (WHO, 21 Mar 2014)
By 8 Oct, three cases had been reported in the Middle East with onset of paralysis in 2014 - two in Iraq and one in Syria. The most recent case reported from Iraq occurred in Mada'in district, Baghdad-Resafa province, with onset of paralysis on 7 Apr. Syria’s most recent case had onset of paralysis on 21 Jan. The fact that six months had passed with no new cases being reported indicates that transmission of the virus has been interrupted. (Global Polio Eradication Initiative, 8 Oct 2014)
8 November 2016, Amman | World Health Organization (WHO) will conduct a polio outbreak simulation exercise (POSE) between 9 – 10 November to test Jordan’s preparedness and capacity to respond to a potential polio outbreak. The workshop, held at Le Meridien Hotel, will be attended by approximately 60 participants including Ministry of Health epidemiologists, immunization, communication and surveillance officers, laboratory workers, university and private sector pediatricians, doctors from Jordan’s Royal Medical Services, and focal points from Rotary Amman and UN agencies.
24 October 2016, Amman | Today, on World Polio Day, polio eradication partners celebrate the successes of the programme to date and rally for the additional support needed to wipe out the disease for good. In the Middle East, polio partners WHO and UNICEF acknowledge the hard work done to keep the region polio free, but urge all countries to maintain vigilance and to guard against the virus being re-introduced.
23 January 2016 - Syria is approaching 2 years without a reported case of polio today despite enormous challenges adversely affecting the delivery of health services, including childhood vaccinations.
25 October, 2015 | Beirut – Despite continuing conflict, declining immunization rates in conflict-affected areas and mass population displacement, no new polio cases have been reported in the Middle East for over 18 months, and experts believe the extensive multi-country outbreak response has been effective in stopping the outbreak.
BAGHDAD, 12 October 2015 -- A nationwide campaign to vaccinate 5.8 million children in Iraq against polio was concluded on the 11th of Oct this year after a two day extension recommended by the Ministry of health for maximum vaccination coverage. This effort to ensure that Iraq remains polio free also included the distribution of life-saving information on how to detect, prevent and treat cholera to 1.5 million households across the country.
The Global Polio Eradication Initiative (GPEI) leadership agreed at the time of the 2013–2018 Polio Eradication and Endgame Strategic Plan (PEESP) development that the programme would regularly assess progress, reflect on the lessons learned, plan for the risks ahead, and make needed adjustments to the activities and costs of the plan going forward. This midterm review (MTR) was conducted by a team from the GPEI partners under the guidance of the Strategy Committee (SC) from March-May 2015.
Lebanon remains concerned with overburdened primary health care (PHC) services and high hospital utilization rates by Syrian refugees. There is an urgent need to continue humanitarian programming to cope with the immediate health needs of refugees while simultaneously strengthening the resilience of the health systems to provide a sustainable response to the health needs of the affected populations, both refugees and host.
IMPACT OF CRISIS
As of 14 January 2015, the number of people reported to be displaced in Iraq stood at 2.1 Million according to “IOM Displacement Tracking Matrix”.
Of this number, approximately 576,846- (27.5%)- are sheltered in Dahok Governorate with a significant percentage of them housed within hosting community, in 17 IDP camps, in unfinished buildings and informal settlements like schools.
WHO fuding request for the Grade 3 emergency
Escalating conflict since January 2014 has left 7.84 people million in need of health assistance. Over the next six months, WHO and Health Cluster partners aim to reach 5.63 million of the 6.95 million people in critical need of health assistance. WHO has already supplied medicines and supplies to treat 3.5 million people. However, WHO and Health Cluster partners may be forced to shut down 84% of health projects unless additional funding is received by 30 June.
The third round of the national polio vaccination campaign was conducted from 24 to 28 May 2015 in Iraq targeting 5.7 million children aged 0 month to 5 years and reaching 5.3 million children (92%) nationwide excluding Mosul and Anbar governorates which started the campaign late due to security concerns.
Health and humanitarian conditions continue to deteriorate at despicable rate as the current conflict in Syria drags into the fifth year.
Iraq is the highest risk country for polio eradication in the Middle East due to unstable security situation leading to disrupted health services and frequent mass movement (IDPs and Refugees). In 2012, World Health Assembly declared the completion of polio eradication a programmatic emergency for global public health.
By the end of 2014, significant progress had been made towards each of the Endgame Plan’s four objectives; the world has never been in a better position to eradicate polio.
As the GPEI enters 2015, efforts are being intensified to build on this progress and stop polio once and for all.
Capitalizing on progress in Nigeria, against outbreaks in central Africa and the Horn of Africa, and against two out of three strains of wild poliovirus
Beginning in 2011, WHO underwent a restructuring of its emergency work to align it with the ongoing reform of the global humanitarian system led by the Inter-agency Standing Committee (IASC). This report describes the emergency risk and crisis management work of the Organization in 2013 and 2014, in the wake of this restructuring, and provides examples of how its new policies and procedures guided the implementation of specific activities for risk management and emergency response.
Iraq is one of the highest risk countries for polio eradication in the Middle East due to vulnerable populations living in multiple governorates. These include internally displaced populations, refugees, and communities dwelling in slums and vast portions of the country where insecurity hinders health outreach activities.
A five day nationwide polio immunization campaign targeting 5.8 million children under five years of age in Iraq will commence Sunday 12 April and will be marked by launch events on 12 April in Baghdad, organized by the Ministry of Health Iraq, and on 13 April in Erbil organized by the Kurdistan Regional Ministry of Health. WHO and UNICEF shall join both events with Rotary International delegates attending the launch in Erbil.
WHO SYRIA reached 40,784 with medicines in Damascus and Aleppo;
WHO LEBANON continued health care worker training on the Mental Health Gap Action Program (MHGAP), finalizing in the South and Bekaa for 62 health care staff in 28 PHC centres;
WHO JORDAN sent one surgical kit to a secondary level health facility in Syria;
WHO IRAQ procured four additional new mobile clinics with funds from the Kingdom of Saudi Arabia for the MoH;
Baghdad, Iraq, 16 March, 2015 -- WHO's Regional Director for the Eastern Mediterranean Dr Ala Alwan continues his visit to Iraq to review the unmet health needs of populations affected by the conflict due to lack of funding. Out of the US$ 314.2 million required by the health sector, only US$ 95.5 million has been received (30.4%), leaving a critical funding gap of US$ 218.7 million.