Ethiopia + 2 more

Horn of Africa cross border meeting on polio eradication held

Consecutive polio campaigns will be conducted in bordering areas
Cross-border meetings have proven to be crucial at the local level, to exchange information and take synchronized action for health service activities in general and disease control and eradication activities in particular. This cross border collaboration meeting is the second of this year, the first meeting was carried out in Kenya in May 2006. This meeting was held at Dire Dawa, Ethiopia from May 31 to June 1, 2006. Representatives from regions and districts of Somalia, Kenya, Ethiopia, shares border, have attended the meeting. Additional delegates from WHO Head quarter, WHO African Regional, and WHO Eastern Mediterranean Regional Offices attended the meeting and played a major facilitating role. The participants discussed their experiences with cross-border coordination activities.

The purpose of the meeting was to:

- Assess the quality of polio supplementary immunization activities in the bordering regions and districts;

- Assess the quality and sustainability of AFP (Acute Flaccid Paralysis) surveillance;

- Emphasize the use of surveillance data to guide supplementary immunization activities,

- Link surveillance focal points of districts of bordering countries so that there will be regular exchange of information and advise on strengthening routine immunization service delivery.

Somalia shares border with Ethiopia in eight districts and one district border with Djibouti. There are many crossing points along these porous borders used for passage of people, animals, vehicles and goods; which has the potential to ease the transmission of the wild polio virus.

Last year nine and five rounds of SIAs were conducted in Somalia and Ethiopia respectively and two rounds from the Kenyan side, but there were many missed areas from the Ethiopia side due to inaccessibility.

Routine immunization is very low in all bordering Woredas/districts. In Somalia and Ethiopia it does not exceed 20% and in many of the districts being less than 10%. The Kenyan side has 50-60% OPV3 coverage but even at this side 100% of the AFP cases who are under one year old have either zero or unknown vaccination status.

Concerning AFP surveillance, though there is some variability the detection rate in general is less than 2 per 100,000 children under five and Stool adequacy is also less than 80% in all bordering areas except Kenya which reached certification level in 2003.

Major Recommendations of the cross border meeting:

Policy issues:

- In order to increase the chances of interrupting wild poliovirus transmission, synchronized SIAs should continue starting from 11th of June, 16th of July, 10th of September,29th of October and 3rd of December 2006 using the appropriate mOPV

- Opportunities like measles SIAs should be used to administer the appropriate mOPV without changing the strategy. Further communication and technical guidance to all countries should be made by both AFRO and EMRO.

- Close collaboration with UN security office at all levels should be enhanced through the deployment of such officers at the appropriate levels as close as possible to the implementation areas.

- Because of the volatile nature of the security situation in some of the areas to be covered, planned SIAs or surveillance activities may not be implemented in all places at the same time. Opportunities should therefore be sought to rapidly implement activities in such areas as and when an opening occurs. For this to occur there is need to

i. Ensure availability of funds, necessary logistics and supplies at all levels at which dispatch is not delayed.

ii. Identify, recruit and train the locally based personnel including credible locally based NGOs to implement polio eradication activities.

- Governments at appropriate levels should consider ways and means of facilitating the movement of staff and logistics across the common borders during SIAs and surveillance activities. This will allow areas that are inaccessible within one country to be covered through approaches from the neighboring border area.

- Central and district levels should immediately disseminate AFP information to border districts, facilitated where applicable, through the WHO and Government networks.

- Cross-border notification of wild poliovirus, compatible and hot AFP cases to be done with neighboring districts as fast as possible.

For Further Information Please Contact WHO Ethiopia at +251-11-551-4031/+251-91-123-3904/+251-91-120-0765 or by yemesracht@et.afro.who.int or asnakewy@et.afro.who.int