Attachments
A. SITUATION ANALYSIS
Description of the disaster
Malawi’s Ministry of Health reported a confirmed case of Type 1 wild poliovirus (WPV1) in Lilongwe district on 17 February 2022 which was followed by a declaration of an outbreak by the Head of State. This was the first case since 1992 and it was also the first detection of a case of WPV1 in Africa since 2016. The African continent had been declared free of wild poliovirus since 2020 and Malawi obtained a Polio free status in 2005. Genetic sequencing of this case linked the virus to a strain that was circulating in Pakistan’s Sindh Province in 2019, indicating that this was an imported virus. The detection of a single case of WPV1 outside of the world’s two remaining endemic countries, Pakistan and Afghanistan, represented an emergency that required an effective and at-scale response to prevent spread.
Following this development, the Ministry of Health, with support from partners, put in place strategies for the elimination of polio in the country which are in line with the World Health Organization (WHO) through the Global Polio End Game Strategy. Ministry of Health had already developed a National Expanded Programme on Immunization (EPI) which dealt with vaccine-preventable diseases including Polio, Measles, and Neonatal Tetanus. These diseases are undergoing eradication and elimination. Immunization of all children is a key health priority area of the Government of Malawi as outlined in the Second Health Sector Strategic Plan (HSSP II) and the Third Malawi Growth and Development Strategy (MGDS III). Through the HSSP II, which is operationalized through the Essential Health Package (EHP) (2017-2022)1 and several issue specific strategic plans such as the Multi-Year Plan for the Expanded Program on Immunization (2017-2021), the Government has committed itself to improve access, equity and quality of primary, secondary and tertiary health services. Immunization is a key area under primary and preventive health.
Malawi’s Expanded Program on Immunization (EPI) has been one of the most successful in Africa, although immunization coverage has trended downwards since 2014. The national EPI program primarily covers children below one year of age, through a strong community outreach program, which has significantly improved coverage of immunization services. For many years, the program has sustained a high coverage of immunization above 80%, High immunization rates in Malawi have resulted in reduced burden of vaccine preventable infectious diseases. The percentage of children aged 12-23 months in Malawi who have received all basic vaccinations declined from 82% in 1992 to 64% in 2004 before surging to 81% in 2010. Between 2010 and 2015/16, the percentage dropped slightly to 76%. During this same period, the proportion of children who received no vaccinations remained low between 2% and 4%, (Source: Malawi Demographic &and Health Survey, (MDHS) (2015-/16).
Malawi administered over 90% of the planned vaccination targets in three out of four categories of traditional vaccines. In 2021, Government successfully administered traditional vaccines with OPV being the highest as 95% of the planned OPV was administered. BCG had the lowest execution rate with 88% of the planned vaccination rolled out. (UNICEF: Expanded Programme on Immunization (EPI) & COVID-19 Vaccination MALAWI BUDGET BRIEF -2021 – 2022).
Like many other countries in the world, Malawi provides a Polio Vaccine that targets Poliovirus type 1 and type 3 following the global eradication of Poliovirus type 2. The country also vaccinates its children with Inactivated Polio Virus vaccine in all the 29 districts across the country with sustained good coverage to date since its introduction in 2018 as vaccines are the most effective and available prevention strategy for this disease, in addition to improved water and sanitation practices.
In this response, the Malawi Government through the Ministry of Health launched vaccination campaign for polio which was done in four rounds; Round 1;( 21-24 March 2022), Round 2 ;( 21-24 April 2022), Round 3; 11-14 August 2022) and Round 4; (13-16 October 2022). The vaccination campaign targeted 2.9 million children of 0-5 years. This operation contributed to scale-up the achievements for these vaccination plan.