The Polio Endgame Strategy 2019-2023, the Immunization Agenda 2030 (IA 2030), and the Gavi 5.0 Strategic Plan (2021-25) each committed to working in a new, systematic, and integrated way to protect populations. The overarching goals encompassed by these strategies are not only to achieve and sustain polio eradication, but also to attain broader aspirations of reaching under-immunized and "zero dose" children to reduce mortality and morbidity from vaccine-preventable diseases (VPDs) across the life cycle. In parallel to these global initiatives, the Global Polio Eradication Initiative (GPEI) has initiated a separate, but related process to shift functions and funding for polio eradication efforts at the country level from GPEI to national governments.
Beyond the focus on immunization goals, the integration of GPEI and the Essential Immunization Program (EPI) includes a core commitment to promoting equity and strengthening immunization's contribution to primary health care and universal health coverage. This commitment entails teamwork with other health programs at all levels. In addition to establishing collaborations with emergency programs to detect and stop communicable disease outbreaks, the polio and immunization programs are also ideally positioned as entry points to further expand other essential health services -- even if done incrementally.
In late 2019, stakeholders in both the GPEI and EPI proposed to align their common objectives and priorities into a Programme of Work for Integrated Actions(POW) which was envisioned to turn the highlevel concepts articulated in their respective strategic frameworks into a comprehensive package of tangible integrated actions.
A multi-agency working group has made significant progress in drafting mutually beneficial integrated strategies for polio eradication and essential immunization efforts covering four priority areas of work: 1) comprehensive VPD surveillance; 2) community engagement and service delivery; 3) outbreak response and recovery; and 4) management and coordination. For each area of work, specific actions were being developed that could be implemented over a four-year period from 2019-2023.
The severe widespread disruptions to immunization and other public health services around the globe caused by the COVID-19 pandemic have precipitated a more urgent need for coordinated approaches. While still acknowledging the need for a longer-term POW as initially planned, this current document, i.e. the interim program of work (iPOW), focuses on the immediate innovative and adaptive integrated strategies required to meet this unprecedented challenge over the next 15 months. Achieving the goal of integration over the longer term will require regularly updating the POW as a 'living document' and ensuring that it concepts and proposed actions are fully incorporated into core elements of the revised GPEI Polio Endgame Strategy and implementation of the IA2030 and Gavi Strategic Plan.