Despite the dramatic drop in polio cases in the last year, the threat of continued transmission due to funding and immunization gaps has driven the Global Polio Eradication Initiative (GPEI) to launch the Global Polio Emergency Action Plan 2012-13.
The plan aims to boost vaccination coverage in the three remaining polio-endemic countries -- Nigeria, Pakistan, and Afghanistan -- to levels needed to stop polio transmission. Health ministers meeting at the World Health Assembly in Geneva adopted a resolution on 25 May that declared “the completion of polio eradication to be a programmatic emergency for global public health.”
Polio eradication activities have resulted in several landmark successes since 2010. India, long regarded as the nation facing the greatest challenges to eradication, was removed from the list of polio-endemic countries by the World Health Organization (WHO) in February. Outbreaks in previously polio-free countries were nearly all stopped.
During that same time span, however, polio outbreaks in China and West Africa due to importation from Pakistan and Nigeria, respectively, have highlighted the continued threat of resurgence. Failure to eradicate the disease could lead within a decade to paralysis of as many as 200,000 children per year worldwide.
“Polio eradication is at a tipping point between success and failure,” says Dr. Margaret Chan, director-general of WHO. “We are in emergency mode to tip it towards success -- working faster and better, focusing on the areas where children are most vulnerable.”
Eradicating polio would generate net benefits of US$40-50 billion globally by 2035, with the bulk of savings in the poorest countries, based on investments made since the GPEI was formed, savings from reduced treatment costs, and gains in productivity.
“We know polio can be eradicated, and our success in India proves it,” says Rotary International President Kalyan Banerjee. “It is now a question of political and societal will. Do we choose to deliver a polio-free world to future generations, or do we choose to allow 55 cases this year to turn into 200,000 children paralyzed for life, every single year?”
Global emergency action plan
The GPEI’s emergency action plan was developed in coordination with new national emergency plans. The plan builds on India’s success and outlines a range of new strategies and initiatives to better support polio eradication efforts, including:
- Intensified focus on the worst-performing areas of Nigeria, Pakistan, and Afghanistan to increase vaccination coverage by the end of 2012 to levels needed to stop transmission
- New approaches tailored to each country to tackle persistent challenges and improve polio vaccination campaign performance
- Heightened accountability, coordination, and oversight to ensure success at every level of government and within every partner agency and organization
- A surge of technical assistance and social mobilization capacity
Full funding of new plan critical
Already, funding shortages have forced the GPEI to cancel or scale back critical immunization activities in 24 high-risk countries, leaving more children vulnerable to the disease and polio-free countries exposed to the risk of reintroduced transmission.
“All our efforts are at risk until all children are fully immunized against polio -- and that means fully funding the global eradication effort and reaching the children we have not yet reached,” says UNICEF Executive Director Anthony Lake. “We have come so far in the battle against this crippling disease. We can now make history -- or later be condemned by history for failing.”
Full implementation of the emergency action plan is hindered by a funding gap of nearly $1 billion through 2013.
“We are all responsible for creating a polio-free world while we still can,” says Chris Elias, president of global development at the Bill & Melinda Gates Foundation. “Achieving this goal is a critical step in protecting all children from vaccine-preventable diseases.”
Working in emergency mode
Since the start of 2012, the GPEI has moved its operations into emergency mode. The U.S. Centers for Disease Control and Prevention (CDC) has activated its Emergency Operations Center, UNICEF has officially activated an Interdivisional Emergency Coordinating Committee operating directly under the deputy executive director, and WHO has moved its polio operations to its Strategic Health Operations Centre.
Such measures are reserved for responding to global health emergencies, such as the H1N1 pandemic and the 2004 Indian Ocean tsunami -- and will generate a massive surge in technical capacity, real-time tracking of program performance, and immediate implementation of corrective action plans as necessary. In March, The Rotary Foundation Trustees reaffirmed that polio eradication is the Foundation’s urgent priority. In addition, Rotary senior leaders have launched a series of one-on-one meetings with the heads of state of the polio-endemic countries.
“We need everyone’s commitment and hard work to eradicate polio and cross the finish line,” says Dr. Thomas Frieden, director of CDC. “It won’t be easy, but together we can eradicate polio forever and for everyone.”