The Global Polio Eradication Initiative officially launched
a Global Emergency Action Plan 2012-2013 in the margins of the World Health Assembly this week.  The Plan aims to better support the remaining endemic countries to boost vaccination coverage to levels needed to stop polio transmission.  The Plan is launched as polio eradication is at a tipping
point.  Although the number of polio cases is lower this year than in any
previous 4-month period over the last ten years, it is estimated that failure
to achieve success could lead within a decade to as many as 200,000 paralyzed children a year worldwide. 

The full Plan is available at www.polioeradication.org

EVANSTON, USA, April 24, 2012-- Rotary International has recognized His Excellency Goodluck Jonathan, president of Nigeria, as a Polio Eradication Champion for his leadership and dedication to a polio-free world.

Presented to Jonathan on April 23rd, by incoming Chairman of The Rotary Foundation, Wilf Wilkinson, the Polio Eradication Champion Award is the highest honor Rotary presents to heads of state, health agency leaders and others who have made significant contributions to the global polio eradication effort.

“On behalf of Rotary’s 1.2 million members worldwide, including nearly 6,000 in Nigeria alone, I would like to express the solidarity of Rotary members in standing firmly beside President Jonathan and the Nigerian people in the polio eradication effort. I am honored to recognize the commitment of President Goodluck Jonathan for support of a polio-free Nigeria, and a polio-free world,” said Wilkinson.

During Jonathan’s term, Nigeria posted a 95 percent decline in polio cases in 2010 as compared with 2009. However, 2011 saw a resurgence of the disease (62 reported cases), emphasizing the need for continued vigilance in the fight against polio.

Jonathan renewed his attention to polio eradication with the launch of Nigeria’s Emergency Action Plan – a comprehensive strategy to accelerate progress toward polio eradication at every level. To support the plan, Jonathan announced that he would significantly increase funding for polio eradication activities: US$30 million annually for 2012 and 2013. 

In receiving Rotary’s Polio Eradication Champion Award, Jonathan joins a roster of distinguished leaders, including India’s Prime Minister Manmohan Singh, Chancellor of Germany Angela Merkel, current UN Secretary-General Ban Ki-moon and former Secretary General Kofi Annan, President Asif Ali Zardari of Pakistan, and former Chairperson of the African Union Commission Alpha Oumar Konare.

A highly infectious disease that can cause paralysis and sometimes death, polio still strikes children in parts of Africa and South Asia. As there is no cure, the best protection is prevention. For as little as 60 cents worth of vaccine, a child can be protected for life.  Globally, the number of polio cases has been reduced from 350,000 children annually in the mid-1980s to fewer than 700 reported cases all last year, a decline of more than 99 percent. Yet, challenges remain in the three polio-endemic countries of Pakistan, Afghanistan, and Nigeria. 

Rotary made polio eradication its top philanthropic goal in 1985.  As the volunteer arm of the Global Polio Eradication Initiative -- a public/private partnership including the World Health Organization, US Centers for Disease Control and Prevention, UNICEF and the Bill & Melinda Gates Foundation -- Rotary has contributed more than US$ 1.2 billion to ending polio, including some US$145 million to support polio eradication activities in Nigeria.

Distributed by the African Press Organization on behalf of Rotary International.

Full text, in English and French, is at http://www.who.int/wer/2012/wer8712.pdf

Editorial note

During 2011, polio eradication efforts in Africa have seen both progress and setbacks. While new outbreaks in 8 countries were interrupted—in 6 countries within 6 months of confirmation—WPV transmission persisted in Angola, Chad, DRC, and Nigeria. The number of WPV cases surged in Chad and Nigeria during 2011 compared with 2010.

The 2010–2012 GPEI Strategic Plan established the following milestones to track progress: (1) stopping WPVtransmission following importation in countries with outbreaks in 2009 by mid-2010; (2) stopping WPV transmission following importation in countries with outbreaks in subsequent years within <6 months after confirmation of the outbreak; (3) stopping WPV transmission in countries with re-established transmission by the end of 2010; (4) stopping WPV transmission in at least 2 of the 4 WPV-endemic countries by the end of 2011; and (5) stopping WPV transmission in all countries by the end of 2012.

Substantial obstacles to implementation of the 2010–2012 Strategic Plan in Africa have prevented achievement of important milestones. The first milestone was met for 14 of the 15 outbreaks occurring in 2009. However, transmission persisted during 2009–2011 in adjoining areas of Kenya and Uganda indicating substantial gaps in field surveillance quality; these gaps are being addressed.

Many areas in other countries of the Horn of Africa remain at risk of outbreaks following WPV importation, due to immunity and surveillance quality gaps. For example, civil conflict has prevented vaccination of around 1 million children aged <5 years in south-central Somalia for the past 18 months.

With re-established transmission continuing into 2011in Angola, Chad, and DRC, the GPEI failed to meet the third milestone. Persistent circulation in Angola caused outbreaks in Western DRC in 2011, from where northeastern Angola was re-infected. Seven years after WPV was first imported from India (2005), Angola now appears to be on-track to finally interrupt transmission.

However, to reliably document and maintain interruption of transmission, Angola also needs to strengthen surveillance and continue to conduct SIAs. In Chad, transmission of WPV3 of Nigerian origin was re-established from November 2007 to March 2011, followed by re-established transmission of WPV1 (also imported from Nigeria) since September 2010.

Prolonged re-established transmission in eastern DRC since 2006 and new outbreaks in western DRC are primarily due to chronic gaps in surveillance and low population immunity. An important additional risk factor in eastern DRC is refusal of vaccination among parents from specific religious communities. In an effort to interrupt finally the transmission of re-established WPV in Chad and DRC, the number of national and international staff working on polio eradication was increased substantially in 2011 in both countries.

Regarding the fourth milestone of the 2010–2012 Strategic Plan, India has not detected a poliomyelitis case since mid-January 2011 and is no longer considered to be an endemic country. However, setbacks occurred in Afghanistan, Pakistan and Nigeria. Nigeria is the only country in Africa that has never eliminated transmission of indigenous WPV. The GPEI’s Independent Monitoring Board indicated that Nigeria and Pakistan pose the greatest risks to achieving the 2012 goal of interrupting the transmission of WPV globally.

Multiple polio outbreaks in previously polio-free African countries since 2003 have been traced to WPV imported from Nigeria. The goals of regional and global polio eradication will never be attained as long as WPV circulation continues in Nigeria. Operational problems in implementing high quality supplementary immunization activities (SIAs) continue to be the main reason why children remain unvaccinated in northern Nigeria.

New serious security challenges arose in Nigeria during 2011, further increasing the existing operational and managerial challenges to conducting SIAs with high coverage. In a concerted effort with GPEI partner agencies, the federal government of Nigeria is developing an emergency action plan aimed at restoring the programmatic momentum attained during 2009–2010.

Many innovative approaches to improve the microplanning and implementation of SIAs are being instituted. In May 2012, the World Health Assembly will consider a resolution declaring polio eradication an emergency for global public health. Urgent action is needed to improve the quality of SIAs implementation in the polio-affected countries of Nigeria, Chad and DRC. All other countries in Africa need to urgently improve the sensitivity of surveillance systems, and attain high levels of population immunity to reliably detect circulating or imported WPV and to prevent or limit the impact of new outbreaks.

As the countries of the world advance towards the eradication of wild poliovirus, it is necessary to maintain good quality laboratory results and improve the timeliness of polio confirmation.

To achieve this, the Global Polio Laboratory Network (GPLN) of the World Health Organization (WHO) recommended the implementation of a new algorithm for viral isolation, using the cells RD and L2OB simultaneously, permitting the report of results within 14 days of receipt of the stool specimen in the laboratory (previously, 28 days were considered appropriate).

PAHO continues to be committed to the global eradication of polio; therefore it will monitor the implementation of this algorithm, and update its Weekly Polio Bulletin in order to show compliance with laboratory indicators.

For more information, please refer to the "Supplement to the WHO Polio Laboratory Manual" available below: http://www.who.int/immunization_monitoring/laboratory_polio_resources/en/index.html