global overview - polio eradicationpolioeradication.org/wp-content/...presentation1.pdf ·...
TRANSCRIPT
Global Overview Polio Partners Group, December 2015
1 Note: Gavi requirements of $122.2 million are not included in this slide
1. Poliovirus detection & interruption
2. OPV2 withdrawal, IPV introduction, immunization system strengthening
3. Facility Containment & Global Certification
4. Legacy Planning
The Polio Endgame Plan
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1985
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2014
Po
lio c
ases
(th
ou
san
ds)
125 Polio Endemic
countries
Wild Poliovirus Eradication 1988-2014
1988 2014
Last type 2 polio
in the world
Last Polio Case in
India
Last Polio Case
in Nigeria
2015
3 Polio Endemic
countries
2 Polio Endemic
countries
Israel = Env. positive isolates (2013 , N=136 ; 2014, N=14 , last 30 Mar 2014) Gaza = Env. positve isolates (2013, N= 7 ; 2014, N=1, Jan )
Wild Poliovirus type 1 Cases, 2014
Endemic countries Infected countries
306
359
Exportations in 2013
Wild Poliovirus Cases, Last 6 months
Last Case in Middle East: Iraq, 7 April, 2014
Last Case in Africa: Somalia, 11 Aug 2014
WPV1 Cases Pakistan: 22 Afghanistan: 12
• November 2012: Most recent case of WPV3
• July 2014: Most recent WPV case in Nigeria
• August 2014: Most recent WPV case in Africa
• Since August 2014: No WPV outside of Afghanistan & Pakistan
• All WPV outbreaks stopped
6
Milestones and achievements (1)
• 20 September 2015: WPV2 eradication certified
• 25 September 2015: Nigeria removed from list of endemic countries by WHO
• 20 October SAGE confirms April 2016 for globally synchronized tOPV-bOPV switch
7
WPV milestones and achievements (2)
• Strong progress, increasing momentum to completion
• Increasing public & donor confidence in the Endgame
• Strong political support – WHA 68.3
• Strong oversight by POB & GPEI partner coordination
• Sustained surge in recent outbreak zones
• Increasing concentration of resources in vulnerable areas
• Final success now depends on Pakistan and Afghanistan
8
Overall Global Programme Context
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49
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Afghanistan Pakistan
Ca
ses
2014 2015
WPV1 Cases, Afghanistan and Pakistan at 11 December, 2014 & 2015
520 532
343 180
35 937
-
100 000
200 000
300 000
400 000
500 000
600 000
Jan
Feb
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Ap
rM
ay Jun
Jul
Au
gSe
pO
ctN
ov
Dec Jan
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rM
ay Jun
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gSe
pO
ctN
ov
Dec Jan
Feb
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rM
ay Jun
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Au
gSe
p
Decline in Inaccessibility, Pakistan Jan 2013-Sep 2015
2013 2014 2015
• Number of children in inaccessible areas reduced to <35k
• Priorities: • Accessing the remaining
children • Maximizing the access
opportunity (SIAs, IPV, health
camps, CCPV)
4-5 June 2015
Female Community Volunteers in high threat areas of Pakistan
Wild Poliovirus Cases – Pakistan, 2014-15
mos
• Engagement of new leadership
• More rigor & innovation to reduce missed children in updated National Emergency Action Plan
• Emergency Operations Center - NEAP implementation
• Access through neutrality & dialogue with all sides
Ensuring Progress in Afghanistan
• Globally synchronized switch from 17 April to 1 May 2016 – a major global public health event
• Risks of continued tOPV use outweigh risks of OPV2 cessation
• Unprecedented scope of IPV introduction
• Management of short IPV supply
• mOPV2 stockpile for outbreak response
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SAGE: tOPV-bOPV Switch confirmed in April 2016
15
cVDPV outbreaks – Gaps in EPI
cVDPV2
cVDPV1
VDPV2: S Sudan
cVDPV2: Nigeria
cVDPV2: Guinea
cVDPV1: Ukraine
cVDPV1: Madagascar
Type 2 MUST BE
STOPPED! Sufficiently in
advance of OPV2 withdrawal
cVDPV1: Lao DPR
cVDPV2: Myanmar
International exportation of poliovirus 2014-2015
March’ 14
March’ 14
February’ 14
January April June
August September
October June’ 15
July August
Phase I
• Destruction of WPV2 & cVDPV2 largely on track, will be completed before OPV2 withdrawal
• Intense efforts to remove all type 2 polio by mid-2016
• Mitigating risks from potentially infectious materials in non-polio facilities through 2016
Phase II
• Designation of poliovirus essential facilities, early 2016
• Certification of containment by national authorities
• Full implementation will require effort and time
• International validation - Global Certification Commission
17
Mitigating Poliovirus Facility-associated Risks Global Action Plan for Containment III (GAPIII)
Internal ‘Midterm review’ of progress against the plan, including assessment of total costs to reach certification
Outcome:
Major Strategic priorities & focus on implementation:
• Addressing surveillance gaps in risk areas
• Tracking & reducing number of missed children
• Preventing, preparing & responding to outbreaks
• Accelerating destruction & containment of polioviruses in facilities
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2013-18 Strategic Plan: GPEI Mid-term review
• WPV interruption in Pakistan & Afghanistan likely during 2016
• Global certification of eradication delayed to 2019
• An additional $1.5 bn required to complete polio eradication
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POB Decision on Mid-term Review: New Timeline, New Budget
Summary
• Major progress milestones
• WPV1 restricted to parts of Pakistan and Afghanistan
• Global certification of polio eradication expected in 2019
• Additional $ 1.5 bn required to complete eradication
• Globally synchronized OPV2 withdrawal in April 2016
• Increasing focus on cVDPV – urgency to stop type 2
• Acceleration of GAPIII to mitigate PV facility associated risks
• Legacy planning gathering momentum and attention