REPORT ON POLIO ERADICATION BY THE W.H.O. SECRETARIAT TO THE WORLD HEALTH ASSEMBLY

Wednesday, 28th of May 2014

Excerpt below; full text is at
http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_38-en.pdf

MAJOR RISKS AND PROGRAMME PRIORITIES FOR 2014

17.The major risks to eradication are: the bans on immunization campaigns in the North Waziristan agency in Pakistan and parts of southern and central Somalia; the continued targeting of vaccinators in Khyber Pakhtunkhwa province and Karachi in Pakistan; ongoing military operations in Khyber Agency (within the Federally Administered Tribal Areas) of Pakistan; insecurity in Eastern Region, Afghanistan, and Borno state, Nigeria; active conflict in the Syrian Arab Republic; and gaps in

programme performance in Kano state, Nigeria, and in the outbreak response performance in Cameroon. These risks are compounded by gaps in polio surveillance and the continued threat of new international spread of wild poliovirus.

18.Management of these risks requires full national ownership of the eradication programme in all infected countries, with deep engagement of all relevant line ministries and departments, and the holding of local authorities fully accountable for the quality of activities, particularly in accessible areas such as Kano state, Nigeria, and in Cameroon. Accessing and vaccinating children in insecure and conflict-affected areas will in addition require the full engagement of relevant international bodies, religious leaders and humanitarian actors to implement area-specific plans, greater community demand and participation, and adapt eradication approaches in line with local contexts. In order to minimize the risks and consequences of international spread of poliovirus, Member States are

urged to enhance surveillance and immunization activities and implement fully recommendations for immunization of travellers

19. In order to be prepared for the withdrawal of the type 2 component of oral polio vaccine by 2016, Member States are encouraged to establis

h plans for the introduction of at least one dose of the inactivated poliovirus vaccine into their routine immunization programmes. Recognizing the complex

financing arrangements and tight supply timelines for introduction of this vaccine globally, it is recommended that countries endemic and at high risk of re-

emergence of polio develop by mid-2014 a plan for inactivated polio vaccine introduction, and all countries develop such plans by the end of 2014.

20. In order to further strengthen governance and oversight of the eradication initiative, the Polio Oversight Board, comprised of the heads of the five core partners, initiated in -person meetings on a six-monthly basis, a systematic risk review process, and a decision-making process that facilitates more systematic input by donors and stakeholders. A comprehensive, independent management review of the eradication initiative will be held in the second quarter of this year in order to improve

programmatic decision-making across the initiative. Within the Secretariat, the Director-General established a cross-cluster Polio Endgame Management Team to enhance organizational support for programme management, strategy implementation, and resource mobilization and management.

ACTION BY THE HEALTH ASSEMBLY

21. The Health Assembly is invited to note the report and encourage: all polio-affected Member States to undertake immediately emergency measures to overcome remaining obstacles to reach all children with oral polio vaccine; all Member States that currently use only oral polio vaccine to establish by the end of 2014 a plan for introducing at least one dose of inactivated poliovirus vaccine into their routine immunization programme by the end of 2015; and all Member States to implement

phase 1 containment activities for poliovirus by the end of 2015, ensure highly sensitive surveillance for polioviruses, and implement relevant polio vaccination recommendations for travellers.

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