SEA/RC62/15 - Follow-up action on pending issues and selected regional committee resolutions/decisions for the last three years: update on the progress and challenges in polio eradication
AbstractPolio eradication continues to be a priority in the South-East Asia Region. In the first four months of 2009*, 40 polio cases were detected in India with 14 type 1 poliovirus (P1) and 26 type 3 poliovirus (P3) cases. This paper presents an update on the progress and challenges in polio eradication. At the start of 2008 a reduction in the transmission of P1 cases, particularly in western Uttar Pradesh (UP) was seen, which, however, was offset by re-importation from Bihar in the latter half of the year, resulting in 62 type P1 cases. Rapid and large-scale mop-up immunizations prevented P1 importation into neighbouring states. The type P3 outbreak of 2007 was rapidly controlled with massive outbreak response and mop-up operations. There are several challenges to the eradication of polio from the Region. The principal challenge in India is overcoming suboptimal vaccine efficacy in the districts of western UP, which continues to be polio-endemic. Another key challenge in the endemic areas is the low levels of sanitation and personal hygiene. While some efforts have been made by the government, these are at present not of sufficient scale to have an impact. More needs to be done in this area. The main challenge for other countries in the Region, in particular the countries that share an open border with India, is to protect their polio-free status by preventing reinfection. A strong routine immunization programme that can deliver and maintain OPV3 coverage greater than 80% in all districts in all countries will help prevent reinfection. Additionally, all polio-free countries must conduct periodic risk assessment to determine the level of risk of reinfection and its spread, and to decide whether or not polio immunization campaigns will be required to boost population immunity. Finally, polio eradication requires substantial funding. A substantial proportion is being met through external funding. Member States can help the eradication effort by committing funds for surveillance, outbreak response, and strengthening routine immunization delivery. The attached working paper was submitted to the High-Level Preparatory (HLP) Meeting for its review and recommendations for consideration by the Sixty-second Session of the Regional Committee. The HLP meeting made the following recommendations: Action by Member States (1) To provide funds to improve and sustain high routine immunization coverage in all districts of the country and provide funds to strengthen AFP surveillance as relevant to the Member State; (2) conduct periodic risk assessment for polio importation and reinfection, particularly in those Member States in close proximity to the polio-endemic areas. Action by WHO/SEARO (1) Review the criteria used for risk assessment for polio and provide these for use by Member States; (2) in Member States that rely on the support of WHO-supported surveillance medical officers networks should support all vaccine-preventable disease surveillance; (3) work with Member States and with donors to maintain the required levels of funding for polio eradication, routine immunization and vaccine preventable disease control, including surveillance. The paper is now submitted to the Sixty-second Session of the Regional Committee for its consideration.
World Health Organization, Regional Office for South-East Asia. (2009). SEA/RC62/15 - Follow-up action on pending issues and selected regional committee resolutions/decisions for the last three years: update on the progress and challenges in polio eradication. WHO Regional Office for South-East Asia. http://www.who.int/iris/handle/10665/128464