SEA/RC67/16 - Challenges in polio eradication (SEA/RC60/R8)
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AbstractOn 27 March 2014, the Regional Certification Commission for Polio Eradication (RCCPE) certified the South-East Asia Region as being polio-free. However, the Region is faced with the risk of importation and spread of poliovirus from polio-infected countries and the challenge of complacency on becoming polio free. In order to overcome these challenges and mitigate associated risks, (1) the South-East Asia Regional Certification Commission for Polio Eradication (SEA-RCCPE) and the National Certification Committee in every Member State need to remain operational at least until the global certification of polio eradication; and (2) Member States need to (i) maintain high population immunity and high-performance surveillance for acute flaccid paralysis (AFP); (ii) conduct regular risk assessment at regional and country levels, and risk-mitigation activities, including introduction of vaccination for travellers to and from polio-infected countries; (iii) be prepared to deal with poliovirus importation and conduct periodic simulation exercises of the preparedness and response plan; (iv) continue containment activities for polioviruses based on the Global Action Plan. Although the last case in the world due to type-2 wild poliovirus was reported from India in 1999, polio cases due to type-2 circulating vaccine-derived polioviruses (cVDPV2) will continue to pose a risk as long as countries use trivalent oral polio vaccine (tOPV). Risk mitigation against the emergence of cVDPV2 will require countries that are using tOPV to switch to bivalent OPV (bOPV). The switch should happen synchronously across the world by 2016. In order to maintain population immunity against all three types of wild polioviruses, at least one dose of inactivated polio vaccine (IPV) should be administered in the routine immunization schedule prior to the vaccine switch.The High-Level Preparatory (HLP) Meeting held in the Regional Office in New Delhi, India, from 14 to 17 July 2014, reviewed the attached working paper and made the following recommendations:Actions by Member States(1)High-quality AFP surveillance and polio immunization should be sustained throughout every Member State.(2)Regular risk assessment and risk mitigation activities, including laboratory containment, simulation exercises of the polio outbreak response and preparedness plans, should be conducted.(3)National certification committees should continue their role till global certification. Actions by the WHO Regional Office(1)The Regional Office should continue to support Member States in risk assessment and planning for risk mitigation activities. (2)Technical support should be provided to Member States to develop national plans for vaccination for travellers to and from polio-infected countries.(3)Member States should be supported in planning for IPV introduction and a timeline for vaccine switch. The working paper and the HLP recommendations are submitted to the Sixty-seventh Session of the Regional Committee for its consideration.
World Health Organization. Regional Office for South-East Asia. (2014). SEA/RC67/16 - Challenges in polio eradication (SEA/RC60/R8). WHO Regional Office for South-East Asia. https://apps.who.int/iris/handle/10665/129379
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