Global polio updates and hss
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Transcript of Global polio updates and hss
GLOBAL POLIO UPDATES AND HEALTH SYSTEMS STRENGTHENINGCGPP-ADRA INDIA ANNUAL REVIEW MEETING,17TH-18TH MAY 2016, MUSSOORIE
Dr. Suchitra Lisam, National Health Programs Manager, ADRA India
PRESENTATION OUTLINE
PART I : POLIO AT A GLANCE PART II: GLOBAL POLIO UPDATES PART III: END GAME /ERADICATION
TIMELINES PART IV: HEALTH SYSTEMS
STRENGTHENING, POLIO LEGACY IN INDIA
POLIO AT A GLANCE
PART I
POLIO AT A GLANCE Global Polio Eradication Initiatives (GPEI)
is a public-private partnership spearheaded by WHO, Rotary International, US-CDC and UNICEF supported by key partners including BMG Foundation and GAVI- the vaccine alliance
99% reduction in polio since 1988 350,000 cases in 125 endemic countries in 1988 74 cases in 2 endemic countries (Pakistan,
Afghanistan) in 2015 3 types of wild polio viruses (type 1, 2, 3) Wild poliovirus type 2 last detected in 1999,
global eradication declared in Sep 2015
POLIO AT A GLANCE –contd. Wild poliovirus type 3 not detected since Dec 2012 2 types of vaccine- OPV and IPV More than 1.5 million childhood deaths prevented
since 1988 15 million cases averted since 1988 More than 5000 m child immunized every year
through Routine Immunization and campaigns World Health Assembly has declared completion of
polio eradication as a programmatic emergency for global public health.
ELIMINATION STATUS
GLOBAL UPDATES
PART II
GLOBAL UPDATES (April’16)
The Global Oral Polio Vaccine Switch, statistics on WPV/cVDPV
Immunization week Strategic Advisory Group of Experts on
Immunization (SAGE) Meeting Protecting Children in Countries
Vulnerable to Polio
GLOBAL OPV SWITCH
GLOBAL OPV SWITCH-contd.
From the 17 April to the 1 May, 155 countries and territories participated in the historic trivalent to bivalent oral polio vaccine switch, withdrawing the type 2 component of the vaccine to protect future generations against circulating vaccine derived polioviruses (cVDPV)
Type 2 component of the oral polio vaccine (OPV) is being removed from use from the trivalent to bivalent oral polio vaccine to withdraw OPV in a phased manner starting with type 2 component following the eradication of wild poliovirus type 2 in September 2015
GLOBAL OPV SWITCH-contd.
152 of 155 (98%) countries and territories have stopped using the trivalent oral polio vaccine.
Independent monitoring to ensure the switch goes smoothly has begun in 126 of 153 countries (82%).
The National Validation Committee has received switch monitoring data from 16 of 153 countries.
The WHO Regional Office has received the National Validation Report from 10 countries.
GLOBAL OPV SWITCH-Contd.
WPV TYPE 1 & cVDPV -STATISTICS
Total cases
Year-to-date 2016
Year-to-date 2015 Total in 2015
WPV cVDPV WPV cVDPV WPV cVDPV
Globally 12 3 23 1 74 32
- in endemic countries
12 0 23 1 74 3
- in non-endemic countries
0 3 0 0 0 29
CountriesYear-to-date
2016Year-to-date
2015 Total in 2015Onset of paralysis of most recent
case
WPV cVDPV WPV cVDPV WPV cVDPV WPV cVDPV
Afghanistan 4 0 1 0 20 0 27-Mar-16 NA
Pakistan 8 0 22 1 54 2 22-Mar-16 09-Feb-15
Guinea 0 0 0 0 0 7 NA 14-Dect-15
Lao PDR 0 3 0 0 0 8 NA 11-Jan-16
Madagascar 0 0 0 0 0 10 NA22-Aug-15
Myanmar 0 0 0 0 0 2 NA 05-Oct-15
Nigeria 0 0 0 0 0 1 NA 16-May-15
Ukraine 0 0 0 0 0 2 NA 07-Jul-15
VULNERABLE COUNTRIES
Polio remains endemic in two countries – Afghanistan and Pakistan.
Until poliovirus transmission is interrupted in these countries, all countries remain at risk of importation of polio, especially vulnerable countries with weak public health and immunization services and travel or trade links to endemic countries.
Circulating vaccine-derived poliovirus is causing an outbreak in Madagascar, Guinea and Ukraine.
Vulnerable countries : Cameroon, Equatorial Guinea, Ethiopia, Iraq, Nigeria, Somalia, South Sudan and Syrian Arab Republic.
POLIO IN NUMBERS-2016 Wild poliovirus in 2016 - Global Total: 12 (23) - Global WPV1: 12 (23) - Global WPV3: 0 (0) Endemic: 12 (23) -Afghanistan: 4 (1) - Pakistan: 8 (22) Importation Countries: 0 (0)
Data as of 27 April 2016. Numbers in brackets represent data at this time in 2015
POLIO PUBLIC HEALTH EMERGENCY
Temporary Recommendations to Reduce International Spread of Poliovirus
On 5 May 2014 the Director-General declared the international spread of wild poliovirus in 2014 a Public Health Emergency of International Concern (PHEIC) under the International Health Regulations [IHR 2005], issued Temporary Recommendations to reduce the international spread of wild poliovirus, and requested a reassessment of this situation by the Emergency Committee every 3 months.
The eight meeting of the Emergency Committee was held in February 2016. Based on the committee’s advice and the reports made by affected States Parties, the Director-General extended the following Temporary Recommendations under the IHR (2005), effective February 2016.
WORLD IMMUNIZATION WEEK
In 2016(April) there have only been 12 cases of polio, down from 23 cases in the same period for 2015.
World Immunization Week took place between 24 – 30 April with the theme “Close the Immunization Gap”.
SAGE MEETING Recommends amendments of
surveillance case definition to include type 2 Sabin so that all type 2 polioviruses will be notified
Urges all countries to ensure completion of phase I for all type 2 polioviruses, incl. Sabin 2
Endorsed the components of updated MOV strategy to improve coverage, equity and timeliness of vaccination
Implementation research- more attention
Immunization specific indicators to assess progress towards <5 mortality target of SDGs
PROTECTING CHILDREN IN VULNERABLE AREAS
Keeping levels of immunity high by strengthening RI, carrying out polio vaccination campaigns and keeping vigilant surveillance systems for early warning should the virus return is a top priority for the GPEI.
In Jordan, the Ministry of Health with the support of WHO, UNICEF and partners, recently completed a mass immunization campaign against polio, reaching >1 million children <5 across the country with OPV
KEY CHALLENGES
Delivering quality health services. Improving reach, tracking missed children
with OPV in endemic countries Keeping up the pressure Despite the gains, there is still much to be
done, not only in Afghanistan and Pakistan but also in countries with declining immunization rates. So long as polio continues to circulate anywhere, children everywhere are at risk.
END GAME PLAN/ ERADICATION TIMELINES
PART-III
Polio Eradication and Endgame Strategic Plan 2013–2018
IPV INTRODUCTION TIMELINES
POLIO ERADICATION TIMELINES
GPEI AND HEALTH SYSTEMS STRENGTHENING, POLIO LEGACY-HEALTH SECTOR
PART -IV
BUILDING BLOCKS FRAMEWORKS OF HEALTH SYSTEMS
POLIO LEGACY/SCOPE IN VPDs PROG
Over the past 25 years, GPEI-funded personnel and infrastructure have supported the distribution of global and country health priorities including
anti-measles vaccines vitamin A supplements anti-malarial bednets deworming pills surveillance for yellow fever and avian
influenza
INDIA POLIO LEGACY Polio legacy in Action Mainstreaming critical polio eradication functions into
other priority health programmes Ensuring that the best practices and knowledge
gained over years are shared with other health initiatives
Transitioning certain polio functional areas to government counterparts
Transitioning the capacities, processes and assets created by the programme to support other vaccine preventable diseases & strengthening health systems
TRANSITION OF ACTION Polio funded assets of WHO, UNICEF & CORE and
others are supporting RI strengthening activities in India
Lessons learnt from polio/best practices being applied for RI & control/elimination of VPDs
Mission Indradhanush (MI) as a good example of government led legacy in action for RI campaigns.
Other transition areas- health, sanitation, nutrition, Ebola
Transition/Legacy Plans are progressing and new initiatives to bring it under one umbrella.
Legacy Documentation is a major priority, ongoing
TRANSITION OF ACTION Transitioning assets/functions and applying lessons learned Strengthening routine immunization • Intensified RI monitoring –
generating data on quality of immunization, availability of vaccines/logistics, reasons for low RI coverage and Zinc/ORS availability.
Accountability through Task Forces, established in 36 states and 668 districts to review program data.
Capacity building of frontline workers Advocacy and integrated communication including high risk areas in RI
session planning – 96% of high risk areas now included in RI micro plans.
New vaccine introduction (Pentavalent; IPV, MR, Rotavirus) – Developing field guidelines, training material and checklists for assessing preparedness at district/state levels; conducting post-introduction and coverage evaluations. Measles elimination and rubella control –
TRANSITION IN ACTION
Supported catch-up campaigns covering approximately 119 million children. Visceral leishmaniasis (Kala Azar) elimination – Monitoring indoor residual spraying; contributing to national elimination strategy development. VPD surveillance
Coordinating validation of MNT elimination; capacity building for lab personnel; launched lab supported surveillance for diphtheria, pertussis and neonatal tetanus with expansion planned in 2015
AEFI surveillance – Assisting with updated guidelines; training AEFI committees; supporting electronic case reporting. Supporting international health programs – Indian SMOs deployed to Nigeria, Sierra Leone and Liberia in 2014-15.
LEGACY DOCUMENTATION Completed Hosting Learning Missions –
Afghanistan and Pakistan Documents on
Transition/Successful Strategies in States
Completed Legacy photographic book
– demonstrating innovations/game
changers to triumph over polio Several films 7 documenting
Social Mobilization strategies, new
PBS film on transition polio to RI, short
film polio for RI. India Polio Learning Exchange
website
Underway/planned 2015-2016 Joint papers with WHO, GOI and partners under discussion SMNet Legacy Review (PWC) – critical factors for success,
SMNet location/# for RI, and transition
options SMNet Impact on RI,
Convergence, Diarrhea morbidly and mortality IPV Introduction preparedness KAP Impact on the mobilizers
themselves
THANK YOU!