Text: World Health Assembly Reports Progress on Polio

18 May 2001

Text: World Health Assembly Reports Progress on Polio

Effort to eradicate crippling disease accelerated

Unprecedented progress has been made in the eradication of polio since 1999 according to a report presented May 18 to the World Health Assembly (WHA) meeting in Geneva. The Polio Technical Consultative Group (TCG) says the number of polio-endemic countries has been reduced from 50 to 20 since the WHA called for acceleration of the campaign against the disease in a 1999 resolution.

In 2000, health officials detected 2,857 polio cases compared to more than 7,100 cases reported in 1999. Ten cases have been reported in 2001.

"The success of the polio eradication program thus far proves that WHO-recommended strategies are extremely effective, and when fully implemented, can result in polio's rapid eradication," said Dr. Walt Orenstein, chairman of the TCG. Orenstein, also the director of the National Immunization Program at the U.S. Centers for Disease Control and Prevention (CDC), underscored the urgency of raising the estimated $400 million necessary to complete the vaccination program in countries where the disease is still a problem, mainly in south Asia and sub-Saharan Africa.

The number of children paralyzed by polio has declined by 99 percent since the launch of the Global Polio Eradication Initiative in 1988. The World Health Organization (WHO), the civic organization Rotary International, the CDC and the United Nations Children's Fund (UNICEF) lead the effort, which promotes widespread vaccination. In 2000 alone, 550 million children were vaccinated against the disease.

Further information about the eradication initiative is available at www.polioeradication.org

Following is the text of the WHO press release.

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WORLD HEALTH ORGANIZATION
World Health Assembly

May 18, 2001

EXPERT BODY STRESSES NEED FOR URGENT POLIO ERADICATION AND FUNDING FOR GLOBAL EFFORT

Policy Options On Stopping Oral Polio Vaccine To Be Further Developed

The Polio Technical Consultative Group (TCG) reported today that there has been unprecedented progress in polio eradication since the World Health Assembly's 1999 Resolution (WHA52.22) calling for the acceleration of polio eradication activities in all countries. Since then, the global polio burden has been cut in half, and the number of polio-endemic countries has been reduced from 50 to 20. The TCG is the oversight body which sets policies and strategic priorities for the Global Polio Eradication Initiative.

It is now urgent that eradication be achieved to ensure that polio-free areas are not reinfected. This success also underscores the need to further develop the policy options on when and how to safely stop the use of oral polio vaccine (OPV).

During a special technical briefing, delegates to the 54th World Health Assembly were presented with highlights from the 2001 Report of the Technical Consultative Group on the Global Eradication of Poliomyelitis. The report stressed that a US$ 400 million funding gap now poses the greatest threat to the programme, with half of those funds urgently required before the end of 2002.

"The success of the polio eradication programme thus far proves that WHO-recommended strategies are extremely effective, and when fully implemented, can result in polio's rapid eradication," said Dr Walt Orenstein, Chairman of the TCG. "However, without the funds, the remaining infected countries simply cannot finish the job," he cautioned. Dr Orenstein is the Director of the National Immunization Program at the U.S. Centers for Disease Control and Prevention (CDC).

Substantial progress has been achieved since accelerated activities began in 1999, notes the TCG report, with polio cases more than halved from 7141 to 2857 reported cases in 2000. In India for example, 2817 polio cases were reported in 1999; so far in 2001, with certification-standard surveillance, only ten cases have been found. Overall, the Global Polio Eradication Initiative has achieved a 99% decline in the number of children paralyzed by polio worldwide since it was launched in 1988. This is largely due to National Immunization Days (NIDs), which since 1999 have used a house-to-house immunization strategy, reaching 550 million children in 2000 alone.

The 20 remaining polio-endemic countries are mainly in south Asia and sub-Saharan Africa. Of these, the TCG highlighted several which require particularly urgent efforts, including densely-populated Nigeria and Pakistan and conflict-affected Afghanistan, Angola and the Democratic Republic of the Congo. Together, these countries account for 60% of the remaining global polio burden. "The inability to access children in Angola in particular, remains a threat to global polio eradication," states the TCG report. The TCG has asked for a mid-year report on progress in these countries.

The Polio Endgame

The TCG stressed the need to avoid a similar outbreak as that on Hispaniola (Dominican Republic and Haiti) which has caused 17 cases of paralysis to date. Genomic sequencing confirmed this outbreak was caused by vaccine-derived polioviruses (VDPVs). This was the consequence of a failure to maintain high immunization coverage in an area of poor sanitation, allowing VDPVs to circulate and cause disease among unvaccinated and inadequately vaccinated children. High vaccination coverage prevents circulation of VDPVs.

Recognizing that the protracted use of OPV in weak routine programmes with low coverage could lead to a risk of the emergence of transmissible VDPVs, the TCG has endorsed the World Health Organization's detailed programme of research to determine when and how the use of OPV can be stopped. Research results are expected within 24 months, but until these are available and the best strategies are subsequently chosen for stopping vaccination, OPV will need to be used with high immunization coverage in all populations.

"Our goal is not only to ensure polio's eradication, but to ensure it remains eradicated," said Dr Peter Figueroa of the Ministry of Health of Jamaica, and the rapporteur of the TCG. "We are confident the research will lead to appropriate strategic options for safely stopping immunization against polio," he added.

At a meeting with key health ministers and donors, Dr Gro Harlem Brundtland, Director-General of WHO, reaffirmed the TCG's findings. Dr Brundtland stressed that "the overriding lesson is the need for urgency - urgency to finish the job and to stop using this vaccine as soon as it is safe to do so. The immediate challenge is filling the US$ 400 million funding gap. Everyone at the global, regional and national levels must help raise these funds."

The Global Polio Eradication Initiative is spearheaded by WHO, Rotary International, the U.S. Centers for Disease Control and Prevention (CDC) and the United Nations Children's Fund (UNICEF). The polio eradication coalition also includes national governments; private foundations (e.g. United Nations Foundation, Bill & Melinda Gates Foundation); development banks (e.g. World Bank); donor governments (e.g. Australia, Austria, Belgium, Canada, Denmark, Finland, Germany, Italy, Japan, the Netherlands, Portugal, United Kingdom and the United States of America); non-governmental humanitarian organizations (e.g. the International Red Cross and Red Crescent movement) and corporate partners (e.g. Aventis Pasteur, De Beers). Volunteers in developing countries play a central role; ten million have participated in mass immunization campaigns.

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