Polio Outbreaks and the Endgame Strategy

If you are a member of Rotary International (aka the Rotary club in your town) you are well aware of PolioPlus as the effort Rotary started in 1985 and now partners with several other worldwide agencies to eradicate polio from the face of the earth. The partners have formed the Global Polio Eradication Initiative (GPEI). You understand when you see a picture of someone with his or her hand in the air holding their forefinger and thumb 2 inches apart they are part of the “This Close” campaign indicating we are so close to eradicating polio worldwide.

In my last blog, I discussed the statistics on how many new cases in the world and the 3 endemic countries. Cases of polio continue to drop in Nigeria and Afghanistan. Most unfortunately, cases in Pakistan are higher this year as of November 14 then in all of 2012.

A Health Ministry official in Pakistan said that one of the main causes of the situation lies in Taliban attacks on medical staff and volunteers in charge of vaccination campaigns. Most of the cases (43) were reported in tribal regions near the Afghanistan borders, where insurgency is particularly active and has killed or injured several health workers this year.  (To read the source of this information, go to  Prensa Latina – Agencia Informativa Latinoamericana’s website:  http://www.plenglish.com/index.php?option=com_content&task=view&id=2052091&Itemid=1 )

On November 11, 2013, thirteen cases of wild poliovirus type 1 (WPV1) have been confirmed in the Syrian Arab Republic. Genetic sequencing indicates that the isolated viruses are most closely linked to virus detected in environmental samples in Egypt in December 2012 (which in turn had been linked to wild poliovirus circulating in Pakistan). Closely related wild poliovirus strains have also been detected in environmental samples in Israel, West Bank and Gaza Strip since February 2013. Wild poliovirus had not been detected in the Syrian Arab Republic since 1999. (To read the source of this information and rest of the text, go to the World Health Organization’s website: http://www.who.int/csr/don/2013_11_11polio/en/index.html )

Wait a minute here………what happened to “This Close!!!!” How can we be “this close” with these outbreaks and the outbreak in Somalia now at 180 cases?

In that previous blog, I discussed the Endgame Strategy being implemented by the GPEI. The Endgame Strategy takes into account the reality of case numbers exploding like they did in Somalia. The plan requires immediate response to these areas to get them back under control. The following is from the GPEI Endgame Strategy just about verbatim.

IMMUNIZATION SYSTEMS:  The plan emphasizes strengthening immunization systems to boost immunity and help introduce new vaccines, including polio vaccines.

ALL POLIO TYPES SIMULTANEOUSLY:  Both wild and vaccine-derived poliovirus are addressed in parallel, using a global vaccine switch to manage long-term poliovirus risks.

RISK MITIGATION:  The plan anticipates and prepares for potential challenges, including insecurity, to enable rapid responses to obstacles and avoid delays.

CONCRETE TIMELINE AND BUDGET:  Rigorous data analysis of recent progress is employed to project a concrete, realistic timeline and budget to reach and sustain eradication.

LESSONS LEARNED:  Recent successes in India and endemic countries are built upon to provide strategies for overcoming potential obstacles.

LEGACY PLANNING:  A process is outlined to prepare for the effective transfer of lessons learned, knowledge and appropriate assets of polio eradication to benefit other health goals.

Basic message in this blog is that we can see the light at the end of the tunnel where the world will finally be polio free. This is a great thing. However, there are challenges and they are showing up in various places. The GPEI members, which include all Rotarians, must remain vigilant. We must all work toward peace and resolution conflict around the world since current areas of hostilities are where the polio outbreaks are occurring.

Please share this blog with whomever……..


PolioPlus Assistant Chair, Rotary District 5170