1. The Global Perspective
&
The Polio Endgame

2. What's the Polio 'Endgame'?

3. 0
100
200
300
400
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Poliocases(thousands)
Polio-paralyzed children, 1988-2012
Type 2 polio
eradicated

4. Last type 2 wild poliovirus: 1999
however…..

5. Vaccine-derived polio outbreaks (cVDPVs)
2000-2013
Type 2 (478 cases)
Type 1 (79 cases)
Type 3 (9 cases)
Type 2
Type 1
Type 3

6. The Endgame Goal: complete the
eradication of all wild & vaccine-related
polioviruses.

7. • Polio detection &
interruption
• Systems strengthening, IPV
intro. & OPV withdrawal
• Containment &
Certification
• Legacy Planning
Endgame Plan, 2013-18

8. Bivalent OPV
(bOPV)
Inactivated Poliovirus
Vaccine (IPV)

9. The 'endgame' approach
Strengthen routine immunization immediately
Introduce at least 1 dose of IPV by end-2015
Switch from tOPV to bOPV by mid-2016

10. The role of IPV
• Reduce risks of OPV2 withdrawal
• Help stop outbreaks if type 2 reintroduced
• Boost immunity against polio types 1 & 3
Inactivated
Polio Vaccine (IPV)

11. The IPV challenge: not ‘business as usual’
IPV
Hep B

12. $5.0 B* pledged for Polio Endgame Plan
* including pledges received since the Summit

13. I s l a m i c Ad v i s o r y
G r o u p ( I AG )

14. Endgame Progress

16. 27 March 2014
80% of world's population
now certified polio-free!

17. 0
250
500
750
1000
1250
2007 2008 2009 2010 2011 2012 2013
Cases
Polio, type 3 cases
Last type 3 case :
10 Nov 2012, Nigeria

18. Polio Cases, 2014
Type 1 Pakistan 71
Afghan 4
Cameroon 3
Eq Guinea 3
Nigeria 3
Iraq 2
Syria 1
Ethiopia 1
Somalia 1Polio 2014

19. IPV today
71 countries already using IPV
85 have plan to introduce by end-2015
39 have not yet announced a plan
0 1,500 3,000750 Kilometers

20. Addressing
Barriers

21. KANO, LQAs trend
BORNO, Access Trend
Mar
100%
Dec
14%
2014
3 cases

22. 0
0.5
1
1.5
2
2.5
3
3.5
Est'd < 5
yr (2010
MoH)
Nov
(MoH)
Dec
(MoH)
Jan (all
sources)
Feb (all
sources)
Apr (all
sources)
Children vaccinated (ml)

23. AUG SEP OCT
NOV DEC JAN
Accessible
Insecurity
Partially
inaccessible
Inaccessible
HORN OF AFRICA outbreak

24. AFGHANISTAN
• South: ongoing
indigenous virus
• East/North: cont'd
importations

25. • new PM Polio Focal Point
• new security strategy KP
• Waziristan dialogue
• DG/WHO engaging PM
FATA, OPV trend
Imran Khan & Maulana Sami Ul Haq, Dec 2013

26. 2013

27. Public Health Emergency of
International Concern (PHEIC)
Temporary recommendations for all 'exporting countries'

28. Risks

29. Syria’s Polio Epidemic: The
Suppressed Truth
Annie Sparrow
Syria's Raging Health Crisis
By ADAM P. COUTTS and FOUAD M. FOUAD
An Apolitical Virus: Strife Fuels Polio's
Return to Middle East
By Christoph Reuter
Misinformation

30. The 'Red List' Countries

31. West
Africa
Niger
Mali
Horn of
Africa
Yemen
S. Sudan
Middle
East
Leb, Jor
Tur, Irq
Central
Africa
CAR
Chad
More 'Red List' Countries

32. Carry
forward
Funding & Cash Gaps
2014 CASH GAP
FRR
Funding Needs: Current Operational Budget 1,032.95$
less Operationalized Funding 690.64$
Cash Gap (Confirmed Only) 342.31$

34. Priorities

35. 1. Nigeria (stop in 2014)
2. Outbreaks (stop in 2014)
3. Pakistan/Afghanistan
4. Red list countries

36. 'Eradication attacks
inequities; the ultimate
in social justice.'

38. circulating Vaccine-Derived Poliovirus
Outbreaks (cVDPVs), 2000-2012
Type 2 (478 cases)
Type 1 (79 cases)
Type 3 (9 cases)
14 countries
have had a
type 2 cVDPV

39. International Spread of Polio
0
50
100
150
200
250
Endemic Outbreaks
Polio cases:
last 12 months
2012 2013

41. • SEARO certified polio-free (27 March)
• No type 3 virus globally for 16 months
• Most countries on track to stop type 1

44. Changes

45. • IPV (all endemics plan HR areas)
• IHR & polio vaccination (Apr 14)
• Access tracking & security group