At the Executive Board of the World Health Organization, experts discuss concrete ways to fight against remaining poliomyelitis
February 3, 2023, Geneva, Switzerland – At the World Health Organization’s Executive Board this week in Geneva, Switzerland, global health and policy experts called for a strong focus on polio control in remaining high-burden areas where the virus can spread further.
Speaking to the Executive Board, WHO Director-General Dr. Tedros Adhanom Ghebreyesus noted that there have been no cases of wild polio since September 2022, and commended global support for the effort, including by allocating US$2.6 billion to the effort. appreciated. in October.
Experts noted a unique window of opportunity for success in 2023, the target year to end all remaining poliovirus transmission worldwide. They also provided guidance for the development of a new post-2023 polio transition vision, supported by specific regional action plans to ensure country progress.
The endemic distribution of wild poliovirus is now confined to geographically limited areas of two countries: Pakistan and Afghanistan. Increased efforts in both countries have resulted in historically low numbers of biologically distinct viruses remaining in circulation. Individual strains of viruses are being successfully eradicated, demonstrating the effectiveness of these strategies.
Polio transmission, either due to wild poliovirus or circulating vaccine-derived poliovirus, primarily affects only seven subnational geographic areas, which now account for 90% of all new polio cases worldwide. These “most consequential geographies” share certain key programmatic characteristics: they are home to the largest populations of “zero-dose” children—in other words, children who are unvaccinated or underserved—and who are exposed to broader humanitarian impacts. , serious emergencies.
In particular, the main programmatic goal for the first half of 2023 should be: to achieve the remaining zero-dose children in each of these geographies by adapting operations to the nature of complex humanitarian emergencies in each of these situations. This means working effectively within a wider humanitarian context. This means working with wider humanitarian partners to deliver the polio vaccine alongside other interventions in the most culturally relevant and appropriate way.
The board noted, of course, that polio had re-emerged in areas that had been polio-free last year, and commended local health authorities for successfully managing these incidents. But most of all, these events are a reminder of what will happen if we fail to achieve global eradication—a global resurgence of the disease. In this context, experts urged countries not to lose sight of the need to plan for a polio-free world, including through the full implementation of containment measures.
The meeting also noted that the capacity developed to eradicate poliomyelitis is the basis of the health system in many places. As we move towards eradication, we need to ensure that this experience is not lost and is instead integrated to strengthen national health systems that are the backbone to prevent future polio outbreaks. A “proof of concept” has been demonstrated by the success of more than 50 polio-free countries in 2022 with the support of the Global Polio Eradication Initiative. In these countries, eradication program expertise and tools have been redirected to support critical immunization, primary health care, emergency preparedness, resilience and response capacity. The guidance provided by Member States in the Executive Council will be critical to shaping the next phase of the polio transition by developing a new global approach guided by specific action plans at the regional level to ensure full alignment of transition efforts. global, regional and national health priorities.
Success for both polio eradication and the transition depends on sustained political and financial resources, and experts appreciate the strong support shown by the international development community in the last quarter of 2022, including by pledging an additional US$2.6 billion in Berlin. Germany, at the World Health Summit in October 2022, aims to eradicate polio. And while more resources still need to be mobilized, in this context the meeting highlighted the ongoing work of Rotary International in helping to ensure public and civil society commitment to these efforts. Speaking on behalf of Rotarians worldwide, Judith Diment MBE, Chair of the Polio Task Force, said: “Rotary has joined donors in Berlin to collectively pledge more than half of the funds needed for the GPEI strategy. We call for further investment from all sectors to overcome the challenges and sustain these achievements for years to come.”
Dr. Tedros concluded the discussion on polio by telling the assembled delegates, “We are much better off than we were before. But the last mile is the hardest. There is no room for disappointment. Now is the time to redouble our efforts. Let’s keep pushing.”
Bottom line: There is a clear window for success this year. But this window will not stay open for long. The virus is getting stronger again. 2023 is our opportunity. Let’s take it. Let’s focus on our collective and clear goals: to take steps towards a sustainable transition to ensure that children in the most at-risk geographies reach zero doses and remain so after a polio-free world is achieved. We all have a part to play in achieving this. We have a collective responsibility.
Therefore, experts urged never to deviate from this focus. If we are razor sharp, we will succeed.
