Citing dramatic gains achieved
with polio vaccines, Prime Minister David Cameron joins Bill and
Melinda Gates to call on world leaders to finish the job
UK
Government Doubles Polio Funding
- Bill Gates call for a final push to end polio, joins UK
Prime Minister David Cameron to announce contributions: New funding
from the United Kingdom and the Crown Prince of Abu Dhabi will help
reduce the US$720 million funding gap of the Global Polio Eradication
Initiative, but Mr Gates, co-chair of the Bill & Melinda Gates
Foundation, reminded readers of his annual letter that eradicating
polio requires "funding from a range of donors, to support
an aggressive program that will get the job done." Mr Cameron
also called on other donors to back polio eradication: noting the
question of international development assistance in the current
financial climate, Mr Cameron said, "There is never a wrong
time to do the right thing."
President of Pakistan kicks off emergency plan to stop polio.
Rotary International
News -- Friday, January 28, 2011The
only polio-endemic country where case numbers rose in the past year,
Pakistan has developed a national emergency action plan that outlines
area-specific strategies and accountability mechanisms. President
of Pakistan kicks off emergency plan to stop polio: President Asif
Ali Zardari formally launched the emergency plan on 24 January.
The only polio-endemic country with an increase in cases in 2010,
Pakistan has struggled in the past six months to slow the transmission
of poliovirus. The number of children paralyzed by the virus jumped
by 60% (from 88 in 2009 to 144 in 2010, as of 1 February 2011).
Polio in Retreat: New Cases Nearly Eliminated Where Virus Once
Flourished
End-2010 data shows
a reduction in new cases in 2010 over 2009 in three of the four
endemic countries (India, Nigeria and Afghanistan); the apparent
cessation of all polio outbreaks in 15 countries in with onset 2009
by mid-2010; the apparent stopping of ten of the eleven new outbreaks
(with 2010 onset) within six months; and progress in two of the
four countries with re-established transmission (southern Sudan
and Chad).
New cases in key Indian
states are hovering near zero—unprecedented, historic lows—suggesting
that a long-time goal of eliminating the virus is within reach in
parts of world where it has long been considered intractable
The world's largest,
most intractable source of polio may be on the brink of elimination.
In India the states of Bihar and Uttar Pradesh have produced more
polio cases this decade—nearly 5,000—than any other
location worldwide that has an active immunization campaign. Nigeria
saw a handful more cases than the two Indian states because it effectively
ceased immunizing in 2003 for a time due to false fears of the vaccine.
Now, even at the peak
of polio season, new cases in Bihar, Uttar Pradesh and indeed all
of India hover near zero—unprecedented, historic lows. In
the past decade the peak months of August and September have seen
an average of roughly 140 people, usually children, stricken by
poliomyelitis, which attacks motor neurons in the nervous system
and can cause paralysis. But for the past four weeks running, Bihar
and Uttar Pradesh have hung zeros on the polio scoreboard, according
to reports published as recently as October 28 by the Global Polio
Eradication Initiative.
END POLIO NOW -
fACTS & fIGURES
There have been 950 cases globally* in 2010 (864 type 1 and 86 type
3), compared with 1,595 cases at the same time in 2009 (477 type
1 and 1,116 type 3 and 2 mixtures). 20 countries reported cases
in 2010, compared with 23 in 2009.
ANGOLA: Renewed leadership commitment: President Jose Eduardo dos
Santos reaffirmed the Government´s and his personal commitment
to eliminating polio in a meeting with the UNICEF Executive Director
and senior leadership from the Bill & Melinda Gates Foundation
and WHO African Regional Office. The President agreed to spearhead
the country's 2011 vaccination campaigns; this pledge was echoed
by Vice Ministers, Vice Governors and civil society organizations,
who agreed they would work across the country to improve vaccination
coverage. *Many of the 540 cases of acute flaccid paralysis (AFP)
reported from Congo do not have stool specimens but are clinically
compatible with polio. When definitively classified, these cases
will add to the yearly total.
ENDEMIC COUNTRIES
AFGHANISTAN
•In the past nine months, no WPV3 has been recorded in Afghanistan.
The recent WPV1 detected in December is a new importation from neighbouring
Pakistan.
•The first Subnational Immunization Days (SNIDs) of the year
were held on 30 January to 2 February, in synchronization with Pakistan.
•Efforts were focused on reaching all populations in the 13
high-risk districts of the Southern Region. Access during supplementary
immunization activities (SIAs) in the latter half of 2010 had improved,
and this trend needs to continue in 2011. During the last three
SIAs, less than 10% of the target population was inaccessible, compared
to more than 25% at the start of 2010.
INDIA
•India continues to report record-low levels of both WPV1
and WPV3, particularly in the traditional endemic reservoir areas.
In Uttar Pradesh, no cases of WPV3 have been reported since April
2010; the most recent WPV1 is from October 2009. In Bihar, no cases
of WPV1 have been reported since 1 September 2010; it has been more
than 12 months since Bihar reported a WPV3.
•The outbreak in West Bengal has persisted for nearly 12 months
and is the longest running outbreak in a previously polio-free area
experiencing a WPV importation in 2010. Confirmation was received
in January of a WPV1 environmental sample collected in November
in Mumbai. For these reasons, urgent efforts are under way to close
any residual immunity gaps, especially in high-risk areas of West
Bengal, and with special strategies to reach mobile population groups.
•In January, over 15,000 children were immunized during the
Ganga Sagar festival in the South 24 Parganas district of West Bengal.
As part of the renewed emphasis on reaching migrant and nomadic
populations, social mobilizers pointed festival goers to the vaccination
teams. The fair saw 620,000 people coming in from other states and
from neighbouring countries. A mop-up is being held on 5 February
in high-risk districts of West Bengal.
•National Immunization Days (NIDs) were launched on 23 January
by the President of India. In response to the West Bengal outbreak,
more than 1,140 NGO volunteers were deployed to deliver focused
community mobilization in the highest-risk areas of Murshidabad
and South 24 Parganas ahead of and during the NIDs.
•A second NID is scheduled for 27 February. These two nationwide
rounds will be followed by SNIDs in March, April, May and June.
NIGERIA
•Nigeria continues to report record-low levels of both WPV1
and WPV3 transmission, with a 95% decrease in cases in 2010 compared
to 2009.
•However, transmission of a circulating vaccine-derived poliovirus
(cVDPV) continues. Transmission of all types of virus, both vaccine-derived
and wild, particularly in the northeast of the country (Borno state,
bordering Chad), and in the northwest (Zamfara, Kebbi and Sokoto
states) threaten neighbouring countries. It is historically from
these areas which poliovirus spread internationally into west Africa
and into Chad. The progress in Nigeria is fragile until transmission
in these areas is stopped.
•The first nationwide Immunization Plus Days (IPDs) in 2011
were conducted on 26 January (in key northern states, the activity
also included an integrated measles campaign). The activity in Borno
was delayed until 2 February; Borno has not conducted any immunization
activities since October 2010, due to a health worker strike.
•The next nationwide IPD is planned for 23 February using
tOPV and will be followed by subnational activities in March. These
two campaigns will be critical, as national elections will be held
in April, and the rainy season will commence in May, both factors
which may compromise immunization activities at that time.
•The next Expert Review Committee on Polio Eradication and
Routine Immunization (ERC) is tentatively scheduled for 7-8 March.
It is expected that the ERC will review the latest risk assessments
and agree on action plans to interrupt all strains of transmission
as rapidly as possible.
PAKISTAN
•Pakistan is the first country to report cases in 2011 and
the only endemic country to report more cases in 2010 than in 2009.
Over half the cases of 2010 are from the Federally Administered
Tribal Agencies (FATA). Five positive environmental samples found
in 2010 at sites as disparate as Lahore, Quetta and Karachi provide
further evidence that polio transmission is widespread.
•NIDs were conducted on 28-30 December, using bivalent OPV.
Access to all children in FATA was again a hurdle, with 26% of the
target population inaccessible.
•To urgently address the increase in transmission in the country
over the past 12 months, the National Emergency Action Plan for
polio eradication was presented to the Prime Minister on 14 January
and launched by President Asif Ali Zardari on 24 January.
•Turning the plan into action will depend on increased engagement
and ownership at all levels, and especially at the district-level
(where the plan is ultimately implemented). The plan is available
at http://www.polioeradication.org/Portals/0/Document/InfectedCountries/Pakistan/PakistanStrategy/NationalEmergencyActionPlan.pdf
•Coordination has started with the Inter-religious Council
for Health (IRCH) in 27 intervention districts on mother and child
health issues, with special emphasis on polio eradication and immunization.
•The first SNIDs of the year were launched on 31 January,
in synchronization with Afghanistan.
RE-ESTABLISHED TRANSMISSION COUNTRIES
ANGOLA
•The outbreak in Angola, which has this year spread to DR
Congo and the Republic of Congo, continues to pose a significant
risk to Africa's eradication effort, particularly given the strong
progress achieved elsewhere on the continent (in particular in Nigeria
and west Africa). A mop-up was held on 14-16 January in Cabinda
in response to the Republic of Congo outbreak.
•President Jose Eduardo Dos Santos has stated his personal
commitment to stopping polio in the country and his intention to
spearhead the 2011 SIA schedule. The Executive Director of UNICEF
and the President of the Global Health Programme at the Bill and
Melinda Gates Foundation, accompanied by the WHO Assistant Regional
Director for Africa, welcomed these commitments and expressed the
support of their organizations.
•Mop-ups will be held on 18-20 February in Luanda, Benguela,
Bengo and Kuanza Norte: these are the first campaigns to be conducted
in response to the latest cases Luanda and Benguela in November.
CHAD
•Chad is the first country in Africa to report cases in 2011.
Since September 2010, Chad is experiencing an expanding WPV1 outbreak.
During Supplementary Immunization Activities (SIAs) in which any
type 1-containing vaccine was used, coverage was insufficient. Chad
is at high risk of further spread of this current importation.
•The percentage of missed children during SIAs has increased
from a low of 8% in March after the President's launch, to a high
of 15% at the end of the year. The proximity of Logone Oriental
and Occidental (which have reported the recent cases) to neighbouring
Cameroon and Central African Republic further increases the risk
of this expanding outbreak.
•It is important to note that this WPV1 outbreak represents
a new outbreak, and is unrelated to the re-established virus transmission
chain (WPV3) affecting the country since November 2007. No cases
linked to that transmission chain have been reported since May 2010.
•A high-level round table for the media was held on 20 January,
to ensure clear communication on the urgency of the outbreak. The
event was presided over by the Secretary of State for Public Health
with participation from the country representatives of WHO and UNICEF,
the President of the N'Djamena Rotary Club and the Vice-President
of the Chad Red Cross.
•NIDs will be conducted on 10-12 February; it will be critical
to increase the sensitivity of independent monitoring, to assure
a clear picture of the outbreak response activities.
DEMOCRATIC REPUBLIC OF THE CONGO (DR CONGO)
•DR Congo is experiencing a severe outbreak in Kasai Occidentale
and Bandundu, the result of polio transmission from across the Angolan
border. At the same time, separate outbreaks are ongoing in Bas-Congo
(related to the Republic of Congo outbreak) and in the east of the
country (related to 2009 transmission).
•An emergency plan is currently being finalized by the government.
On an official visit to DR Congo on 7-8 February, WHO Director-General
Dr Margaret Chan met President Laurent Kabila, who stated his intention
to combat the current poliovirus circulation "without mercy."
Dr Chan also discussed the agency's support to the government's
response plan with the Prime Minister and Minister of Health.
IMPORTATION COUNTRIES
REPUBLIC OF CONGO
•Many of the 540 cases of acute flaccid paralysis (AFP) reported
from Congo do not have stool specimens but are clinically compatible
with polio. Final classification of these cases is expected by March.
•In the epicentre of the outbreak in Pointe Noire and Kouilou,
the large number of cases without stool samples are now being reviewed
and classified, many of which will likely be confirmed as polio.
•The network Al-Jazeera English broadcast a moving documentary
on the obligation to complete polio eradication, illustrating the
tragedy of paralysis and death that polio can cause through the
stories of two young men affected by the outbreak. The full 25-minute
programme can be viewed
here:
HORN OF AFRICA
•An international mission of technical experts is taking place
in early February, to finalize an SIA plan and review operational
plans to strengthen disease surveillance in both Kenya and Uganda.
This is critical, as in some areas of Kenya, upwards of 20% of children
were missed during outbreak response activities in 2010, and the
outbreak from 2009 continued undetected into 2010. Corrective actions,
including the deployment of additional STOP team members, have begun.
•Ethiopia is preparing for a second phase of Child Health
Days in February; the first was held in October. In Somalia, preparations
are also under way for NIDs in late March and late April. Both countries
continue to be at risk of polio, given ongoing WPV transmission
in the Uganda/Kenya border area, and evidence of a cVDPV in Ethiopia
in early 2010.
CENTRAL ASIA AND RUSSIA
•Six months have passed since the most recent case in Tajikistan
(4 July 2010), the first site of the outbreak in Central Asia.
•The European Regional Certification Commission met in January
in St. Petersburg and discussed further SIAs, surveillance and analysis
of risks.
•Comprehensive outbreak response is continuing in all four
countries, with a focus on the North Caucasus region of Russia.
NEPAL
•Mop-ups are continuing in highest-risk border districts with
India. All cases in 2010 were from the Central Development Region
(CDR), in Rautahat and Mahottari districts, bordering Bihar, India.
•NIDs will be conducted in Nepal in February and March 2011.
WEST AFRICA
•The outbreak appears to be slowing, as four months have passed
since the most recent case. In order to protect these gains, NIDs
took place in Niger (14 January) and Burkina Faso (4 February),
and SNIDs in Guinea (17 January). Further rounds across west Africa
are planned for 25 March and 22 April. = false;
Source: Rotary International
Copyright © 2003-04
Rotary eClub NY1 * Updated 2011
Design & Maintenance of this site by TechnoTouch
e-Strategists
