Over 400 scientists, physicians, and other leaders have signed a declaration to eradicate polio by 2018.

Cases of wild poliovirus have dropped dramatically in recent decades. In 2012, only 223 cases were reported, compared with 350,000 new cases in 1988. India, long a hotbed of polio activity, has not seen a case in over 2 years.

The Polio Eradication and Endgame Strategic Plan 2013–2018 calls for:

• delivering routine vaccines to more at-risk children, especially in endemic areas like Afghanistan, Nigeria, and Pakistan;
• phasing out the oral polio vaccine and introducing the inactivated polio vaccines to eliminate both wild and vaccine-derived poliovirus.
• protecting vaccination teams by increasing engagement with civic and religious leaders.

·         By Kelly Young

Source: Scientific Declaration on Polio Eradication

 Polio Eradication Is Achievable and Urgent, Declare 400+ Global Scientists

 

Experts from 80 countries cite time-limited opportunity, endorse comprehensive new eradication strategy

 

Hundreds of scientists, doctors and other experts from around the world launched the Scientific Declaration on Polio Eradication today, declaring that an end to the paralyzing disease is achievable and endorsing a comprehensive new strategy to secure a lasting polio-free world by 2018. The declaration’s launch coincides with the 58th anniversary of the announcement of Jonas Salk’s revolutionary vaccine.

 

The more than 400 signatories to the declaration urged governments, international organizations and civil society to

do their part to seize the historic opportunity to end polio and protect the world’s most vulnerable children and future

generations from this debilitating but preventable disease. The declaration calls for full funding and implementation

of the Polio Eradication and Endgame Strategic Plan 2013-2018, developed by the Global Polio Eradication Initiative

(GPEI). With polio cases at an all-time low and the disease remaining endemic in just three countries, the GPEI esti-

mates that ending the disease entirely by 2018 can be achieved for a cost of approximately $5.5 billion.

 

“We have the tools we need and a time-limited opening to defeat polio. The GPEI plan is the comprehensive roadmap that, if followed, will get us there,” said Dr. Walter Orenstein, professor and associate director of the Emory Vaccine Center at Emory University and former director of the U.S. Centers for Disease Control and Prevention’s National Im- munization Program. Dr. Orenstein is one of the scientists spearheading the declaration and among the signatories who were on the frontlines of ending smallpox, the only human disease to be successfully eradicated.

 

The declaration – housed online by Emory University at vaccines.emory.edu/poliodeclaration – notes that polio vac- cines have already protected hundreds of millions of children from the disease and eliminated one of the three types of wild poliovirus, proving that eradication is scientifically feasible. It calls on the international community to meet

the goals in the GPEI plan for delivering polio vaccines to more children at risk, particularly in Afghanistan, Nigeria

and Pakistan, where polio remains endemic and emergency action plans launched over the past year have resulted in

significant improvements in vaccine coverage.

 

“Securing a lasting polio-free world goes hand in hand with strengthening routine immunization. We need all coun- tries to prioritize investments in routine immunization,” said Dr. Zulfiqar Bhutta, founding director of the Center of Ex- cellence in Women and Child Health at Aga Khan University. Dr. Bhutta, one of the declaration’s leaders, is a member of the Strategic Advisory Group of Experts (SAGE) on Immunization, a technical advisory body to the GPEI.

 

The declaration emphasizes that achieving polio eradication requires efforts interrelated with strengthening routine immunization, a new focus of the GPEI plan. As the last cases of polio are contained, high levels of routine immuniza- tion will be critical. At the same time, resources and learning from polio eradication efforts can be used to strengthen coverage of other life-saving vaccines, including for children who have never been reached with any health interven- tions before.

 

The scientists and experts signing the declaration called on the international community to take steps outlined in the GPEI plan to address challenges that have posed obstacles to polio eradication in the past, including improving immu- nization campaign quality to reach missed children and eliminating rare polio cases originated by the oral polio vac- cine. While previous polio efforts have sought to interrupt wild virus transmission and then address vaccine-derived virus, the new GPEI plan addresses both simultaneously with a timetable to phase out use of oral polio vaccines and introduce inactivated polio vaccines. The declaration urges vaccine manufacturers to provide an affordable supply of

 

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the different vaccines required for eradication, and calls on scientists to continue researching new and better tools.

 

“As long as it exists anywhere in the world, polio threatens children everywhere,” said Professor Helen Rees, executive director of the Wits Reproductive Health and HIV Institute at the University of the Witwatersrand in South Africa, who signed the declaration and chairs SAGE. “By pursuing in parallel all of the steps needed to reach eradication, includ-

ing the introduction of inactivated vaccines, countries have a complete path to eliminate polio’s threat.” In November

2012, SAGE recommended the introduction of at least one dose of inactivated polio vaccine into all routine immuniza-

tion programs prior to the phase-out of oral polio vaccines.

 

In light of recent attacks on health workers in some endemic countries, the declaration stresses the need to protect polio vaccination teams as they do their work. The GPEI plan includes a series of risk-mitigation strategies for insecure areas, including deepening engagement with community and religious leaders.

 

The scientists and experts signing the declaration hail from 80 countries and include Nobel laureates, vaccine and in- fectious disease experts, public health school deans, pediatricians and other health authorities. More than 40 leading universities and schools of public health and medicine are promoting the declaration on their websites, including Aga Khan University, the Harvard School of Public Health, the London School of Hygiene & Tropical Medicine, Al Azhar Uni- versity (Egypt), University of Cape Town, Redeemer’s University (Nigeria) and Christian Medical College Vellore (India).

 

The declaration notes that the world has a unique window of opportunity to eradicate polio. Only 223 new cases due to wild poliovirus were recorded in 2012, an historic low and a more than 99 percent decrease from the estimated

350,000 cases in 1988. Just 16 new cases have been reported so far in 2013 (as of 9 April). India, long-regarded as the most difficult place to eliminate polio, has not recorded a case in more than two years.

 

“Eradicating polio is no longer a question of technical or scientific feasibility. Rather, getting the most effective vac- cines to children at risk requires stronger political and societal commitment,” said Dr. David Heymann, head and senior fellow at the Chatham House Centre on Global Health Security and a signatory of the declaration. “Eliminating the last one percent of polio cases is an immense challenge, as is the eradication endgame after that. But by working together we can make history and leave the legacy of a polio-free world for future generations.”

 

 

 

 

For additional information about the Scientific Declaration or to view a full list of signatories, please visit the Emory  Vaccine Center Website. The Polio Eradication and Endgame Strategic Plan 2013-2018 is available online from the Global Polio Eradication Initiative. The plan will be publicly shared with the immunization community at the Global Vaccine Summit taking place 24-25 April 2013 in Abu Dhabi.

 

Source: http://vaccines.emory.edu

 

 

Scientific Declaration on Polio Eradication

 

 

Polio is a highly infectious disease that can cause irreversible paralysis and death. Today, the disease mostly affects children living in some of the world’s poorest and most marginalized communities. Yet we are closer than ever to a world where no child will ever again be crippled or die from this disease. At this unique moment, an international group of scientists has come together to stress the achievability of polio eradication and endorse

the Eradication and Endgame Strategic Plan, a new strategy by the Global Polio Eradication Initiative (GPEI) to reach and sustain eradication by 2018. The plan was developed in consultation with a range of technical experts, governments, funding partners and stakeholders and received unanimous support from the WHO Executive Board in January 2013.

 

Whereas,

 

1. Unprecedented progress, scientific advances and new tools give us confidence that eradication is achievable.

 

• New cases of wild poliovirus have dropped from an estimated 350,000 cases in more than 125 countries in

1988 to fewer than 250 cases in just five countries in 2012.

• 2012 was a turning point for the remaining endemic countries. Nigeria, Afghanistan and Pakistan launched national emergency action plans that resulted in significant improvements in immunization campaign quality and the fewest new cases on record.

• India stopped wild poliovirus transmission in 2011, proving that polio can be eliminated in the most challenging circumstances.

• Two effective vaccines have protected hundreds of millions of children against the disease: oral polio vaccine (OPV) and inactivated polio vaccine (IPV). The worldwide elimination of one of the three types of wild poliovirus (type 2) more than a decade ago proves that eradication through the polio eradication strategy is feasible.

• We have successful strategies to deliver vaccines and monitor coverage, strong surveillance to quickly detect and contain the virus, and innovative technologies and approaches such as geographic information system (GIS) mapping and new vaccine formulations to ensure that children are reached and protected.

 

2. The new Strategic Plan provides a clear path forward that capitalizes on this historic opportunity to end polio.

 

• The plan is a long-term, comprehensive strategy to complete and sustain eradication. The plan’s strategies

are sound and, when implemented, will interrupt transmission, sustain eradication and maximize

post-eradication benefits.

• The plan is a significant step forward over previous eradication strategies and offers strong solutions to

challenges by including:

1) Data-driven strategies to overcome operational challenges—including missed children—to ensure

high quality immunization campaigns that can interrupt transmission globally; and

2) Plans to eliminate both wild poliovirus and vaccine-derived poliovirus, starting with the withdrawal

of type 2 from OPV and introduction of IPV in all countries to boost immunity to remaining strains.

• Insecurity in endemic countries is a serious threat to the program. To overcome this challenge, the GPEI will improve coordination between civilian and security services, increase community demand for vaccination services, enhance advocacy efforts by religious leaders and institutions, and increase vaccinations in areas bordering insecure places to reduce spread of the disease.

 

3. The new plan emphasizes the urgency of improving routine immunization systems and lays a foundation to protect children against other diseases.

 

• The plan recognizes that eradication efforts are interdependent with strengthened routine immunization.

High levels of routine immunization are needed to achieve and sustain polio eradication.                               1

At the same time, eradication efforts demonstrate that it is possible to reach nearly every child, even in

the most underserved and remote areas, with vaccines and other life-saving interventions.

• The Strategic Plan calls for GPEI to use its robust infrastructure to benefit routine immunization and other health programs. It includes strategies for polio eradication staff and processes to help strengthen routine immunization, in partnership with national immunization programs and the GAVI Alliance and in alignment with the Global Vaccine Action Plan.

• Eradication would demonstrate that worldwide collaborations can successfully combat complex health

threats, including in remote communities too often left behind.

 

 

4.  Scaling back efforts would have devastating consequences.

 

• For polioviruses to survive, they must be transmitted from infected persons to susceptible persons in a continuous chain of human-to-human transmission. When immunity levels are high, the chains are broken. Today, there are fewer chains than ever before, creating an unprecedented opportunity to stop transmission.

• Weakening our efforts would lower immunity levels, setting the stage for a resurgence of outbreaks. Polio is highly infectious and spreads quickly. If we aim for control rather than eradication—relying only on routine immunization to vaccinate against polio and eliminating mass vaccination and other eradication strategies—we can expect up to 200,000 cases annually.

 

We, members of the scientific community, declare our conviction that the eradication of polio is an urgent and achievable global health priority. We endorse the Eradication and Endgame Strategic Plan and call on actors in the global community to do their part to ensure the full implementation of the plan. We urge:

 

• Scientists to develop new and better tools to accelerate and sustain eradication, including

low-cost IPV options, and to continue providing technical support to endemic countries.

• Partners, including GPEI and vaccine manufacturers, to ensure sufficient supply of and access to different types of vaccines required for eradication, including IPV use in

resource-poor countries.

• Endemic country leaders and international program officials to stay fully committed and accountable to stop transmission. They can build on emergency plans to increase accountability and strengthen campaign quality. They can continue to develop regional- and community-specific solutions to bottlenecks such as vaccine refusals.

• Endemic country governments and partners to strengthen security measures and deepen engagement with community and religious leaders to promote demand and protect vaccination teams and volunteers, in light of recent attacks on health workers across Pakistan and Nigeria.

• International partners and national programs to strengthen linkages across polio vaccination efforts, routine immunization and other initiatives, including measles prevention, maternal and child health and nutrition, to address the broad health needs of communities.

• Partners, and national and global programs, to commit to strengthen routine immunization with the same urgency, robust technical and financial support and clear measurement indicators.

• Partners to fully fund the Strategic Plan. Funding gaps in 2012 led to cancelled and scaled-back

vaccination campaigns in 24 countries, leaving children in these areas more susceptible to polio.

• Civil society to continue to support efforts to end polio forever.

 

Polio eradication can be our generation’s legacy to all future generations. Only working together can we make history and end polio.

 

For more information about the declaration and for a full list of signatories, please visit http://vaccines.emory.edu/poliodeclaration/