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GPEI recommends postponing polio eradication efforts due to COVID-19

Amid a growing COVID-19 pandemic, the Global Polio Eradication Initiative, or GPEI, recommended that polio vaccination campaigns be postponed until the second half of the year and that countries responding to outbreaks of polio suspend those efforts until June 1, and then re-evaluate the situation.

The GPEI said its “thousands of polio workers, and an extensive laboratory and surveillance network, is positioned and ready to ensure that our resources are used by countries in their preparedness and response” to the pandemic.

“The COVID-19 pandemic response requires worldwide solidarity and an urgent global effort,” the GPEI said. “The COVID-19 emergency means that many aspects of the polio eradication program will be — and in some areas are already — substantially affected.”

The GPEI said it will make available all of its assets — technical expertise, surveillance and community networks and logistic capacity — to support the global response to COVID-19 for the next 4 to 6 months. It also is making its financial management systems available to help channel COVID-19 funding for the response, if needed.

The group suggested that critical functions related to polio acute flaccid paralysis and environmental surveillance remain a priority and that governments do anything possible to continue to monitor the circulation of wild and vaccine-derived polioviruses. It recommended that this be paired with COVID-19 surveillance.

For countries that do not wish to postpone outbreak campaigns, vaccines approved for supplemental immunization activities and outbreak response will be shipped, according to the GPEI. “New vaccine requests will be considered on a case-by-case basis,” it said.

Wild poliovirus is endemic in only three countries — Afghanistan, Pakistan and Nigeria, although Nigeria has not experienced a case since 2016. According to the GPEI, as of April 1, Afghanistan has reported three cases of wild poliovirus in 2020 and Pakistan has reported 36. Sixteen nonendemic countries are battling outbreaks either from the importation of wild poliovirus or the emergence of vaccine-derived cases.

“While halting important polio eradication activities is necessary, it will result in increased spread of disease and number of children paralyzed by wild and circulating vaccine-derived polioviruses This will require a scale up of polio eradication efforts once the COVID-19 situation has stabilized,” the GPEI said.

“Without compromising support to the COVID-19 response, country programs should take the opportunity during the pause in vaccination campaigns to improve other elements of the program such as strategic planning and performance management processes. Finally, GPEI and country programs must develop a comprehensive set of context-specific strategies and a plan for resumption of operations.”

The GPEI’s strategy committee will review the provided recommendations on a biweekly basis. – by Ken Downey Jr.

Reference:

GPEI. Polio eradication in the context of the COVID-19 pandemic. http://polioeradication.org/wp-content/uploads/2020/03/GPEI-POB-recommendations-for-countries-on-covid-20200324.pdf. Accessed April 6, 2020.

Amid a growing COVID-19 pandemic, the Global Polio Eradication Initiative, or GPEI, recommended that polio vaccination campaigns be postponed until the second half of the year and that countries responding to outbreaks of polio suspend those efforts until June 1, and then re-evaluate the situation.

The GPEI said its “thousands of polio workers, and an extensive laboratory and surveillance network, is positioned and ready to ensure that our resources are used by countries in their preparedness and response” to the pandemic.

“The COVID-19 pandemic response requires worldwide solidarity and an urgent global effort,” the GPEI said. “The COVID-19 emergency means that many aspects of the polio eradication program will be — and in some areas are already — substantially affected.”

The GPEI said it will make available all of its assets — technical expertise, surveillance and community networks and logistic capacity — to support the global response to COVID-19 for the next 4 to 6 months. It also is making its financial management systems available to help channel COVID-19 funding for the response, if needed.

The group suggested that critical functions related to polio acute flaccid paralysis and environmental surveillance remain a priority and that governments do anything possible to continue to monitor the circulation of wild and vaccine-derived polioviruses. It recommended that this be paired with COVID-19 surveillance.

For countries that do not wish to postpone outbreak campaigns, vaccines approved for supplemental immunization activities and outbreak response will be shipped, according to the GPEI. “New vaccine requests will be considered on a case-by-case basis,” it said.

Wild poliovirus is endemic in only three countries — Afghanistan, Pakistan and Nigeria, although Nigeria has not experienced a case since 2016. According to the GPEI, as of April 1, Afghanistan has reported three cases of wild poliovirus in 2020 and Pakistan has reported 36. Sixteen nonendemic countries are battling outbreaks either from the importation of wild poliovirus or the emergence of vaccine-derived cases.

“While halting important polio eradication activities is necessary, it will result in increased spread of disease and number of children paralyzed by wild and circulating vaccine-derived polioviruses This will require a scale up of polio eradication efforts once the COVID-19 situation has stabilized,” the GPEI said.

“Without compromising support to the COVID-19 response, country programs should take the opportunity during the pause in vaccination campaigns to improve other elements of the program such as strategic planning and performance management processes. Finally, GPEI and country programs must develop a comprehensive set of context-specific strategies and a plan for resumption of operations.”

The GPEI’s strategy committee will review the provided recommendations on a biweekly basis. – by Ken Downey Jr.

Reference:

GPEI. Polio eradication in the context of the COVID-19 pandemic. http://polioeradication.org/wp-content/uploads/2020/03/GPEI-POB-recommendations-for-countries-on-covid-20200324.pdf. Accessed April 6, 2020.

    Perspective

    Apoorva Mallya

    The COVID-19 pandemic requires an urgent, coordinated effort the world over. This includes mobilizing the entire global health community and the polio eradication program is no exception.

    The decision to temporarily suspend vaccination campaigns was not made lightly, but it was what we needed to do to protect the health of the workforce and the communities we’re serving. We also know that the expertise and resources built that have been developed to stop polio can be tremendously valuable in supporting countries and communities in their fight against the pandemic. Wherever possible, the systems built for polio eradication will be used to coordinate response operations, conduct surveillance for suspected cases and train health care workers.

    Undoubtedly, the suspension of vaccination activities and pivot to COVID-19 response support will have an impact on the polio eradication effort, and sadly we expect to see more children paralyzed by polio several months from now. That said, the program is making every effort to continue activities that don’t require people to go house-to-house or gather in large groups. That includes routine immunization activities, tracking polio through our surveillance systems and continuing the development of an improved oral polio vaccine.

    We remain fully committed to achieving a polio-free world. As soon as it is safe to do so, we will come back stronger and faster, ready to recover lost ground and tackle the remaining barriers to eradication.

    Disclosure: Mallya reports no relevant financial disclosures.

    • Apoorva Mallya
    • Senior program officer, polio team
      Gates Foundation

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