GPEI-EU provides critical support to health systems strengthening and polio eradication in Nigeria

Nigerian Minister of Health (left) and EU Ambassador signing the documents for the €70 million grant

At an event in Abuja on 16 February 2017, the Government of Nigeria and the European Union signed a historic partnership to support health systems and polio eradication efforts in the country. Attended by key ministries and partners such as WHO and UNICEF, a €70 million grant agreement was signed targeted at improving maternal, newborn and child health, strengthening Nigeria’s health system and supporting ongoing efforts to eradicate polio.

The project is the first phase of support from the European Union to the Nigerian health sector under the 11th European Development Fund, and will be jointly implemented by United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) in partnership with the Federal Government of Nigeria and key target states in the country.

Fifty million euro of the grant aims to ensure that by 2020, Adamawa, Bauchi and Kebbi states of Nigeria have functional primary health care centers, providing round-the-clock services to three million children under the age of ﬁve years as well as to almost a million pregnant women and lactating mothers.

Twenty million euro, to be dispersed by WHO, will go specifically towards health systems strengthening to achieve universal health coverage and support the push to eradicate polio from Nigeria for good. The grant comes at a critical time for polio eradication in Nigeria, with emergency efforts underway to stop the virus in the last remaining polio reservoir on the African continent.

Michel Arrion, the EU Ambassador to Nigeria and ECOWAS, said at the event, “The European Union is working together with the Nigerian authorities to address developmental challenges in key priority areas under its 11th European Development Fund. This project will help to improve access to eﬀective health and nutrition in the prioritized states and support the ﬁnal push to eradicate polio in Nigeria”.

The EU has been major supporter of polio eradication efforts worldwide and in particular Nigeria, providing €45 million to the country between 2011 and 2017. Additionally, the EU has provided significant emergency funding to help successfully stop past outbreaks in the Horn of Africa and the Middle East, and supported the eradication effort in other parts of the world.

Thanking the EU for on-going commitment, Dr Wondimagegnehu Alemu, WHO Country Representative, said, “Our partnership with the EU will enable the organization to continue providing the necessary technical support to the government of Nigeria towards strengthening health systems and enhancing timely interventions during supplemental immunization activities, including reaching children in areas with insecurity in the northeast.”

Polio eradication efforts have always played an important role in health systems strengthening. The polio network routinely conducts surveillance for other diseases of public health importance, including measles, yellow fever, neonatal tetanus and avian influenza. With local knowledge of communities, health systems and government structures, the polio network’s technical capacity in disease surveillance and planning of large-scale operations often helps sustain international and national relief efforts. At the country level, polio staff spend, on average, 50% of their time working on broader public health efforts, over and beyond polio eradication, providing a critical contribution to strengthening of health systems.

Surrounded by mothers with their babies, polio vaccinator Aisha Bulama is one of the most popular women in Maiduguri. As a polio vaccinator, Aisha is a key member of one of thousands of UNICEF-supported polio vaccination teams. © Unicef

A US$ 33.3 million grant from the Government of Japan in humanitarian emergency funding to UNICEF was announced this week and will help to protect millions of children from polio in Nigeria and the Lake Chad region.

In response to the urgent need to rapidly raise immunity to polio virus in the region, Japan has generously provided exceptional funding from their supplementary budget envelope to purchase polio vaccines, conduct house-to-house polio campaigns and support communication efforts to mobilize communities for vaccination in Nigeria, Chad, Niger, Cameroon and the Central African Republic.

The detection of wild poliovirus in north-eastern Nigeria occurred in August 2016 following the large-scale movement of families affected by conflict in Borno State out of areas inaccessible to health services. National Governments, in collaboration with the Global Polio Eradication Initiative (GPEI), comprising the World Health Organization, UNICEF, Rotary International, CDC and the Bill & Melinda Gates Foundation (BMGF), have implemented emergency vaccination campaigns throughout the region to rapidly raise childhood immunity to the polio virus and guard against further spread.

UNICEF Director of Polio Eradication Mr Reza Hossaini said the Japanese funding was gratefully received and filled an urgent need. “This additional funding is very timely to support the ongoing polio vaccination campaigns and give Africa the very real opportunity to be completely polio-free,” Mr Hossaini said. “These campaigns aim to not only stop transmission of polio in north-eastern Nigeria but protect its neighbours against the spread of the virus through provision of vaccines and targeted social mobilization activities.”

Japan remains one of the champion donors to the GPEI and the Global Health agenda in general, with contributions to polio eradication through UNICEF since 2002 totalling more than US$ 333 million. This funding – and the leadership provided by both the Tokyo International Conference on African Development (TICAD) process and the Japan International Cooperation Agency (JICA)’s innovative soft loan in partnership with BMGF in Nigeria and Pakistan for polio eradication – has proven instrumental in the historic reduction of wild poliovirus transmission globally.

In 2016, wild poliovirus transmission was limited to just 37 cases globally in the three remaining polio-endemic countries – Nigeria, Pakistan and Afghanistan. This year, to date, only two cases have been recorded worldwide, in Afghanistan. However, while the opportunity to finally eradicate polio is real, the risk remains: as long as one child is infected, every child remains at risk. It is critical that all countries continue to maintain high immunity to polio until the virus is eradicated, once and for all.

Today, Bill and Melinda Gates released their Annual Letter. This year the letter is addressed to Warren Buffett, who donated the bulk of his fortune to the Bill & Melinda Gates Foundation 10 years ago, and focuses on the gains that have been made since then to improve health of children around the world.

Bill and Melinda use the letter to highlight numbers that tell a story of how the world is doing in several different areas – 48 million children saved since 2000, 300 million women in the developing world who use contraceptives. But they say there is one number they work toward every day: zero.

As Bill and Melinda explain in their letter, the “magic number is zero” when thinking about many of the health challenges we face today – ending malaria, TB, HIV – and polio is the closest to reaching this goal. Bill and Melinda discuss the persistence and dedication of health workers around the world and Rotary International in achieving this magic number.

It is in part because of the contributions from Warren and other generous donors that the world has made this incredible progress – and now zero is in sight.

Read the full letter here: gatesletter.com

Hear from Ann Lee Hussey, a polio survivor and volunteer for Rotary International, as she shares her story of living with polio. Her experiences drive her commitment to reach zero and end the disease once and for all.

WHO_EB140_23JAN2017_0005 — 140th session of WHO Executive Board, Geneva, Switzerland. Photo: WHO/C.Black

27 January 2017, Geneva, Switzerland – Ministries of health gathering at this week’s Executive Board of the World Health Organization (WHO) reviewed the latest global poliovirus epidemiology and concluded that the world has never had a better chance to complete the job. Amid discussions on Ebola, Zika and pre-elections for the new WHO Director-General, delegates stressed the urgent need to secure a lasting polio-free world, by fully implementing the Global Polio Eradication Initiative (GPEI) Polio Eradication Endgame Strategic Plan.

Endemic polio is now restricted to a handful of areas of Pakistan, Afghanistan and Nigeria, all of which are implementing regionally-coordinated emergency plans to reach and vaccinate the remaining pockets of under-immunized children.

Despite more children being reached in these traditional ‘reservoir’ areas for the virus, delegates cautioned that risks remained, as underscored by the detection of polio cases in Borno state of Nigeria, the first in two years anywhere in Africa. Countries are now focusing on making sure there are no surveillance gaps at a subnational level so that virus cannot circulate undetected, while working to increase population immunity levels.

Delegates commended the successful global switch from trivalent oral polio vaccine (OPV) to bivalent OPV in 2016, and emphasized that strong surveillance to detect any type 2 poliovirus from any source is now critical. A global stockpile of monovalent OPV type 2 (mOPV2) remains on hand for potential response as needed. A critical global supply shortage of inactivated polio vaccine (IPV) continues to pose a risk, but is being managed by prioritizing available supply to high-risk areas and implementing new measures to stretch available supply, notably use of fractional IPV, as recommended by the Strategic Advisory Group of Experts on immunization (SAGE).

At the same time, countries expressed appreciation at the ongoing efforts to fully implement global laboratory containment activities. They also encouraged plans to transition the infrastructure of the GPEI for the long-term, to ensure the assets and infrastructure established to eradicate polio will continue to benefit broader public health efforts even after the disease is gone. At the World Health Assembly in May, the GPEI will present a strategic roadmap towards polio transition and the development of a post-certification strategy.

With all technical and programmatic building blocks in place to achieve success, ministries urged all stakeholders to ensure that the necessary financial resources to fully implement the Endgame Plan are rapidly mobilized.

Closing the discussion, partners from civil society addressed the ministries through Rotary International with a clear call to action: “We must protect hard won gains by sustaining immunity levels and careful monitoring of virus transmission. An additional US$1.3 billion is needed through 2019 to reach more than 400 million children in up to 60 countries and to ensure high quality surveillance. The eradication of polio will be a monumental achievement by a global partnership. Such achievements exemplify what we can do when united for a common purpose. Together we can end polio and forever build a better future for all children.”

Women in Toutou village, Niger wait to have their children vaccinated against the polio virus as part of outbreak response activities. © UNICEF/UN026556/Parry

Polio is highly infectious, and can easily fly undetected with a child from one country to another. But when anyone flies from the Republic of Korea, they are directly supporting the effort to ensure this disease never travels again at all.

An innovative financing mechanism titled the ‘‘Global Disease Eradication Fund” air-ticket solidarity levy means the Government of Korea collects 1,000 South Korean Won (about US$0.85) from each international passenger departing Korea’s airports. This week, the Government of Korea announced it was giving US $4 million of those funds to UNICEF and WHO to support disease surveillance and a rapid outbreak response wherever it occurs.

This contribution has been generously matched by the Bill & Melinda Gates Foundation, doubling its impact to $8 million and reducing the polio eradication funding need, which is currently estimated at $1.3 billion for 2016-2019.

This unique new funding agreement was made possible through the committed work of Korean Rotary members, who used the global stage of their Rotary International Convention in Seoul in May to highlight the opportunity for Korea to support polio eradication.

Michael K. McGovern, the Chair of Rotary’s International PolioPlus Committee, expressed his thanks to the Government of Korea for its support. “We are getting closer to our goal of a polio-free world, but we’re not done yet,” Mr McGovern said. “This new funding from Korea will help ensure the right financial resources are in place to get the world to the finish line: a future where no child has to suffer the devastating effects of polio.”

UNICEF and WHO welcomed the funding, which will be used to detect and respond to any potential outbreak of polio. UNICEF received $3 million, with WHO receiving $1 million of the funds.

UNICEF Director of Polio Eradication Reza Hossaini said the funding would be utilized for rapid outbreak response. “UNICEF is responsible for supply and demand in an outbreak response – the rapid supply of safe and effective vaccines, and generating the demand in the community to ensure they seek the vaccine and can quickly protect their children from the virus.”

WHO’s Director of Polio Eradication, Dr Michel Zaffran, said the funding would support the roll-out of effective disease surveillance globally. “To eradicate poliovirus, we must know where it is,” Dr Zaffran said. “Korea’s contribution is key to ensuring that we can find poliovirus anywhere it still survives through sensitive disease surveillance mechanisms.”

Dr Raul Bonifaco, Punjab team leader, demonstrating how to examine a child with acute flaccid paraysis. © WHO

In the last stages of polio eradication, a sensitive surveillance system that can detect every single poliovirus is indispensable to find it in its last hiding places. In Pakistan, surveillance for cases of acute flaccid paralysis (AFP), subsequent testing and supplementary environmental sampling from the environment are informing the progress made towards eradication.

The poliovirus has proven to be a constant and resilient foe, continuing to show up in several areas of Pakistan. However, transmission is the lowest it has ever been. So far in 2016, fewer children have been paralysed by polio than at any other year in history, with the virus limited to a few areas in just three countries – Pakistan, Afghanistan and Nigeria. Pakistan has made strong progress in identifying and vaccinating missed children in the country’s most challenging areas, resulting in historical low numbers of cases this year. This remarkable achievement is especially visible in the core reservoir districts where persistent transmission has been the norm.

Training surveillance officers

The training of dedicated surveillance officers is key to ensuring Pakistan’s surveillance system is built strongly for eradication. A recent training for 32 district surveillance officers from across Pakistan highlighted the importance of effective AFP and environmental surveillance in tracking down the virus. World Health Organization’s National Surveillance Coordinator, Dr Tahir Malik said the training is essential to ensure surveillance officers down to the district level are highly skilled in identifying and investigating cases. “This is critical not only to orient new surveillance officers but also for old officers to bring alignment in surveillance procedures”. He further explained, “After training we expect from the participants to fully understand poliovirus epidemiology, AFP surveillance, but also in detail its components and mechanics in Pakistan.”

“The training, which also covered specifics on the role of laboratory, surveillance indicators, healthy children sampling and environmental surveillance, aims to bring all officers on one page in terms of programme priorities,” Dr Tahir said.

Constantly improving

Supported by contributions from the Canadian Government, the training is part of the programmes surveillance improvement plan that was recommended by the Technical Advisory Group (TAG) for Polio Eradication in Pakistan, to place a greater emphasis on disease surveillance including scaling up the workforce of dedicated staff, realigning environmental surveillance sites and ensuring surveillance targets are met by including private and informal health sectors, pushing for timely investigation, and reprioritizing reporting sites to focus on silent UCs and Tehsils.

“Make the paediatrician your friend, talk continuously to the community, walk, move, sensitise, orient, visit facilities and care providers. Surveillance is not beautiful graphs on a laptop, it is hard field work,” says TAG chair Jean-Marc Olive to District Surveillance Officers. ©WHO

The Chairman of the TAG Jean-Marc Olive, who was visiting Pakistan during the training, addressed the Surveillance officers from Punjab, Balochistan, FATA and KP. “Make the paediatrician your friend, talk continuously to the community, walk, move, sensitise, orient, visit facilities and care providers. Surveillance is not beautiful graphs on a laptop, it is hard field work,” he said. “Be proud of what you do for the children of Pakistan.”

The 2016-2017 National Emergency Action Plan for polio eradication also highlights the intensification of surveillance as a critical activity so that virus signal are picked up as early as possible and response initiated rapidly and aggressively. In response, the programme is working to engage private clinics, traditional healers and pharmacies to make it more likely that all cases of polio will be reported and immediate case response can be launched when needed.

Environmental surveillance

In addition, there has been an increase in the work being done for environmental surveillance. The number of sites that test for presence of the virus in sewage water has been increased to 43 sites across Pakistan’s highest risk areas and environmental samples are being taken more frequently, which is proving to support the programme to detect and track the virus, a critical step as the country edges closer to stopping transmission.

Leaving no stone unturned

Once Pakistan is able to demonstrate that no poliovirus is present, both from AFP surveillance and supplementary environmental surveillance, for three consecutive years, the country will be declared polio-free. Until that time Pakistan will continue to leave no stone unturned in pursuit of the virus and no child unvaccinated and vulnerable.

Canada is one of the leading supporters of the Global Polio Eradication Initiative’s goal of eradicating the disease by 2018, and this year again extended its support to polio eradication in Pakistan with a renewed commitment of Can$40 million. The contribution, in part made through WHO, continues to contribute to the efforts to strengthen the monitoring and surveillance of the virus to track it down to its last hiding place.

Rotary’s PolioPlus was a major driver for selection of this award — Rotarians partner together on National Immunization Day in Moradabad, India.

The award honors organizations that show philanthropic commitment and leadership through financial support, innovation, encouragement of others, and involvement in public affairs.

“We are honored to receive this recognition from the AFP, which gives us even more reason to celebrate during our Foundation’s centennial year,” says Rotary Foundation Trustee Chair Kalyan Banerjee. “The continued strong support of Rotary members will help us keep our promise of a polio-free world for all children and enable the Foundation to carry out its mission of advancing world understanding, goodwill, and peace. We look forward to another 100 years of Rotary members taking action to make communities better around the world.”

ws20161018_globalcitizen — © Global Citizen

The world is in a better position than ever to finish the job on polio. To bring us over the finish line, Global Citizens, engaged citizens from all around the world, have signed petitions, tweeted, emailed, and even called their leaders asking them to fill the funding gap needed to achieve full eradication by 2019. In the lead up to this year’s Global Citizen Festival held on 24 September, individual Global Citizens took 134 470 actions to end polio leading Prime Minister Muscat of Malta and Prime Minister Bettel of Luxembourg to announce new funding commitments of $30,000 and at least 2 million euros until 2019, respectively, for polio eradication.

Canadian Prime Minister Justin Trudeau also encouraged Global Citizens to email world leaders on polio; instead, they took it one step further and called him, by the thousands. He received the message and responded to Global Citizens (and Rihanna) in a video message, showcased at the Global Citizen Festival, with Usher:

“Lately my office has been flooded with phone calls and tweets from many of you. Thanks Rihanna! I’ve heard your voices loud and clear on a whole range of issues – from supporting the eradication of polio, to ensuring every girl everywhere has the chance to go to school. Canada has long supported efforts to fight polio, which is now 99.9 % eliminated. And we will be a strong partner through to the end. Thank you for keeping these issues on our global agenda. Keep calling, keep tweeting, keep lighting up our switchboards. We’re listening, and we’re taking action. You’ve shown to the world that change starts with you. Together, we will end it for good.” – Justin Trudeau, Prime Minister of Canada

Global Citizens are holding Prime Minister Trudeau to his promise. They will continue to call on Canada, UK, and other countries to fully fund efforts to end polio. Together, we can make polio the second disease to be eradicated within our lifetimes.

About Global Citizen: Global Citizen is a campaigning and advocacy organization that is catalyzing a movement to end extreme poverty by 2030. As one of its longest running campaigns, Global Citizen has campaigned to bring about the end of polio by raising public awareness and campaigning towards government funding of the Global Polio Eradication Initiative. To learn more: https://www.globalcitizen.org/en/

20160920_g7leaders — G7 leaders in Kobe emphasised the importance of reaching every last child with polio vaccines, especially in challenging environments such as northern Nigeria. ©WHO/H. Dicko.

One year into the implementation of the 2030 Agenda for Sustainable Development, global leaders reconfirmed their full commitment to implementing ensuring healthy lives and well-being for all, including ending polio.

Health Ministers and high representatives of Canada, France, Germany, Italy, Japan, the United Kingdom, the United States and the European Commissioner for Health and Food Safety gathered in Kobe on 11 – 12 September, in continuation of the G7 Ise-Shima Summit in May to address major global health challenges.

In a statement released following the meeting, the leaders called for commitments from all stakeholders in the polio eradication programme to ensure that every last child is reached with polio vaccines. They particularly emphasised the need to fill the programme’s funding gap in order to ensure the achievement of this global good.

As well highlighting the importance of going above and beyond to reach children even in the most challenging environments, the G7 leaders also looked to the future, stating that polio assets have the potential to contribute to strengthening health systems if transitioned to other programmes once polio eradication has been achieved.

Read the full statement here.

20160803_RotaryTulip — © Rotary International

Polio tulips

In 2013, a group of Dutch Rotarians began selling boxes of tulip bulbs, with proceeds going to EndPolioNow, as part of Rotary’s fight against polio. In that year alone, tulips found their way to Rotarians across the Netherlands. Since then the tulip initiative has spread, with 4500 boxes sold in 2015, raising more than €45,000. This was tripled by the Bill and Melinda Gates Foundation resulting in a donation of $144,727 for the End Polio Now fund.

In 2016 the campaign has committed to committed to selling at least one box of Rotary tulip bulbs per Rotarian in the Netherlands, with over 18,000 members in the country. The campaign has also grown to become international in scope, with tulips sold across, Germany, Switzerland and the United States of America.

Rotary’s work

The EndPolioNow tulip campaign is just one example of efforts made by Rotarians across the world to end polio for good. Through its PolioPlus programme, established in 1985, Rotary was the first to have the vision of a polio-free world. More than one million Rotary members have volunteered their time and personal resources to polio eradication in nearly every country. Rotary members also provide valuable field support during National Immunization Days through social mobilization and by administering the oral polio vaccine to children.

It is thanks to the dedicated work of Global Polio Eradication Initiative partners such as Rotary International and Rotarians across the globe that we are now closer than ever to eradicating polio for good.

Learn more about Rotary’s work to eradicate polio here.

20160725_UAE — Immunization campaigns have helped to secure a polio free future for millions of children across Pakistan ©UNICEF/ Pakistan

The United Arab Emirates (UAE) has provided more than 116 million units of polio vaccine for Pakistani children between January 2014 and the end of May 2016 through the Emirates Polio Campaign. This commitment has played an important role in the progress seen in Pakistan in recent years, as highlighted by the recent meeting of the Technical Advisory Group (TAG) Islamabad.

Support for immunisation campaigns

The Emirates Polio Campaign was launched under the directives from President His Highness Shaikh Khalifa Bin Zayed Al Nahyan, and as part of an initiative of His Highness Shaikh Mohammad Bin Zayed Al Nahyan, Crown Prince of Abu Dhabi and Deputy Supreme Commander of UAE Armed Forces, to eradicate the disease.
The UAE-Pakistan Assistance Programme (UAE-PAP), which contributed to the anti-polio drive in Pakistan, benefitted children in 66 areas in Khyber Pakhtunkhwa, Balochistan, Sindh and the Federally Administered Tribal Areas in the first five months of this year.

The effort is part of the UAE government’s 2013 financial pledge to support global efforts to put the world over the finish line for polio eradication, with a focus on Pakistan, one of the last endemic countries.

Sustained commitment

The UAE has provided essential support to immunisation efforts in Pakistan over the last decade as part of a continuing collaboration with partners of the initiative. In 2011, Shaikh Mohammad Bin Zayed and Bill Gates, co-chair of the Bill and Melinda Gates Foundation, announced they were working together to provide life-saving vaccinations to children in Afghanistan and Pakistan.

The partnership committed a total of $100 million — $50 million from each partner — for the purchase and delivery of vital vaccines that protect Afghan and Pakistani children and prevent the disease for a lifetime.

In 2014 alone, over 13 million units of vaccine were administered to Pakistani children. In the period from January to May 2016, approximately 30 million additional units were delivered to the four provinces. The UAE-PAP polio campaign harnessed its teams, health care centres and mobile units to deliver vaccines to remote villages, refugee camps and border areas.

New opportunities for joint collaboration

Earlier this month Dr Michel Thieren, WHO Pakistan Representative, visited the United Arab Emirates embassy in Islamabad and met with Mr Abdullah Khalifa Al Ghafli, Director of the United Arab Emirates Pakistan Assistance Programme (UAE/PAP), to review existing projects and discuss future initiatives. Mr Abdullah expressed satisfaction with the meeting and agreed to explore new activities and events for joint collaboration with WHO to end polio in Pakistan.

The partnership would like to thank the UAE government for its continued support in fighting polio in Pakistan. It is only through maintaining and building on existing collaborations that we can continue to innovate in the face of remaining challenges in the path towards eradication, and protect vulnerable children across the globe.

At the 42nd G7 Summit presided by Japan on 26 – 27 May, G7 leaders reaffirmed their continued commitment to reaching polio eradication targets. Courtesy G7

The G7 Communique and Global Health

At the 42nd G7 Summit on 26-27 May 2016 in Ise-Shima, Japan, global leaders discussed the most pressing issues in the world today. As part of an ambitious global health agenda promoted by the Government of Japan, the Leaders discussed pandemic and public health emergency response, anti-microbial resistance, and universal health coverage.

Polio Eradication

G7 Leaders in Tokyo reaffirmed their continued commitment to polio eradication in the Ise-Shima leaders’ statement, emphasizing immunization as one of the key cost effective measures to prevent the spread of infectious diseases and to stop emerging pandemics.

As part of the Ise-Shima Vision for Global Health, the G7 leaders committed to continuing global efforts to achieve the targets of the Global Vaccine Action Plan and to achieving polio eradication targets and improving children’s health. They added: “We recognize the tremendous progress achieved towards polio eradication where global eradication is now within reach.” The Global Polio Eradication Initiative is reporting unprecedented progress with the last case of wild poliovirus in Africa in the summer 2014, significant advances in the last two endemic countries, Afghanistan and Pakistan, and renewed momentum following the Oral Polio Vaccine switch in 155 countries and territories in April 2016.

G7 Leaders emphasized the significant contribution that polio related assets, resources and infrastructure can have for strengthening health systems and advancing universal health coverage. This essential mark of recognition from the G7 is particularly timely as the countries are embarking on a major transition planning effort for the potential transfer of some of the most critical polio assets by 2019 so that the investments made in polio eradication can continue to positively impact health into the future.

Polio eradication was also included in the Accountability Report, reflecting G7 leaders historic financial commitments to the programme and referring to the urgency of raising the additional US$1.5 billion needed to see eradication efforts through to their end.

A long history of commitment from the G7 towards polio eradication

The G7 already expressed its commitment to polio eradication numerous times before. In 2002, then Prime Minister Jean Chrétien of Canada gathered his counterparts from the G8 in Kananaskis; the importance of accelerating the elimination and mitigation of polio in Africa by providing sufficient resources to eliminate polio was highlighted for the first time by the G8. The Leaders of France, the United States of America, the UK, The Russian Federation, Germany, Japan and Italy reiterated year after year the G8 commitment to ending polio. G7 countries and the European Commission have represented the most important public donor base for polio eradication since the beginning of the programme, representing 40% of total contributions historically. The G7 and the European Commission account for approximately one third of total contributions since 2013 and approximately half of public sector contributions. Their reiterated political and financial commitment will be critical to securing the additional US$1.5 billion needed to achieve eradication.

This is the second time that polio eradication is highlighted as part of the G7 leaders’ Statement under Japanese Presidency. In 2008, in Hokkaido Toyako, Japan, the G8 Leaders Statement referred to the need to “… maintain momentum towards the historical achievement of eradicating polio.”

Left to right: polio survivor and Rotary member Steve Crane; Ralph Munro, member of Polio Eradication Advocacy Task Force for U.S.; 2016 Polio Eradication Champion Rep. Dave Reichert; International PolioPlus Committee Chair Mike McGovern. Rotary © Rotary

In May, Rotary recognized five members of Congress for their support of the humanitarian service organization’s top priority to eradicate polio, a vaccine-preventable disease that still paralyzes children in parts of the world today.

The following lawmakers were presented with Rotary’s Polio Eradication Champion Award during an event at the Capitol Building in Washington, D.C. on May 11, 2016: Sen. Roy Blunt (MO.), Sen. Jeff Merkley (OR.), Sen. Brian Schatz (HI), Rep. Tom Cole (OK), and Rep. Dave Reichert (WA).

These five lawmakers serve as advocates for securing U.S. government funding for polio eradication activities through the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Agency for International Development (USAID). As key allies, they influence both their constituents at home and congressional colleagues to support a polio-free world.

As the world’s largest funder of polio eradication, the U.S. government has contributed more than $2.8 billion since the mid-1980s. To support the final push to end polio, Rotary and its partners are asking for $234 million in U.S. funding in 2017 through the CDC and USAID.

Rotary established the Polio Eradication Champion Award in 1995 to recognize heads of state, health agency leaders and others who have made a significant contribution to polio eradication.

Past recipients of the Rotary award include Angela Merkel, Chancellor of Germany; Prime Minister David Cameron of the United Kingdom, United Nations Secretary-General Ban Ki-moon, and 43 current members of the 114th Congress previously recognized by Rotary as Champions.

Last week, global political commitment to eradicating polio was affirmed at the World Health Assembly (WHA) in Geneva. During the polio agenda item, member states discussed progress made in the last year and the remaining hurdles that stand in the way of polio eradication.

In her opening address to the WHA, Dr Margaret Chan, Director General of WHO, said polio eradication has never been so close to the finish line. “During the short span of 2 weeks in April, 155 countries successfully switched from trivalent to bivalent oral polio vaccine, marking the largest coordinated vaccine withdrawal in history. I thank you and your country teams for this marvellous feat,” she said.

Member states reviewed the latest global epidemiology, noting the strong progress made across Africa with no case of wild poliovirus in approaching two years. Delegates from Afghanistan and Pakistan, the final remaining polio endemic countries, outlined the steps they are taking to ensure that transmission is interrupted as a matter of urgency. With fewer missed children than ever before and just 74 cases across the two in 2015, achieving eradication has never appeared to be such an achievable target.

Many member states spoke to reaffirm their commitments to fulfilling the objectives of the resolution passed at the last WHA to commit to ending polio once and for all. Michel Zaffran, Director of Polio Eradication at WHO, stated that strong progress had been made against all four objectives of the Polio Eradication and Endgame Strategic Plan.

Delegates also commended the historic achievement of the switch, warning that shortages of the inactivated polio vaccine and potential outbreaks of type 2 vaccine-derived polioviruses would be some of the major challenges of the coming year. They also expressed appreciation for the global contingency plans put in place to adequately manage the risks associated with the supply shortage, notably the availability of the stockpile of monovalent oral polio vaccine type 2.

Gavi, the Vaccine Alliance, supported the interjections of several member states highlighting the importance of ramping up transition planning in countries to prepare for the end of the polio infrastructure after eradication. “To be sustainable, the decision on which polio assets to sustain must be fully led and driven by countries themselves, based on national ownership, national plans and investments,” said the Gavi spokesperson.

Rotary international spoke to affirm that their 1.2 million volunteers worldwide remain fully committed to polio eradication. “We have three key challenges remaining,” said the Rotarian speaker. “First, we have to interrupt polio in Pakistan and Afghanistan. Second, we must avoid complacency. An additional US $1.5 billion is needed through 2019 to sustain high levels of immunity, repeatedly reaching more than 400,000,000 children in up to 60 countries and carrying out high quality surveillance to protect progress. Finally we must fully leverage the physical and intellectual assets of polio eradication so that they can benefit broader public health priorities.”

Dr Flavia Bustreo from WHO and Hon. Marie-Claude Bibeau, Canada’s Minister for International Development, at the Women Deliver conference in Copenhagen. © Pablo Berlanga — Dr Flavia Bustreo from WHO and Hon. Marie-Claude Bibeau, Canada’s Minister for International Development, at the Women Deliver conference in Copenhagen.
© Pablo Berlanga

The Government of Canada announced a Can$19.9 million contribution to Nigeria’s polio programme yesterday to help keep the country free from the debilitating virus, as part of its Can$ 250 million commitment to polio eradication for 2013-18. The announcement was made by Canada’s Minister for International Development, Hon. Marie-Claude Bibeau at the global Women Deliver conference in Copenhagen. This high-level event focused on the Sustainable Development Goals and developing solutions to the health, economic and social challenges facing girls and women around the world today.

Through WHO’s ‘Sustaining Polio Eradication Through Strengthened Routine Immunization project’, the additional funding will help to immunize more than 13 million children against polio in 11 high-risk Nigerian states, and train upwards of 150,000 vaccinators. It complements Canada’s polio eradication support for the Hard-to-Reach Project through UNICEF, an initiative to bring polio vaccines to the most vulnerable and remote communities alongside other health interventions such as routine vaccines, maternity care, deworming tablets and Vitamin A supplements.

“Polio will be eradicated in a few years,” said Minister Bibeau in a press statement. “Consider the powerful impact of such a statement. It can happen with a sustained effort aimed at immunizing every child. Our aim is to help reduce the burden of diseases affecting mothers and children, and eradicate polio from Nigeria for good.”

Citing the conference as an opportune time to make the announcement, WHO thanked the Government of Canada for its continuous support to polio eradication efforts in Nigeria and beyond.

“We are grateful for Canada’s leadership and significant support to polio eradication and its commitment to keep Nigeria polio free,” said Dr Flavia Bustreo, WHO Assistant Director General for Family, Women’s and Children’s Health. “Given the leadership role that women play in polio eradication worldwide, it is particularly meaningful that this announcement is made at Women Deliver,” she added. “As the caretakers in many families, women are well placed to convince families to accept vaccination. Thanks to the critical action of women as community mobilizers and vaccinators, the programme is reducing the number of chronically missed children by building community trust.”

Nigeria successfully removed itself from the list of polio endemic countries in 2015 with its last case in July 2014, a remarkable achievement for a country that for decades struggled to stamp out the virus. Although now polio-free, like many other countries, it remains at significant risk of poliovirus importation.

“Polio is still endemic in Afghanistan and Pakistan, and so long as transmission occurs in these countries, we are not out of the woods,” said Joseph Swan, Communications Officer for WHO’s polio hub based in Amman, Jordan, who attended the conference. “WHO and partners continue to work closely with governments of countries like Nigeria to enhance immunization coverage and improve surveillance systems to detect polio, should it reappear. We mustn’t be complacent. We must continue to innovate to reach every last child in the poorest and most underserved communities of the world. Because until polio transmission is stopped for good, no country is safe from outbreaks,” he said.

Women are increasingly empowered with new roles to serve their communities, which could have lasting changes on societies. A new strategy to employ local women to administer the vaccine and make regular house visits in some of the highest risk areas is being implemented in high-risk areas of Pakistan. Female teams are now covering nearly 40% of Karachi’s 2.2 million children younger than five, and the initiative will be scaled up.

The Women Deliver conference brought together more than 5000 participants, from policymakers to activists, youth leaders, and members of civil society and the corporate sector, as well as partners of the Global Polio Eradication Initiative.

The Canadian announcement comes weeks after its Can$40 million contribution to aid eradication efforts in Pakistan.

In addition to its yearly contribution of 25 000 Swiss francs to the Global Polio Eradication Initiative, Liechtenstein has further contributed 15 000 Swiss francs to polio eradication through Rotary International, one of the spearheading partners of the Global Polio Eradication Initiative. The country made the contribution working closely with Rotarians in Liechtenstein and Switzerland, for the organization’s ‘End Polio Now’ campaign. With the Bill & Melinda Gates Foundations’ pledge to triple commitments made to polio eradication, and previous support by the country for WHO’s polio eradication activities, this brings Liechtenstein’s contribution for 2016 to 70 000 Swiss francs. Liechtenstein’s 2016 commitment to polio eradication equates to a per-capita contribution of more than 2 Swiss francs for every inhabitant of the country.

Dr Aurelia Frick, Foreign Minister of Liechtenstein, commented: “We are part of the global community and we are committed to playing our part in the global effort to wipe this devastating disease from the face of the planet. Our world is interconnected, and we know that our children remain at risk of reinfection until the disease has been stopped, once and for all. We will continue to support polio eradication until we have reached our goal.”

The financial support will play a critical role in supporting the Global Polio Eradication Initiative, through the US Centers for Disease Control and Prevention and through the U.S. Agency for International Development. The funds will support ongoing efforts to stop wild poliovirus transmission in the remaining polio endemic countries, and help to reach more than 430 million children who remain at risk for contracting polio in a number of countries, primarily in Africa and Asia. 2015 saw significant progress in polio eradication with Nigeria and the entire continent of Africa passing a year without any new wild polio cases. World Health Organization removed Nigeria from the list of endemic countries. Only Pakistan and Afghanistan have confirmed cases of wild polio this year (66 as of December 18th) and we have seen a 79 percent reduction in cases from the same period of time last year.

“We’re delighted by the news of the US’s continued financial commitment to a polio free world at this critical time when we are so close to the finish line,” says Rotary Polio Eradication Advocacy Task Force for the United States Chair Jim Lacy. “Congress’ support of polio eradication is a fantastic example of bi-partisan collaboration on an issue of shared concern with concrete results. Members of Rotary clubs throughout the US and globally deeply appreciate the longstanding leadership of the US Government and are proud of the progress achieved through this public-private partnership.” [Read more]

On 30 November 2015, Rotary International honoured four current and former Irish Government officials for their contribution to the global fight against poliovirus.

Diarmuid McClean of the Irish Embassy in Mozambique encouraged Ireland’s early commitment to the Global Polio Eradication Initiative, while member of the Irish Parliament Joe Costello facilitated Ireland’s multi-year commitment of €5 million, announced at the 2013 Vaccines Summit in Abu Dhabi. Former member of the European Parliament Gay Mitchell was honoured for raising the profile of polio in the European parliament, and Member of the European Parliament Mairead McGuiness for gathering support for increased funding from the European Union.

With a commitment of more than US $27.2 million since 1988, the Government of Ireland has played a substantial part in reducing the burden of paralytic poliovirus, from over 350,000 cases a year in 1988 to 60 thus far in 2015.

Rotary International made polio eradication is main philanthropic goal in 1985. Since then, it has contributed more than US $1.5 billion, of which more than US $1 million has come from 2,000 members of the 72 Rotary clubs in Ireland.

With the world closer to eradicating polio that at any point in the past, it is more important now than ever that we maintain the momentum that has brought us this far. In this ‘low-season’ for virus transmission, support for eradication must be redoubled to ensure that every possible child is vaccinated against polio.

Ireland to provide €5 million in fight to eradicate Polio

Yemen launches on Saturday 15 August a national round of vaccination campaign against measles and polio, to protect children from these preventable diseases and ensure that Yemen remains polio-free. Despite the ongoing conflict in Yemen, the campaign is aiming to cover the entire country – more than 5 million under five years of age with polio vaccine and 1.4 million children under the age of 15. More than 40,000 health workers and volunteers are being mobilized for this effort, supported by the government and the Global Polio Eradication Initiative.

The conflict in Yemen has posed challenges to the polio eradication programme, including difficulties in distributing vaccines to health facilities, the closure of over 20% of health centres, and the inability of people to reach the centres that remain due to conflict. In spite of the political unrest in Yemen, 88% of children were reached with routine vaccines through health facilities and campaigns in 2014. A national measles, rubella and polio campaign was implemented in November 2014 reaching as many as 93% of children.

The campaign is made possible by contributors to the Horn of Africa polio outbreak, which has included operations in Yemen. The Global Polio Eradication Initiative receives financial support from governments of countries affected by polio; private sector foundations, donor governments, multilateral organizations, private individuals, humanitarian and nongovernmental organizations and corporate partners. Full list of all contributors.

National polio, measles and rubella campaign launched in Yemen [press release]

In recognition of his leadership and the support of the Japanese government toward ending the paralyzing disease polio, Rotary presented Prime Minister Shinzo Abe with its Polio Eradication Champion Award for outstanding commitment to ending polio on 28 May 2015.

“Prime Minister Shinzo Abe and the government of Japan have played a critical role in protecting children from polio, which just over two decades ago paralyzed 1,000 children each day,” said Rotary International President Gary C.K. Huang. “Yet wiping a disease from the face of the earth is not easy, and the final push is the most challenging. As long as polio exists anywhere, we run the risk of outbreaks everywhere. The continued support of Japan and other governments will remain vital as we strive to eradicate this disease.”

With a commitment of ¥ 55.3 billion (US$475 million) to polio eradication since 1988, Japan is the third largest government donor to the Global Polio Eradication Initiative. Japan has supported a number of innovative initiatives in the three countries where polio has never been stopped – Pakistan, Afghanistan and Nigeria – and other countries at high-risk for polio outbreaks. Under Prime Minister Abe’s leadership, the Japan International Cooperation Agency (JICA) approved a ¥ 8.285 billion loan to purchase oral polio vaccine (OPV) for polio immunization campaigns in Nigeria. Japan has also approved innovative funding through JICA which is supporting efforts to end the disease in Pakistan. Most recently, the government of Japan announced a contribution of ¥ 562 million (US$5.4 million) to support critical polio immunization activities in Pakistan.

Rotary established the Polio Eradication Champion Award in 1995 to honour heads of state, health agency leaders and others who have made significant contributions to the global eradication of polio. Prime Minister Abe is the third Japanese leader recognized with this award. Previously, Prime Minister Junichiro Koizumi received the Polio Eradication Champion Award in 2006. Since that time, Japan has contributed ¥ 18.8 billion (US$161.38 million) to the Global Polio Eradication Initiative. Prime Minister Ryutaro Hashimoto received the award in 2003.

In addition to donating to the global effort to end polio, Japanese Rotarians travel abroad at their own expense to immunize children against polio in endemic and high-risk countries.

Japan also played a key role in championing polio eradication during its 2008 G8 Presidency, which acknowledged considerable progress on polio eradication, and included a reference to the importance of meeting commitments to support the GPEI in its health approach. Japan will be convening the next G7 in 2016. More

The continued fight to eradicate polio gets an additional US$ 34.8 million boost from Rotary in support of immunization activities and research to be carried out by the Global Polio Eradication Initiative. The funds will be used by the World Health Organization (WHO) and UNICEF for polio immunization, surveillance and research activities in ten countries, as well as to provide technical assistance to additional countries in Africa.

In 2014, the world saw significant progress against polio in most places. Nigeria – the last polio-endemic country in Africa – saw a nearly 90% reduction in cases in 2014 over 2013, with the last case recorded six months ago. In addition, more than half of the world’s polio cases in 2013 were the result of outbreaks in previously polio-free countries, largely caused by instability and conflict in countries such as Syria, Iraq and Somalia. These outbreaks appear to have been stopped in 2014 following special vaccination efforts in 11 countries, reaching more than 56 million children.

The exception to this progress was Pakistan, which saw an explosive outbreak which resulted in more than 300 cases in 2014, the highest number in the country in more than a decade. As a result, Pakistan accounted for over 80% of the world’s cases in 2014. In 2015, Pakistan has the opportunity to reverse that trend and in doing so, help the world end polio forever.

The progress made against the disease in 2014, while significant, is fragile. Rotary’s funds will support efforts to end polio in the three countries where the disease has never been stopped: US$ 8.1 million in Nigeria; US$ 1.1 million in Pakistan and US$ 6.7 million in Afghanistan.

Additional funds will support efforts to keep other at-risk countries polio-free. The grants include US$ 1.6 million, Cameroon: US$ 2.5 million, Chad; US$ 3.3 million, Democratic Republic of the Congo; US$ 1.1 million, Ethiopia; US$ 250 000, Kenya; US$ 2.8 million, Niger; and US$ 7 million, Somalia. In addition, grants totalling US$ 321 000 will provide technical assistance in Africa.

“We are encouraged to see the tangible progress made against this disease in 2014,” said Mike McGovern, chair of Rotary’s International PolioPlus Committee. “However, until we eliminate polio from its final reservoirs, children everywhere are at risk from this disease. Rotary – along with our partners – will work hard to ensure the world’s most vulnerable children are kept safe from polio.”

Rotary launched its polio immunization program PolioPlus in 1985 and in 1988 became a spearheading partner in the Global Polio Eradication Initiative with the WHO, UNICEF, and the U.S. Centers for Disease Control and Prevention. Since the initiative launched in 1988, the incidence of polio has plummeted by more than 99 percent, from about 350 000 cases a year to 350 confirmed to date in 2014.

Rotary’s roles within the initiative are fundraising, advocacy, and social mobilization. To date, Rotary has contributed more than US$ 1.3 billion and countless volunteer hours to fight polio. Through 2018, every new dollar Rotary commits to polio eradication will be matched two-to-one by the Bill & Melinda Gates Foundation up to US$ 35 million a year.

Monaco’s contribution comes at a critical moment because Niger remains at particular risk for polio and has been repeatedly re-infected by virus imported from neighbouring northern Nigeria. The wild poliovirus type 1 case with onset 15 November 2012 was linked to Nigeria as well as the 11 July 2013 case due to circulating vaccine-derived poliovirus type 2 (cVDPV2) which was related to cVDPV2 cases detected in 2013 in Cameroon, Chad and Nigeria.
The Government of Niger implemented a comprehensive response in line with international outbreak response guidelines issued by the World Health Assembly (WHA) in Resolution WHA59.1. Following an initial supplementary immunization activity (SIA) on 15 January 2013, 4 nationwide and 3 subnational SIAs were conducted and, a joint national and international team of epidemiologists and public health experts were deployed by the World Health Organization ‘s Regional Office for Africa to assist the Government of Niger in the investigations, help plan response activities and support active searches for additional cases of paralytic polio.

Thanks to strong routine immunization (estimated at 95%), strong disease surveillance which rapidly detects new importations and strong outbreak response activities, poliovirus has so far not managed to re-establish a foothold following re-infection. Thanks to this, Niger is not only protecting its own children, but is in fact acting as an immunity ‘firewall’, minimizing the risk of further onward spread of poliovirus to other areas of West Africa.

On the left, WHO Assistant Director-General Bruce Aylward exchanges the memorandum with Mr Ibrahim Al Sugair, Chief Economist; The Saudi Fund for Development WHO/K. Alves

Geneva – The World Health Organization (WHO) and the Saudi Fund for Development signed a memorandum of understanding last week allowing for the transfer of the final installment of the Fund’s US$ 30 million commitment to ending polio.

Thanks to this agreement, a further US$ 7.5 million will flow from the Saudi Fund for Development to the WHO for the cost of polio eradication operations in the Horn of Africa and Afghanistan. UNICEF has already received US$ 17.5 million for the purchase of oral polio vaccine (OPV) and WHO a previous installment of US$ 5 million.

WHO Assistant Director-General for Polio, Emergencies and Country Collaboration, Dr. Bruce Aylward welcomed the contribution: “Saudi Arabia is an important partner in polio eradication and a leader in their region. Their support will play a critical role in putting a stop to the virus in the Horn of Africa and Afghanistan.”

The Saudi Fund’s contribution comes at a critical moment. Polio virus continues to threaten children in the Horn of Africa region due to an ongoing outbreak centred in Somalia. These funds will help the Global Polio Eradication Initiative to carry out mass vaccination campaigns, increase immunity levels in the affected countries, stop the outbreak and protect other countries in the region from becoming infected with the virus. Additionally, support for the Afghanistan program will help to ensure that the progress made in 2013 continues. Afghanistan is seeing a 60% reduction in polio cases compared to this time last year and has seen no cases in its endemic southern region for a year.

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