EFTA01144759.pdf

BILL&MELINDA GATES foundation EXECUTIVE BRIEFING FOR HRH ALAWALEED BIN TALAL AL SAUD Polio, a highly infectious disease that can cause lifelong paralysis and even death, is on the threshold of eradication. The more than 99-percent decline in polio cases since 1988—and the drop from 125 endemic countries to only three today—is a testament to the power of vaccines. POLIO-A HISTORICAL PERSPECTIVE The development of vaccines that now effectively protect against polio was a major medical breakthrough of the 20th century. Decades of unrelenting effort have reduced infection rates to an all-time low, creating an unprecedented opportunity to eradicate this tragic disease once and for all. 1970s National 1997 2012 19SS immunization 1994 134 million India is declared Jonas Salk's programs launched All countries Indian polio-free; the injected leading to control of in the Western children are number of polio- polio polio in many Hemisphere immunized endemic vaccine developing are certified on a single countries drops introduced countries polio-free day to three 1961 1979 1996 2000 Albert Small pox The number of A record 500 Sabin's oral becomes the nations declared million children polio first human polio-free receive oral polio vaccine disease to increases to ISO. vaccine this year licensed ever be Reported - the Western eradicated incidence of polio Pacific, spanning is 85 percent less from Australia to than in 1988. China, is declared polio-free MAJOR SUCCESSES IN THE GLOBAL FIGHT TO ERADICATE POLIO • The number of polio cases dropped by 99 percent between 1988 to 2000—from 350,000 annual cases to less than 250 in 2012. • India, long-regarded as the most difficult place to end polio, was declared polio-free in 2012. To ensure that gains are sustained, more than 2 million vaccinators continue to work to protect all of India's 172 million children. • There are now just three countries that have never eliminated polio: Afghanistan, Pakistan, and Nigeria. • The total number of global polio cases plunged from 650 in 2011 to 218 in 2012. • Angola, which battled re-infection for seven years, is once again polio-free and the Democratic Republic of Congo also recently re-established its polio-free status. • New tools and digital advances, coupled with the support of community health workers, have helped to improve vaccine coverage in high-risk areas. As a result, thousands of previously unreached children are now protected from polio. • Today, we have the fewest number of cases in the fewest countries ever. CURRENT STATUS OF POLIO IN THE WORLD As long as polio continues to circulate anywhere, it threatens children everywhere. India's success is a proof of concept—with adequate financial resources and the right partners, we can eliminate polio from the remaining three endemic countries. EFTA01144759 Afghanistan—"Emergency" status with high-level commitment • Major outbreak in 2011 highlighted significant gaps in supplementary immunization activities (SIAs) and continuing security challenges. • In September 2012, President Karzai restated his personal commitment and leadership to enhance eradication efforts; immunization days are scheduled for 10-12 February in 14 provinces. • Afghanistan reduced the number of polio cases by half from 2011 to 2012 and no cases have been reported in 2013. Pakistan—Unprecedented political commitment • Improvements in Pakistan's polio program resulted in two-thirds fewer cases in 2012 as compared to 2011. • Almost three-quarters of all cases occur in tribal regions and accessibility remains an ongoing challenge. • Pakistan has successfully engaged political representatives at the highest levels of government to work on polio. Nigeria—Doubling down to reach more children • There were 121 cases of wild poliovirus in Nigeria in 2012, more than double the 58 cases in 2011 • Continuing transmission in Nigeria poses an ongoing risk for reintroduction and outbreaks in polio-free countries and is a major obstacle to achieving global eradication. • Northern states are the main source of polio infections elsewhere in Nigeria and in neighboring countries. • Using innovative mapping technologies, teams are working hard to add communities to the immunization campaigns, ensuring children are not left unprotected from polio. • Additional developments include an increase in field staff and the deployment of female volunteers to engage mothers about vaccine safety. _[ I 1_ FL INI I L H I I I r I i .S i _I I • In December and January, militants targeted and killed a number of health workers in Pakistan, temporarily suspending vaccination campaigns. Catch-up vaccination activities are being conducted to immunize the 1.4 million children who remain unvaccinated as a result of the attacks. Partners, including the government, are committed to continuing the program and increasing efforts to improve the safety of workers. • Egypt has not had a case of polio since 2004 but polio was recently found in the capital's sewage, which is believed to have come into the country from Pakistan. A vaccination drive is being planned for late February and health workers are currently canvassing the neighborhoods where the sewage samples were taken, looking for children or adults who may have recently contracted the disease. KEY PLAYERS WORKING TOWARD POLIO ERADICATION The Global Polio Eradication Initiative (GPEI) is a public-private partnership led by national governments and spearheaded by the World Health Organization (WHO), Rotary International, the U.S. Centers for Disease Control and Prevention (CDC), and the United Nations Children's Fund (UNICEF). WHO—UN directing and coordinating authority for health • Responsible for collection and dissemination of information on strategy implementation and impact • Leads operational and basic research • Provides support to ministries of health • Coordinates human resources for supplementary technical assistance 2 EFTA01144760 • Serves as secretariat to certification process • Facilitates implementation and monitoring of bio containment activities CDC-U.S. National Health Institute • Deploys scientists and health experts to GPEI partners • Provides funding for vaccines, lab, and technical support Rotary International-World's largest humanitarian service organization • Leading private-sector donor to polio eradication • Advocates to governments and communities • Provides field-level support in supplementary immunization activities (SIA), implementation, and social mobilization UNICEF—UN program providing humanitarian assistance to children and families in developing countries • Lead partner in communications, social mobilization, and procurement and distribution of oral polio vaccine (OPV) for SIA • Works with partners to strengthen routine immunization, including support for vaccine supply and distribution mechanisms at national and sub-national levels The Independent Monitoring Board (IMB) assesses progress of the GPEI toward the attainment of a polio-free world • Independently monitors and guides the progress of the GPEI strategic plan and milestones • Comprised of global experts from a variety of fields relevant to the work of the GPEI • Provides assessment of the risks from existing funding gaps • If the IMB finds that any of the milestones or process indicators are at risk or missed, the relevant national authorities and/or implementing/donor partners are engaged to establish emergency corrective action plans • Assesses the quality, implementation, and impact of corrective plans at subsequent meetings • Reports from the board meetings go directly to the heads of the spearheading partner agencies—WHO, Rotary International, CDC, and UNICEF—and the Bill & Melinda Gates Foundation, and are made public shortly thereafter THE BILL & MELINDA GATES FOUNDATION'S ROLE IN POLIO ERADICATION As the foundation's number one priority, the polio program benefits from direct oversight by co- chair, Bill Gates. The polio team briefs him monthly on all activities that fall under the foundation's role as supporter, ambassador, and advocate for the polio eradication program. Advocate Advocate with governments in polio-endemic countries to maintain program mornentumand sustain commitment to eradication Definition Offer innovative financing options that will give Example Pakistan the resources needed to reach elimination 3 EFTA01144761