Global Polio Eradication Initiative Monthly Situation Report - December 2010All data as of 14 December 2010 For latest news and polio case data by country, updated every week: http://www.polioeradication.org FACTS & FIGURES ? There have been 874 cases globally this year (794 type 1 and 80 type 3), compared with 1,503 cases at this time last year (464 type 1 and 1,039 type 3). ? 20 countries have reported cases in 2010, compared with 23 at this time last year. ?[/center] HEADLINES Economic benefits of GPEI estimated at US$40-50 billion: A new study released in November in the medical journal Vaccine estimates that the Global Polio Eradication Initiative (GPEI) could provide net benefits of at least US$40-50 billion through 2035. More than eight million cases of polio in children will have been prevented, and significant additional humanitarian and economic benefits reaped through 'add on' health interventions (such as Vitamin A). New Independent Monitoring Board convenes inaugural meeting: The newly-established Independent Monitoring Board (IMB) convened in Geneva, Switzerland, on 21-22 December 2010, to assess progress towards the attainment of a polio-free world. The IMB was established at the request of the Executive Board (EB) and the World Health Assembly (WHA) to independently evaluate progress against each of the major milestones of the new GPEI Strategic Plan 2010-2012. The IMB, comprised of global experts from a variety of fields relevant to the work of the GPEI, evaluates whether global milestones and country-specific indicators are 'on track', 'at risk' or 'missed', and provides assessments of the risks posed by existing funding gaps. The report from the group's inaugural meeting is expected to be made available mid-January 2011. 2011-12 Financial Resource Requirements updated: Against a two-year US$1.86 billion budget, the GPEI faces a US$ 720 million funding gap to fully implement activities to achieve GPEI Strategic Plan milestones. The most significant geographic gaps are in Africa. The full financial situation will be published in a revised Financial Resource Requirements (FRR) by mid-January 2011. More.??India and Nigeria report historic lows of polio transmission: With the high season for polio transmission nearly completed, both countries continue to report historic low levels of poliovirus transmission, particularly in key reservoir areas. This presents both national and international opportunities, given that both countries continued to export virus internationally in 2010. In both countries, aggressive mop-up strategies are now being implemented to tackle any residual transmission, and technical staff from polio-free areas of both countries is deployed to support the mop-ups to maximise the impact of operations.?? UNICEF Executive Director Tony Lake in India: On 8 December, UNICEF Executive Director Tony Lake participated in polio immunization activities in Bihar, and discussed additional steps to eradicating polio in the country with key partners and representatives of the Government of India.? Key expert groups convene to evaluate new research projects: The Polio Research Committee (PRC), which helps guide the GPEI's research agenda, convened in Delhi, India, on 15 December to discuss new studies to improve supplementary immunization activity (SIA) operations. At the same time, also in Delhi, a special meeting on mucosal immunity reviewed the current science and future research needs to better understand the role mucosal immunity plays in polio transmission and immunization.?? Enhanced action urgently needed to address emerging risks to polio eradication: Urgent action is needed in three countries with uncontrolled polio transmission, namely Pakistan (the only endemic country with an increase in cases in 2010), and the Democratic Republic of Congo (DR Congo) and Angola. Virus associated with outbreaks in these areas has spread internationally this year, including to cause a large-scale explosive outbreak in the Republic of Congo. All three countries are currently finalizing emergency action plans for 2011 to rapidly control the situation. ENDEMIC COUNTRIES AFGHANISTAN ? 23 cases in 2010 (15 WPV1, 8 WPV3). 31 cases at this time in 2009 (15 WPV1, 16 WPV3). ? In the past six months, no WPV3 has been recorded in Afghanistan, and only four districts in the country have recorded WPV1 cases. Despite intense transmission in neighbouring Pakistan, the border regions of Afghanistan have remained polio-free. ? Reports from recent immunization campaigns indicate improved access to children in traditionally security-compromised high-risk districts of Southern Region. ? A high-level meting on polio to develop action plans for 2011 will be convened in the new year. INDIA ?41 cases in 2010 (17 WPV1, 24 WPV3). 672 cases at this time in 2009 (77 WPV1, 594 WPV3). ? An aggressive mop-up strategy continues to be implemented in India, in response to residual polio transmission in the country. ? Special strategies are also focusing on reaching mobile population groups. ? A surveillance review was conducted in east/central Uttar Pradesh, and a communications review in Uttar Pradesh, Bihar and West Bengal. In both cases, the reviews determined that the programmes were robust and working at high capacity. Recommendations to further sensitize the approaches were nevertheless put forward. ? Mr Chandramouli has been appointed as new Secretary of Health, Government of India. He took office on 1 December. NIGERIA ?13 cases in 2010 (6 WPV1, 7 WPV3). 388 cases at this time in 2009 (75 WPV1, 313 WPV3). ? The Government of Nigeria recently released a further US$2.4 million towards its polio eradication efforts, further testimony of the strong commitment by the government towards achieving a polio-free Nigeria. ? New cases will now be responded to with an aggressive mop-up strategy. To this effect, the Executive Director of the National Primary Healthcare Development Agency (NPHCDA) has inaugurated a Mop-up Task Team. ? The Chairmen of high-risk Local Government Areas (LGAs) have issued a joint statement, committing to providing active leadership to polio eradication, allocating adequate human and financial resources to activities, and reporting to their respective state governors. ? Despite the strong achievements over the past 12 months, key high-risk areas across northern Nigeria persist, with under-immunized population groups. Of particular concern are Borno and Zamfara states. ? New operational approaches continue to be investigated in Nigeria, to further improve campaign performance. During a pilot project in November, vaccination teams were equipped with Geographic Information Systems (GIS) devices, which tracked the teams' movements during the day, in relation to pre-prepared microplans. Analysis of the real-time data allowed for the immediate identification of any missed areas, which were subsequently re-visited by the teams. More. PAKISTAN ? 134 cases in 2010 (24 WPV1, 110 WPV3). 84 cases at this time last year (58 WPV1, 25 WPV3). ? Pakistan is the only endemic country to report more cases this year, compared to 2009. ? The country is affected by a large-scale outbreak, which is geographically widespread, with most of the virus having spread from Khyber Pakhtunkhwa (formerly known as North West Frontier Province), to re-infect other areas of the country. ? At the President's request, an Emergency Action Plan for 2011 has now been finalized by the Ministry of Health, with support from the partner agencies. As part of the plan, new measures will be implemented to urgently sensitive independent monitoring of immunization activities and increase political accountability at national, federal and district-levels. RE-ESTABLISHED TRANSMISSION COUNTRIES ANGOLA ?30 WPV1 cases in 2010. 29 WPV1 cases at this time last year. ? 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). ? An emergency action plan is now being finalized with the Ministry of Health, including to feature new approaches to urgently improve the quality of outbreak response operations. ? New tactics could include rolling immunizations in the 33 highest-risk municipios (districts), to allow a concentration of technical staff to deliver improvements in campaign quality. A similar approach was implemented with positive results earlier this year in Chad. CHAD ? 18 WPV3 cases and 4 WPV1 cases in 2010. 57 WPV3 cases at this time last year. ? Four WPV1 cases were reported in the past month (from the greater N'Djamena area). These recent cases mean that Chad is now affected by an outbreak of both WPV1 and WPV3. ? The country's Technical Advisory Group (TAG) convened on 29-30 November, to review progress and finalize an immunization plan for 2011. ? Chad conducted two rounds of immunization campaigns in November and December, using bivalent OPV, to boost population immunity against both type 1 and 3 serotypes. DEMOCRATIC REPUBLIC OF THE CONGO (DRC) ? 75 WPV1 cases in 2010, 3 WPV3 cases at this time last year. ? 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). ? Emergency plans are being drawn up to urgently fill both SIA quality and surveillance gaps. ? IMPORTATION COUNTRIES REPUBLIC OF CONGO ?24 cases of WPV1 reported in 2010, and at least 476 AFP cases pending classification. At least 179 deaths have been associated with this explosive outbreak. ? Outbreak response is continuing in the Republic of Congo. The vast majority of AFP cases have occurred in the port city of Pointe Noire. Unusually, most cases are occurring in young adults, particularly in 15-25 year-old men. ? Given the explosive, deadly nature of this outbreak and the high risk of further national and international spread, emergency outbreak response activities are also being carried out in high-risk districts of Angola and DR Congo. ? Full coverage data from the first two National Immunization Days (NIDs) from November and December are still being analysed, though early indications are that they were of generally good quality, with approximately 75% of the target population reached. ? Of note, lessons from the first NID was already integrated into improving tactical implementation of the second round, particularly with strengthening fixed-vaccination post approaches, to facilitate vaccination of an adult population (which might not be reachable at home during the day, during the visit of house-to-house vaccination teams). ? Given the severity of the outbreak, the Government of the Republic of Congo has established a 'National Crisis Committee' to urgently address the outbreak. It is throwing all available resources at addressing the outbreak as rapidly as possible, as are WHO, UNICEF and Rotary International. ? WHO, Rotary International and UNICEF have launched an urgent US$22 million funding appeal for emergency outbreak response activities. More. HORN OF AFRICA ? 2 cases in 2010. 71 WPV1 cases at this time last year. ? Outbreak response is continuing in both Uganda and Kenya. ? The two cases reported from Uganda are linked to the WPV1 outbreak which occurred in northern Kenya from February to July 2009. ? Efforts are also ongoing to strengthen surveillance on both sides of the border. CENTRAL ASIA AND RUSSIA Tajikstan: 458 WPV1 cases in 2010.? Turkmenistan: 3 WPV1 cases in 2010. ?Russia: 14 WPV1 cases in 2010.? Kazakhstan: 1 WPV1 case in 2010. ? The large outbreak of WPV1 in Tajikistan this year has slowed dramatically, but not before poliovirus from Tajikistan spread to infect Turkmenistan, Russia and Kazakhstan. The most recent case in Tajikistan had onset of paralysis on 4 July. ? Comprehensive outbreak response is continuing in all four countries, to stop residual transmission of the outbreak. NEPAL ?6 WPV1 cases in 2010. ? Mop-ups are continuing in highest-risk border districts with India. All cases this year are from the Central Development Region (CDR), in Rautahat and Mahottari districts, bordering Bihar, India. WEST AFRICA ? 32 cases in 2010 (all WPV1 except 2 WPV3 cases in Niger and 1 WPV3 case in Mali): Senegal 18, Mauritania 5, Mali 4, Niger 2, Liberia 2, Sierra Leone 1. 133 cases in 11 countries at this time last year. ? Outbreak response is continuing in key high-risk areas of west Africa, to rapidly interrupt any remaining residual virus transmission. ? Detection of a new case in Liberia from September, related to transmission earlier this year, underscores the ongoing danger of residual transmission, and the need to continue to maintain high population immunity and strong disease surveillance. ? At the same time, a new importation of a WPV3 into Mali (from September) is still being investigated to determine its origin, though it is likely to be related to WPV3 from Niger.
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