Update on the Polio Eradication Initiative in the Africa

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• Update on the Polio Eradication Initiative in the
  Africa
• Region
• 11th TFI MEETING
• Luanda, Angola
• 1st Dec 2003

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Outline of Presentation

• PEI Progress
• Challenges
• 2004 Priorities
• Issues for TFI consideration

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Progress of Polio Eradication in the Africa Region
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Interrupting WPV transmission
2000
2003
36 countries have been Polio-free for gt 2 yrs
5
Acute Flaccid Paralysis Surveillance
2003
2002
Significant Improvement in South East Block
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Optimizing Impact of PEI

• Integrating disease control interventions
• Vit A during OPV campaigns
• Antihelminthics during OPV campaigns
• AFP Surveillance extended to
• implement NNT, Measles and/or YF case based
  surveillance in 26 countries in AFRO
• support IMCI-Malaria monitoring
• support collection of monthly district
  vaccination coverage data

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Challenges
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WPV transmission in AFRO, 2003
Data as of 26th Nov 2003
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2003 WPV 1 Clusters, WEAF-B Genotype
Cluster I-3 in Nigeria, Niger Ghana, Togo
BFA Cluster I-1 in Nigeria Chad
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Failure to close Immunity Gap
Vaccination Status of Confirmed WPV Cases
2003
2002
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Quality of SIAs

• SIA quality in endemic, high risk and countries
  with importations in 2003 has been compromised by
• delayed initiation of micro-planning
• late release of operational funds
• increasing resistance and/or non-compliance due
  to rumours about OPV safety

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Persistent PEI funding Gap

• Resulted in scaling down of eradication
  activities
• No of countries conducting SIAs been reduced
• Increased risk of importations
• Reduced funding available for surveillance
• Has affected Polio funded staff
• Shorter contracts (6 instead of 11 months),
  longer contract breaks led to staff demotivation

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AFRO PEI Priorities in 2004
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Interruption of WPV transmission

• Proposed 2004 SIA
• 4 rounds of NIDS in Nigeria/Niger
• 2 additional rounds of SNIDS in endemic states in
  Nigeria/Niger
• At least 2 rounds of NIDS in 4-5 West Africa
  countries (Benin, Togo, Ghana, B.Faso, CIV)
• At least 2 round SNIDS in 2 Central Africa (Chad,
  Cameroon)

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Interruption of WPV transmission (2)

• Emphasis on SIA quality
• Continue to support national ownership
• Advocacy effective communication strategies to
  promote commitment by all leaders participation
  of communities, parents
• Provide additional techical support.
• Timely provision of required financial and
  material resources by PEI partners including
  Govts

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Interruption of WPV transmission (3)

• Improve routine OPV3 in highest risk districts
• Use monthly routine district coverage data
  collected by surveillance officers to guide
  micro-planing for improving routine EPI
• Link implementation of R.E.D to districts at
  highest risk for polio

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Prompt identification and response to importations

• Ensure highest AFP surveillance quality
• Sustain human financial support
• Document and disseminate best practices from
  ongoing surveillance reviews
• Timely investigation of suspected hot cases
  (including clusters of compatibles)
• Timely release of resources for response

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Achieve Regional Certification

• Sustain AFP surveillance performance
• Support to Regional Polio laboratory Network
• Support ongoing efforts of the NCCs, NPEC and
  containment NTF

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Conclusions

• The progress in P.E.I. in the Africa Region
  achieved between 1996-2002 has largely been
  sustained.
• Interruption of persistent WPV transmission in
  Nigeria remains the most crucial step to
  attainment of Polio-free Africa.

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Issues for TFI

• Is the proposed SIA Plan adequate to interrupt
  WPV transmission in the Africa Region by 2004?
• Are the proposed AFP surveillance activities
  appropriate adequate to enable timely detection
  of outbreaks (including importations) and sustain
  quality of AFP required for regional
  certification?

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Acknowledgements

• We acknowledge with sincere gratitude continuous
  support to Polio Eradication in Africa,
  particularly from
• National Authorities in WHO/AFRO countries
• Partner and Donor Agencies
• Communities and parents.