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Global Polio Eradication Initiative

Global Polio Eradication Initiative (GPEI)
Polio vaccination in India
A morning briefing on how to vaccinate children in Pakistan
Polio vaccine in the DRC
Polio Vaccination - Egypt
12-year-old child affected by polio
Checking for Polio Vaccination Marks - Pakistan
text: GPEI, from top left to right: polio vaccination in India (2002), a morning briefing on how to vaccinate children in Pakistan, polio vaccine in the DRC, polio vaccination in Egypt, polio sequelle, checking for polio vaccination marks in Pakistan, bear in mind the live OPV vaccine taken orally confers protection to unvaccinated but may in rare cases cause vaccine-derived polio if populations are not sufficiently immunized.
CountryWorldwide
Launched1988
WebsiteOfficial website

The Global Polio Eradication Initiative is an initiative created in 1988, just after the World Health Assembly resolved to eradicate the disease poliomyelitis.[1] Led by the World Health Organization, it is the largest international public health initiative in history.[2]

History

In 1987 Rotary International began a campaign to raise U.S. $100 million by its 100th anniversary, for the purpose of dealing with global polio.[3] The following year, the World Health Assembly voted for the Global Polio Eradication Initiative. At the time, there were 125 countries with endemic polio.[4] Efforts were built upon those used to control wild poliovirus in the Americas in the early 1980s, and on lessons from smallpox eradication.[1] Its first coordinator was Nick Ward.[5]

Strategy and structure

The strategy for the eradication of polio rests on immunising every at-risk child until there is no one left for the disease to transmit to, and the disease eventually dies out.

The initiative is spearheaded by the following organisations in the form of multistakeholder governance:

  • WHO (World Health Organization), who are responsible for planning, technical direction, surveillance and eradication certification
  • Rotary International, whose responsibilities include fundraising, advocacy, and volunteer recruitment
  • The CDC, who are in charge of deploying scientists and public health experts to WHO and UNICEF
  • UNICEF is in charge of the distribution of the vaccine and helping countries develop communication and awareness strategies.
  • The Gates Foundation provided a large portion of the funding.[6]

Key tactics used by the GPEI include strengthening childhood immunisation through oral vaccines, conducting surveillance through investigation of acute flaccid paralysis cases among children under 15 years old (in order to determine areas where the virus is truly eradicated), and conducting "mop up" campaigns in areas where cases of polio have been identified.[7]

Funding

At the peak of its work, the programme directly employed 4000 people across 75 countries and managed a budget of nearly U.S. $1 billion.[8]

As of 2021, the GPEI had raised 18 billion dollars in funding,[9] with annual contributions around 800 million to 1 billion dollars. Around 30% of the funding came from the Gates Foundation 30% from developed governments, 27% from countries at risk of polio, and the rest was made up of donations from nonprofits, private funders, and other foundations.[10]

The EIB funded €500 million to the Global Polio Eradication Initiative in 2023. This is part of a new initiative along with the European Commission, the European Investment Bank and the Bill & Melinda Gates Foundation, meant to cover polio immunisations for around 370 million children yearly, provide measles vaccines, and build health systems to adapt to other health risks.[11][12]

Evaluation

Main article: Global Certification Commission

In 1995 the Global Certification Commission was created to oversee the certification of the eradication of wild-type poliovirus transmissions. Certification for the six WHO regions requires all of the countries in that region to be certified by the commission. By 2000, both the regions of the Western Pacific and the Americas met the criteria to be certified free of polio transmissions.[13] By 2012 the initial number of estimated cases in 1988 of 350,000 across 125 endemic countries had dropped to 650 confirmed cases. As of 2020, five of the six WHO regions are now certified polio-eradicated (Europe, the Americas, Africa, South-East Asian, and Western Pacific Region). India was certified polio-free in 2014,[14] and Africa was declared polio free in 2020.[15] The only countries with endemic polio were Afghanistan and Pakistan as of 2021.[16]

See also

References

  1. ^ a b Aylward, Bruce; Tangermann, Rudolf (December 30, 2011). "The global polio eradication initiative: Lessons learned and prospects for success". Vaccine. Smallpox Eradication after 30 Years: Lessons, Legacies and Innovations. 29: D80 – D85. doi:10.1016/j.vaccine.2011.10.005. ISSN 0264-410X. PMID 22486981.
  2. ^ Duintjer Tebbens, Radboud J.; et al. (December 16, 2010). "Economic analysis of the global polio eradication initiative". Vaccine. 29 (2): 334–343. doi:10.1016/j.vaccine.2010.10.026. ISSN 0264-410X. PMID 21029809.
  3. ^ Brookes, Tim (2007). The End of Polio?: Behind the Scenes of the Campaign to Vaccinate Every Child on the Planet. American Public Health Association. p. 74. ISBN 978-0-87553-186-1.
  4. ^ Hall, Robert G. (2011). "5. Political and social determinants of disease eradication". In Cochi, Stephen L.; Dowdle, Walter R. (eds.). Disease Eradication in the 21st Century: Implications for Global Health. Cambridge: The MIT Press. pp. 49–50. ISBN 978-0-262-01673-5.
  5. ^ "Certification of Poliomyelitis Eradication" Archived October 8, 2020, at the Wayback Machine. Fifteenth meeting of the European Regional Certification Commission Copenhagen, 19–21 June 2002, p. 25
  6. ^ "Unicef's Engagement in the Global Polio Eradication Initiative" (PDF). Unicef.org. Archived from the original (PDF) on August 11, 2016. Retrieved June 21, 2016.
  7. ^ Wassilak/Orenstein, Steven/Walter (2010). "Challenges faced by the global polio eradication initiative". Expert Review of Vaccines. 9 (5): 447–449. doi:10.1586/erv.10.45. PMID 20450316. S2CID 37377866.
  8. ^ Aylward, Bruce (2011). "2. Lessons from the late stages of the global polio eradication initiative". In Cochi, Stephen L.; Dowdle, Walter R. (eds.). Disease Eradication in the 21st Century: Implications for Global Health. Cambridge: The MIT Press. pp. 13–24. ISBN 978-0-262-01673-5.
  9. ^ "GPEI-Historical Contributions, 1988-2020".
  10. ^ "Vaccination funding landscape". Givewell.org. Retrieved June 20, 2016.
  11. ^ Bank, European Investment (June 13, 2024). EIB Global Impact Report 2023/2024. European Investment Bank. ISBN 978-92-861-5769-1.
  12. ^ "New funding, to protect 370 million children from polio every year, puts world on verge of eradicating polio once and for all". European Investment Bank. Retrieved June 27, 2024.
  13. ^ Technical Consultative Group to the World Health Organization on the Global Eradication of Poliomyelitis (2002). ""Endgame" Issues for the Global Polio Eradication Initiative". Clinical Infectious Diseases. 34 (1): 72–77. doi:10.1086/338262. PMID 11731948.
  14. ^ "Marking five years of polio-free certification, WHO South-East Asia Region uses polio legacy to enhance overall immunization".
  15. ^ "Africa eradicates wild poliovirus". October 10, 2023.
  16. ^ "Data Monitoring". Global Polio Eradication Initiative. Retrieved June 20, 2016.
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