SEATTLE — The Global Polio Eradication Initiative (GPEI) is known as history’s largest coordinated mobilization initiative in the realm of global health. Since 1988, GPEI has made tremendous strides and has reduced the number of new polio cases by 99.9 percent; however, it has yet to reduce the case count to zero.
What Is the Global Polio Eradication Initiative?
The GPEI is a public-private partnership that is led by national governments and supported by five major international institutions:
- World Health Organization
- Rotary International
- U.S. Centers for Disease Control and Prevention
- The Bill & Melinda Gates Foundation
This coalition is able to unite healthcare workers, national governments and global leaders in achieving a world where children are forever safe from the threat of contracting polio.
Polio is a crippling and potentially fatal infectious disease that is caused by a human enterovirus called poliovirus, which enters through the mouth and multiplies in the intestine. Poliovirus is spread through fecal-oral contact and newly infected individuals shed the poliovirus into their environments for several weeks.
There are three major types of wild poliovirus. Type 2 poliovirus was declared eradicated in September 2015 and type 3 poliovirus has not been detected anywhere in the world since November 2012.
If the infection does not reach the central nervous system, it causes a minor illness with mild symptoms.
If the infection reacher the central nervous system, it may cause severe paralysis. However, less than 1 percent of poliovirus infections result in paralysis. There is no cure for polio, but there are safe and effective vaccines.
Diminishing the Polio-Endemic Map
Today, polio exists in the smallest geographic area in history. In 1988, there were 350,000 annual cases of wild poliovirus in 125 countries. In 2017, there were only 22 wild poliovirus cases reported in two countries: Pakistan and Afghanistan. Nigeria has not reported a new case of polio since 2016.
GPEI had created a comprehensive, long-term strategy to ensure a polio-free world by the end of 2018. The Polio Eradication & Endgame Strategic Plan has four objectives:
- To detect and interrupt all poliovirus transmission
- To strengthen primary immunization systems and withdraw the use of oral polio vaccines
- To contain the poliovirus in a small number of facilities in the post-eradication era, which will further certify global polio eradication
- To plan polio’s legacy and ensure the transfer of lessons learned to other relevant eradication initiatives
GPEI’s Most Challenging Region: Pakistan and Afghanistan
Pakistan has reduced its polio cases by more than 97 percent and has expanded its surveillance network since 2014. While Pakistan experienced a record low of eight cases in 2017, nationwide surveillance indicates that the virus continues to circulate in the environment. This is largely due to Pakistan’s limited access to adequate sanitation facilities.
Afghanistan is a country speckled with major conflict zones in which it is difficult to mobilize healthcare providers to distribute the vaccine. While Afghanistan has experienced an 80 percent drop in the number of poliovirus cases since 2011, these gains remain very fragile.
GPEI has utilized a range of interventions, including collaborating with religious and community leaders and implementing coordinated strategies to reach mobile populations. It has cut the number of children missed during vaccination campaigns from more than 300,000 in a January 2017 campaign to approximately 60,000 in a March 2018 campaign.
While the Global Polio Eradication Initiative has surpassed many milestones since its implementation, there are still significant barriers that are hindering its ability to achieve full eradication. In order to achieve its primary goal, GPEI is prioritizing access to hard-to-reach areas and mobile populations while also improving polio surveillance and community engagement. These efforts, along with the involvement of national immunization campaigns, are critical in stopping the transmission of polio worldwide.
– Lolontika Hoque