Updates on CDC’s Polio Eradication Efforts

December 12, 2014

CDC Continues to Support the Global Polio Eradication Effort

The eradication of polio is an important priority for the Centers for Disease Control and Prevention (CDC). We are closer than we have ever been to eradicating polio and it is critical that we take advantage of this opportunity.

On December 2, 2011, CDC Director Thomas R. Frieden, MD, MPH, activated CDC’s Emergency Operations Center (EOC) to strengthen the agency’s partnership engagement through the Global Polio Eradication Initiative (GPEI), which is committed to completing the eradication of polio. On December 14, 2011, Dr. Frieden enlisted the support of the entire CDC community to become active participants in an intensified effort to eradicate polio worldwide.

CDC’s Involvement
In the final push toward global polio eradication, CDC continues its close collaboration with partners, including the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), Rotary International, and the Bill and Melinda Gates Foundation to ensure a coordinated global and country-level response.

CDC polio eradication activities and staff have moved into the EOC operational structure to ensure maximum use of CDC resources to support polio eradication, and to scale up timely technical expertise and support for polio-infected countries (Afghanistan, Cameroon, Equatorial Guinea, Ethiopia, Iraq, Nigeria, Pakistan, and Syrian Arab Republic) and for countries at risk of polio outbreaks, in coordination with GPEI partners.

Since December 2, 2011, approximately 545 workers have supported CDC’s polio eradication efforts in the EOC and in the field. Of these, 167 workers have completed 799 field deployments to Angola, Chad, Cote d’Ivoire, and other areas. Each day an average of 41 people are working on polio eradication in CDC’s EOC.

Activation of the EOC has provided enhanced capacity for CDC’s STOP Transmission of Polio (STOP) program, which trains public health volunteers in the United States and globally to improve polio surveillance and help plan, implement, and evaluate vaccination campaigns. Since December 2, 2011, 537 individuals have been deployed on 1140 assignments to work with the STOP program in dozens of countries, including Chad, Haiti, and Kenya.

In addition, the EOC has provided enhanced capacity to scale up in-country technical expertise and support for – polio surveillance, planning, implementation, and monitoring of polio vaccination campaigns – strengthening routine immunization, strengthening management and accountability.

A few additional examples of CDC polio eradication activities include:

• An in-depth review of priority countries’ polio eradication plans to assess program gaps and training needs, and elaboration of plans for CDC’s engagement in those countries.
• Publication of several joint World Health Organization Weekly Epidemiologic Record/CDC Morbidity and Mortality Weekly Reports (MMWR) highlighting polio eradication progress related to Nigeria, Afghanistan and Pakistan, risk assessment for polio outbreaks, possible eradication of wild poliovirus type 3, polio-free certification in SEARO andprogress towards worldwide eradication.
• Collaboration with GPEI partners on detailed country-plans for expanded technical and management support, including assistance with outbreak responses, surveillance reviews, vaccination campaign planning and monitoring, and data management.
• The development of indicators for monitoring polio vaccination campaign performance in the areas of planning, implementation, and evaluation.
• Review of WHO proposed outbreak response protocols for all polio-affected and at risk countries.

The Global Push toward the Finish Line

Polio incidence has dropped more than 99 percent since the launch of global polio eradication efforts in 1988. According to global polio surveillance data from December 10, 2014, 325 polio cases have been reported to date in 2014 from Afghanistan, Cameroon, Equatorial Guinea, Ethiopia, Iraq, Nigeria, Pakistan, and Syria. In 2013, a total of 416 polio cases were reported from the following countries: Afghanistan, Cameroon, Ethiopia, Kenya, Nigeria, Pakistan, Somalia, and Syrian Arab Republic.

On March 27, 2014, Dr. Frieden and senior CDC immunization staff were present when India, along with the other 10 countries of the South East Asia Region, was certified polio-free.  The country was once considered the most complex challenge to achieving global polio eradication. Four of the six regions of the World Health Organization have been certified polio-free: the Americas (1994), Western Pacific (2000), Europe (2002) and South East Asia (2014). 80% of the world’s people now live in polio-free areas.

While no polio cases have been detected in India for more than three years, poliovirus transmission is ongoing in the three endemic countries – Afghanistan, Nigeria, and Pakistan. GPEI’s Independent Monitoring Board considers Nigeria and Pakistan to be the greatest challenges for eradicating polio. On May 5, 2014, after receiving advice from an Emergency Committee of independent experts and in order to protect progress toward eradication, WHO Director-General Margaret Chan declared the recent international spread of wild poliovirus a “public health emergency of international concern,” and issued Temporary Recommendations under the International Health Regulations (2005) to prevent further spread of the disease.

It is therefore imperative that we make this final push toward eradication one of our highest priorities. As Dr. Frieden has stated, “If we fail to get over the finish line, we will need to continue expensive control measures for the indefinite future…,More importantly, without eradication,  a resurgence of polio could paralyze more than 200,000 children worldwide every year within a decade.” Now is the time, we must not fail.