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Joint press release
Embargoed until 13 May 2003, 14.00 GMT
Changing epidemiology of polio prompts tactical shift in the
world's largest public health initiative
Supplementary Polio Immunization To Be Narrowed to Key
Countries
Tokyo/Brussels/Geneva/Washington DC, 13 May 2003 - The Polio
Eradication Initiative announced today that leading experts deem an
unprecedented tactical shift essential in the campaign to free the
world of polio. Immunization campaigns will be revised in 93
countries where polio transmission has already been stopped in order
to commit more resources to the remaining seven polio-endemic
countries, and six countries considered at high risk of reinfection.
The shift comes in response to the changing epidemiology of the
disease, with polio more geographically contained than ever. Only
seven countries remain endemic: India, Nigeria, Pakistan, Egypt,
Afghanistan, Niger, and Somalia (listed from highest to lowest
burden of disease). Virtually all the world's polio cases (99%) are
concentrated in just three countries: India, Nigeria and Pakistan.
Throughout the remainder of 2003 and during 2004, the eradication
campaigns will focus only on the seven endemic countries, along with
six other countries considered at high risk of polio reinfection -
Angola, Bangladesh, the Democratic Republic of the Congo, Ethiopia,
Nepal, and the Sudan.
In 2003, there will be 51 polio immunization campaigns in the 13
target countries. Additional campaigns will only be conducted as an
emergency response to importations. By comparison, 93 countries held
266 campaigns in 2002. This shift in tactics will accelerate the
accomplishment of global eradication by focusing on the endemic
areas while protecting the substantial investments that has been
made in these areas which are now polio-free.
The shift was announced by the core partners of the Global Polio
Eradication Initiative, spearheaded by the World Health Organization
(WHO), Rotary International, the US Centers for Disease Control and
Prevention (CDC), and UNICEF.
The new tactic will shift 297 million additional doses of oral
polio vaccine into the tightened geographic target zone, along with
US$ 35 million in additional resources in 2003.
"Until we stop transmission of the poliovirus in the seven
remaining infected countries, children everywhere will remain at
risk of contracting this disease," said
Dr Gro Harlem Brundtland, Director-General of WHO. "Concentrating
our resources on these strategic countries is crucial to root out
and extinguish the remaining reservoirs of wild poliovirus."
The tactical shift was finalized and adopted on 12 May 2003 by
the Technical Consultative Group on the Global Eradication of
Poliomyelitis (TCG), following its deliberations on 24-25 April in
Geneva. This independent, technical body meets annually to provide
strategic oversight to the Polio Eradication Initiative.
Even within the endemic countries, polio has been restricted to
highly concentrated areas. In India, for example, the disease is
contained primarily to areas of the north, but these pockets of
disease have proven to be extremely dangerous. Following a cut-back
in the number of polio immunization campaigns in India last year,
the pockets of transmission in northern India caused the largest
outbreak in recent history, a six-fold increase in new cases, and
the re-establishment of transmission in previously polio-free parts
of the country.
"The disease can be imported into countries that are polio-free
by persons infected in polio-endemic countries," said Dr Walter
Orenstein, Director, National Immunization Program, CDC, and
chairman of the global TCG. Dr Orenstein noted that genetic
sequencing had confirmed that a recent case of polio in Lebanon had
been imported from India. "That is why stopping transmission in the
reservoir countries and intensifying surveillance in non-endemic
countries is so critical. This focused approach is precisely the
type of action needed to stop polio once and for all."
Protecting both the investment that has been made by the
international community and particularly polio-free areas will
require even stronger surveillance, combined with a global emergency
response capacity.
"Basically we're tightening the noose," said Carol Bellamy,
Executive Director of UNICEF. "Unfortunately, the funding needed to
finish the job is extremely tight, too." Ms Bellamy said that at the
end of 2002, an additional US$ 275 million were needed to finish the
job by 2005, with US$ 33 million urgently required for 2003 alone.
"We need that money to make sure this new tactic is fully
implemented, and we need it now," Ms Bellamy emphasized.
To help narrow the funding gap through 2005, Rotary International
launched a second major global fundraising drive among its
membership, aiming to raise
US$ 80 million by June 2003, for activities over the next three
years. This is in addition to the US$ 500 million and countless
volunteer hours Rotary members have committed to polio eradication
since 1985. "The past successes of this initiative have been led by
a unique sense of hope," said Bill Sergeant, Rotary International.
"The future successes will be led by the positive partnerships that
have been forged since the initiative began."
If successful, polio will be the first disease to be eradicated
in the 21st century, and only the second after smallpox in 1979.
Public health experts point to the dire circumstances if the
eradication initiative falters now. Failure to eradicate polio would
result in the resources invested being wasted, including over US$ 2
billion and the work of 20 million volunteers worldwide,
international confidence in future global public health initiatives
being compromised, and the number of annual polio cases drastically
increasing.
Further information about the Global Polio Eradication
Initiative:
" The Global Polio Eradication Initiative is spearheaded by WHO,
Rotary International, CDC and UNICEF.
" There are now 209 countries, territories and areas free of
polio. Since 1988, the Global Polio Eradication Initiative has
succeeded in reducing the number of polio cases from an annual 350
000 in more than 125 countries, to just 1919 in 2002, in seven
countries, representing a more than 99 per cent reduction in annual
polio cases. The seven remaining polio endemic countries are (from
highest to lowest burden of disease): India, Nigeria, Pakistan,
Egypt, Afghanistan, Niger, and Somalia. It is the lowest number of
polio endemic countries in history.
" One of the primary strategies behind the Initiative's success
is the organization of mass immunization campaigns, known as
national immunization days (NIDs). Thousands of volunteers and
health workers systematically fan out across a country to find and
immunize every child under the age of five years against polio.
Typically, such campaigns last between one and eight days and
supplement routine immmunization activities of a country. In 2002
alone, more than 500 million children were immunized during 266
immunization campaigns in 93 countries.
" Poliomyelitis is a highly infectious disease caused by a virus
that mainly affects children under five years of age. It invades the
nervous system and can lead to paralysis within five days of
infection. The virus enters the body through the mouth and
multiplies in the intestine. Initial symptoms are fever, fatigue,
headache, vomiting, stiffness in the neck and pain in the limbs. One
in 200 infections leads to irreversible paralysis (usually in the
legs). Amongst those paralysed, 5%-10% die when their breathing
muscles become immobilized. There is no cure for polio; it can only
be prevented. Polio vaccine, given multiple times, can protect a
child for life.
" The polio eradication coalition includes governments of
countries affected by polio; private foundations (e.g. United
Nations Foundation, Bill & Melinda Gates Foundation); development
banks (e.g. The World Bank); donor governments
(e.g. Australia, Austria, Belgium, Canada, Denmark, Finland,
Germany, Ireland, Italy, Japan, Luxembourg, the Netherlands, Norway,
the United Kingdom and the United States of America); the European
Commission; humanitarian and nongovernmental organizations (e.g. the
International Red Cross and Red Crescent societies) and corporate
partners (e.g. Aventis Pasteur, De Beers). Volunteers in developing
countries also play a key role; 10 million have participated in mass
immunization campaigns.
###
For further information, please contact :
Melissa Corkum, WHO/Geneva,
tel. +41 22 791 2765, corkumm@who.int
Oliver Rosenbauer,
WHO/Geneva, tel. +41 22 791 3832, rosenbauero@who.int
Vivian Fiore, Rotary
Int'l/Chicago, tel. +1 847 866 3234, fiorev@rotaryintl.org
Steve Stewart, CDC/Atlanta,
tel. +1 404 639 8327, znc4@cdc.gov
Mohammad Jalloh, UNICEF/New
York, (1-212) 326-7516, mjalloh@unicef.org
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