India may be gearing up against Ebola but a more serious threat is at hand.
One of 21st century's greatest public health achievements - India wiping out polio, is now under serious threat from across its borders.
The 10th meeting of the Independent Monitoring Board (IMB) of the Global Polio Eradication Initiative (GPEI) held in London recently has concluded that the goal of stopping global polio transmission by the end of 2014 will be missed because of the worrying transmission in Pakistan and active export of the virus to other countries.
The World Health Organisation has confirmed that poliovirus from Pakistan has spread to Israel, West Bank and Gaza, and Iraq.
In 2012, there were 223 cases of polio in five countries. In 2013, there were 407 cases in eight countries.
IMB confirmed that it "cannot conclude that the grip on polio control is yet sufficiently strong. This is particularly because with just four months remaining until the 2014 deadline for stopping polio transmission, Pakistan has little hope of meeting this deadline, and Nigeria, with impending elections, is at real risk of losing the vital opportunity".
WHO says "Pakistan's situation is particularly problematic. Its polio control programme is years behind that in the other endemic countries. As currently constituted, the structure of the Prime Minister's Polio Monitoring Cell does not allow effective action against polio. A much stronger form of management and co-ordination is required".
WHO admitted that currently Pakistan appears likely to become the last polio endemic country in the world. This poses a serious threat to neighbours India which was in March 2014 declared polio free.
"It is an indictment of this country's programme that even in the easier eradication context of the low season, Pakistan has almost as many cases in the first 4 months of 2014 as in the whole of 2012 - and 9 times as many as in the same period in 2013. While some progress has been made in Peshawar, Karachi and Quetta, this is not sufficient to stop poliovirus transmission. It is vital that the prime minister and president urgently activate an emergency body with the resources, power and capability to transform this grave situation," WHO has said.
The deadline for global polio eradication has been repeatedly postponed and each time missed: the deadline years of 2000, 2004 and 2012 have all passed without the ultimate goal being reached.
IMB which is meeting against in London in October says that as the end-2014 deadline fast approaches, Nigeria and Pakistan are both at risk of failing to stop transmission in time (with greatest risk in Pakistan).
"There is a significant risk of one or more of the current outbreaks becoming prolonged. There is serious risk of failure to anticipate and prevent an outbreak elsewhere. Given these factors, the IMB's considered analysis is that the latest strategic plan goal of interrupting transmission by the end of 2014 is at extreme risk," WHO says.
The World Health Assembly recently declared polio eradication a programmatic emergency for global public health. WHO has called the spread of polio a public health emergency of international concern.
WHO says the last 1% cannot be allowed to persist any longer.
The IMB says that in late 2012, there was considerable optimism regarding the achievement of the polio free goal. Polio transmission in India had been interrupted and the three remaining endemic countries (Afghanistan, Nigeria, Pakistan) had made significant programmatic improvements. However, within a few months, events made the achievement of this goal appear less likely - targeted killing of polio vaccinators in Pakistan, polio virus entered Waziristan, a part of Pakistan in which polio vaccination had been - and remains - banned by Taliban commanders.
Poliovirus also spread from Pakistan to Syria, causing a major outbreak during the country's civil war. The IMB meanwhile has made several recommendations starting with the "establishment of an Emergency Operations Centre (EOC) in Pakistan, building upon Pakistan's recent experiences in responding to natural disasters. Top-level civil servants, senior representatives of national, regional and local government, religious leaders as well as military leaders should be a key part of this process".
It also recommends that "the heads of the Global Polio Eradication Initiative core partner agencies should meet urgently with the President and Prime Minister of Pakistan to support their essential leadership of the Pakistan polio eradication programme, and to offer every possible assistance".
The next meeting of the IMB will be held in London on September 30-October 2, 2014.
Monday, August 11, 2014
'India under polio threat from Pakistan'
India may be gearing up against Ebola but a more serious threat is at hand.
One of 21st century's greatest public health achievements - India wiping out polio, is now under serious threat from across its borders.
The 10th meeting of the Independent Monitoring Board (IMB) of the Global Polio Eradication Initiative (GPEI) held in London recently has concluded that the goal of stopping global polio transmission by the end of 2014 will be missed because of the worrying transmission in Pakistan and active export of the virus to other countries.
The World Health Organisation has confirmed that poliovirus from Pakistan has spread to Israel, West Bank and Gaza, and Iraq.
In 2012, there were 223 cases of polio in five countries. In 2013, there were 407 cases in eight countries.
IMB confirmed that it "cannot conclude that the grip on polio control is yet sufficiently strong. This is particularly because with just four months remaining until the 2014 deadline for stopping polio transmission, Pakistan has little hope of meeting this deadline, and Nigeria, with impending elections, is at real risk of losing the vital opportunity".
WHO says "Pakistan's situation is particularly problematic. Its polio control programme is years behind that in the other endemic countries. As currently constituted, the structure of the Prime Minister's Polio Monitoring Cell does not allow effective action against polio. A much stronger form of management and co-ordination is required".
WHO admitted that currently Pakistan appears likely to become the last polio endemic country in the world. This poses a serious threat to neighbours India which was in March 2014 declared polio free.
"It is an indictment of this country's programme that even in the easier eradication context of the low season, Pakistan has almost as many cases in the first 4 months of 2014 as in the whole of 2012 - and 9 times as many as in the same period in 2013. While some progress has been made in Peshawar, Karachi and Quetta, this is not sufficient to stop poliovirus transmission. It is vital that the prime minister and president urgently activate an emergency body with the resources, power and capability to transform this grave situation," WHO has said.
The deadline for global polio eradication has been repeatedly postponed and each time missed: the deadline years of 2000, 2004 and 2012 have all passed without the ultimate goal being reached.
IMB which is meeting against in London in October says that as the end-2014 deadline fast approaches, Nigeria and Pakistan are both at risk of failing to stop transmission in time (with greatest risk in Pakistan).
"There is a significant risk of one or more of the current outbreaks becoming prolonged. There is serious risk of failure to anticipate and prevent an outbreak elsewhere. Given these factors, the IMB's considered analysis is that the latest strategic plan goal of interrupting transmission by the end of 2014 is at extreme risk," WHO says.
The World Health Assembly recently declared polio eradication a programmatic emergency for global public health. WHO has called the spread of polio a public health emergency of international concern.
WHO says the last 1% cannot be allowed to persist any longer.
The IMB says that in late 2012, there was considerable optimism regarding the achievement of the polio free goal. Polio transmission in India had been interrupted and the three remaining endemic countries (Afghanistan, Nigeria, Pakistan) had made significant programmatic improvements. However, within a few months, events made the achievement of this goal appear less likely - targeted killing of polio vaccinators in Pakistan, polio virus entered Waziristan, a part of Pakistan in which polio vaccination had been - and remains - banned by Taliban commanders.
Poliovirus also spread from Pakistan to Syria, causing a major outbreak during the country's civil war. The IMB meanwhile has made several recommendations starting with the "establishment of an Emergency Operations Centre (EOC) in Pakistan, building upon Pakistan's recent experiences in responding to natural disasters. Top-level civil servants, senior representatives of national, regional and local government, religious leaders as well as military leaders should be a key part of this process".
It also recommends that "the heads of the Global Polio Eradication Initiative core partner agencies should meet urgently with the President and Prime Minister of Pakistan to support their essential leadership of the Pakistan polio eradication programme, and to offer every possible assistance".
The next meeting of the IMB will be held in London on September 30-October 2, 2014.
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