What is that Polio Picture?  The Most Consequential Geographies

2023 is a critical year for the global effort to eradicate Polio.  It is the year where all remaining poliovirus transmission globally is slated to be fully interrupted, per the GPEI Polio Eradication Strategy 2022-2026.  A unique epidemiological window of opportunity is presenting itself at the start of the year, that we must capitalize on.  So what is the programme’s focus for achieving success this year?  The answer is:  reaching zero-dose children in the most consequential geographies.

In the two countries which remaining endemic to wild poliovirus – Pakistan and Afghanistan – virus transmission is more geographically restricted than ever before.  In Pakistan, for example, all cases in 2022 were concentrated in just six districts of one province, out of a total of 180 districts in the country.  But even more importantly:  the biodiversity of the virus (ie the individually-distinct virus lines that actively circulate in the country) continues to decline.  In 2020, the country was affected by 11 separate and individual chains of transmission, and this was reduced to four in 2021, and to just one single chain in 2022.  This means that individual virus lines are being successfully knocked out.   The situation in Afghanistan is very similar, and incidentally, we saw the same thing in other countries as they approached their final eradication efforts, notably India, Nigeria and Egypt.

The virus is at its weakest now, and the opportunity to wiping it out completely is now at its greatest.  How do we do this?  Very concretely, it means focusing all efforts on the ‘most consequential geographies’.  There are the areas which have the greatest impact on the global eradication effort.

But what are most consequential geographies?  Put simply, they are seven subnational areas around the world (eastern Afghanistan; southern Khyber Pakhtunkhwa, Pakistan; Tete province and its hinterland in northern Mozambique; eastern Democratic Republic of Congo; northern Yemen; northern Nigeria; south-central Somalia).  These areas share certain key programmatic characteristics:  they feature some of the highest and most densely-populated proportions of zero-dose children (children who are either un- or under-vaccinated), and they are also affected by broader humanitarian, complex emergencies, including in some areas insecurity, meaning reaching these most marginalized and last-remaining under-vaccinated communities is all the more challenging.

• Approximately 575 million doses of nOPV2 have been administered to date, in 26 countries, since rollout of the vaccine began in March 2021. In 2022 alone, 385 million doses were administered, across 22 countries.

 A Win Against Polio is a Win for Global Health!

2023 Circulating Vaccine Derived Polio Cases – 0

New Polio Cases & Samples This Week – Afghanistan – 3 WPV1 Samples, Botswana – 1 cVDPV2 Sample, Canada (Montreal) – 2 cVDPV2 Samples (linked to NY Case), Malawi – 1 cVDPV1 Case, Mozambique – 1 cVDPV1 Case, Nigeria – 6 cVDPV2 Samples, Pakistan – 1 WPV1 Sample.

2022 Circulating Vaccine Derived Polio Case Total – 702.  Afghanistan – 43, Algeria – 2, Benin – 10 (3 in 2021), Cameroon – 2 (3 in 2021), Central African Republic – 4, Chad – 27 (0 in 2021), DR Congo – 339 (28 in 2021), Eritrea – 1, Ethiopia – 1, Ghana – 3, Indonesia – 1, Israel – 1, Madagascar – 13 (13 in 2021), Malawi – 4, Mozambique – 19 (2 in 2021), Niger – 14 (18 in 2021), Nigeria – 43 (415 in 2021), Pakistan – 8, Somalia – 5 (1 in 2021), Sudan – 1, Togo – 2, United States – 1, Yemen – 159 (69 in 2021).

2021 Circulating Vaccine Derived Polio Cases -689 in 22 Countries.  

2020 Circulating Vaccine Derived Polio Cases – 1,113 in 26 countries in 2020.

Quote of the Day

”The best dreams happen when you’re awake.” 

— Cherie Gilderbloom, Account Coordinator, Turnberry Solutions

The Final Two Polio Endemic Countries:

as of 1/28/2023

0 new Polio cases reported this week. The most recent cases had an onset of paralysis on 9/10/22.
3 WPV1 and 0 CVDPV2-Positive Environmental Samples were reported this week in Afghanistan.
   2 Wild Polio case – 2022
   4 Wild Polio cases – 2021
   56 Wild Polio cases – 2020

Our Goal is Global Polio Eradication!!

Terry Ziegler, Endowment/Major Gifts Adviser Rotary Region 36