PDF version

WHO events addressing public health priorities

Citation: Certification of poliomyelitis eradication. East Mediterr Health J. 2019;25(9):662–663. https://doi.org/10.26719/2019.25.9.662

Copyright © World Health Organization (WHO) 2019. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

¹This summary is extracted from the report on the Thirty-third meeting of the Eastern Mediterranean Regional Commission for Certification of Poliomyelitis Eradication, Muscat, Oman, 23–25 April 2019 (http://applications.emro.who.int/docs/IC_meet_rep_2019_23810_en.pdf?ua=1).

---

Introduction

The Eastern Mediterranean Regional Commission for Certification of Poliomyelitis Eradication (RCC) held its 33rd meeting in Muscat, Oman, from 23 to 25 April 2019 (1). The meeting was attended by members of the RCC, chairpersons of the National Certification Committees (NCCs) or their representatives, and immunization programme or polio eradication programme staff of 21 countries of the Region. The meeting was also attended by representatives of Rotary International, the Centers for Disease Control and Prevention, Atlanta, United States of America, and staff from WHO headquarters, regional offices for Africa, Europe and the Eastern Mediterranean, in addition to the Afghanistan, Pakistan and Somalia country offices. His Excellency Dr Mohamed Al Hosni, Under Secretary for Health Affairs of the Ministry of Health of Oman, attended the inaugural session.

A message from Dr Ahmed Al Mandhari, WHO Regional Director for the Eastern Mediterranean, was delivered by Dr Humayun Asghar, Polio Eradication Programme Coordinator, WHO Regional Office for the Eastern Mediterranean. In his message, the Regional Director thanked participants for their unwavering commitment and sustained efforts to achieve the target of eradicating polio in the Region. He applauded the work of the Islamic Advisory Group, in coordination with the Islamic Fiqh Academy and Al-Azhar Al Sharif, in engaging religious scholars in promoting vaccination.

The Regional Director also expressed concern about the diverse challenges in the remaining two polio-endemic countries – Afghanistan and Pakistan, and hoped that the target of eradicating polio could be achieved very soon, in spite of challenges relating to access and the complex security situation in some Member States.

Summary of discussions

The RCC noted the updates on polio eradication efforts, and expressed concern over the high number of polio cases and positive environmental samples in the first quarter of 2019, compared with the same period in 2018 in Afghanistan and Pakistan, and the presence of widespread isolation of WPV1, particularly in Pakistan (2). The RCC noted with appreciation multi-country and

inter-regional coordination through the Horn of Africa hub based in Nairobi and cross-border coordination meetings of countries in the WHO Eastern Mediterranean and African regions.

Stopping transmission of WPVs in Pakistan and Afghanistan through implementation of national emergency action plans is a main regional polio priority, in addition to: stopping the outbreak in Somalia; protecting all countries of the Region against importation and/or outbreaks; maintaining a certification standard AFP surveillance system in all countries, encouraging inter-regional coordination; achieving certification of eradication; and transitioning polio assets and experience for future global health initiatives. Also, under consideration is the formation of a new hub to consolidate and coordinate eradication efforts.

In conclusion, the regional polio programme continued to work towards a polio-free Region in 2018, as outlined in the regional Vision 2023. Outbreaks of circulating vaccine-derived poliovirus are being dealt with, and WPV continues to be detected in Afghanistan and Pakistan. Strong support is being provided for the implementation of national emergency action plans for polio eradication. If WPV transmission can be interrupted by early 2020, which is entirely possible, the Region is on track to be certified as polio-free in 2023.

Recommendations

To WHO

Requesting the Regional Director for the WHO Regional Office for the Eastern Mediterranean to convey the concerns of the RCC to the leadership of the two endemic countries to expedite eradication efforts for polio free certification by 2023.

Asking the WHO Secretariat to develop a summary of certification-related indicators for all Member States and share with RCC members at the time of reviewing of country reports.

Requesting the WHO Secretariat to develop/revise the certification documents as follows:

The national basic document should be frozen and not used for the two remaining endemic countries, i.e. Afghanistan and Pakistan.

A final completion report should be developed to replace the national basic documentation to address all necessary elements of certifying endemic countries as polio free.

The format of the regional report for polio-free certification for submission to the GCC should be developed for review and approval of the RCC members.

To Member States

The RCC urges the Islamic Republic of Iran and Pakistan’s polio essential facilities to apply for certificate of participation to the national authority for containment in their respective countries by the end of December 2019.

Member States should continue the POSE exercise, which should preferably be performed by national teams.

Once a WPV1-endemic country is free of WPV1, it should submit a final completion report for three consecutive years.

Polio-free countries should continue to submit the annual report.

References

1. World Health Organization Regional Office for the Eastern Mediterranean. Report on the Thirty-third meeting of the Eastern Mediterranean Regional Commission for Certification of Poliomyelitis Eradication. Cairo: WHO/EMRO; 2019 (http://applications.emro.who.int/docs/IC_meet_rep_2019_23810_en.pdf?ua=1).
2. World Health Organization. Poliomyelitis: key facts. Geneva: World Health Organization; 2019 (https://www.who.int/news-room/fact-sheets/detail/poliomyelitis).