Inactivated polio vaccine support

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There is no cure for polio but it can be prevented with polio vaccine

In 2013, only three countries in the world remain polio-endemic

Nigerian child receives IPV

Nigerian child receives IPV. Photo: WHO/F. Caillette/2006

Crippling, potentially fatal

Polio is a crippling and potentially fatal infectious disease that mainly affects young children under the age of five. The virus is transmitted through contaminated food and water, and multiplies in the intestine, from where it can invade the nervous system.

Many infected people have no symptoms, but do excrete the virus in their faeces, hence transmitting infection to others.

Polio invades the nervous system, and can cause total paralysis in a matter of hours. 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). Among those paralysed, 5% to 10% die when their breathing muscles become immobilised.

Polio eradication efforts

There is no cure for polio, it can only be prevented. Polio vaccine, given multiple times, can protect a child for life.
Since the Global Polio Eradication Initiative (GPEI) was launched in 1988, polio cases have decreased by over 99%: from an estimated 350 000 cases in more than 125 endemic countries then, to 223 reported cases in 2012.

In 2013, only parts of three countries in the world remain polio-endemic – Afghanistan, Nigeria and Pakistan. India, once the world’s epicentre of polio, has remained polio free since January 2011.

GPEI is a public-private partnership spearheaded by national governments, the World Health Organization, Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF. Its goal is to eradicate polio worldwide.

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Gavi to support GPEI endgame plan by strengthening routine immunisation services and by introducing IPV as part of routine immunisation programmes

Supporting the polio endgame

Gavi will support GPEI’s endgame plan by strengthening routine immunisation services in the poorest countries, using the human resources and infrastructure used for polio eradication efforts, and by introducing IPV as part of routine immunisation programmes.

In 2013, the Gavi Board decided to begin supporting the introduction of inactivated polio vaccine (IPV) as part of routine immunisation programmes in the world’s 73 poorest countries. This will enable Gavi to reach more children with important vaccines, and play a complementary role supporting the efforts of the World Health Organization (WHO) and the Global Polio Eradication Initiative (GPEI) in eradicating polio as part of implementing the polio endgame strategy.

In May 2013, the World Health Assembly endorsed the new Polio Eradication & Endgame Strategic Plan 2013-2018, calling on countries to introduce at least one dose of IPV and begin the phased removal of oral polio vaccines. 

Removing oral polio vaccines (OPV) will eliminate the risk of vaccine-associated polio outbreaks.  Introducing IPV is a critical step to manage any risks associated with this phased removal. Adding IPV to routine immunisation programmes will improve immunity and help prevent new vaccine-associated outbreaks from emerging.

Polio endgame

At the same time, it will hasten eradication of wild polio serotypes in the remaining endemic countries of Afghanistan, Nigeria and Pakistan.

IPV introduction

Given the global health priority of polio eradication, the Gavi Board agreed to a number of policy exceptions for IPV, such as allowing countries that are graduating from Gavi’s support to request IPV support, encouraging but not requiring co-financing and allowing countries that do not have more than 70% routine coverage to apply for IPV.

Gavi-eligible and graduating countries will be able to apply for support until June 2015, with introduction targeted by the end of 2015. The IPV vaccine would be introduced in routine immunisation programmes in countries currently using oral polio vaccine.

Similar to the process for other new vaccine support, Gavi will be making available an application form and guidelines to enable countries to request support for IPV. In line with the Endgame Plan, all countries must apply for IPV support before a deadline of June 2015.

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