polio eradication: progress against milestones · status of milestones – reinfected countries...

Endemic countries1. Reduction in polio-infected districts: on track for a >50%

reduction for type 1 poliovirus.2. Increase in polio vaccination coverage: on track in 7 of the 9

endemic transmission zones in the 4 countries.

Re-infected countries3. Interruption of outbreaks in countries with imported poliovirus in

2006: on track, with outbreaks already stopped in 10 of the 13 re-infected countries.

Financing4. Sufficient funding for all planned eradication activities in 2007:

missed, with US$ 60 million gap for 4th quarter activities.

Polio Eradication: Progress against MilestonesInterim report September 2007

Milestone 1: by end-2007, 50% reduction in infected districts in the endemic countries relative to 2006

Status: 75% decline in type 1 polio-infected districts*

** source: WHO/UNICEF 2006 Joint Reporting Form (2005 for India)†Jan-Aug 07 - data in WHO/HQ as of 18 Sep 2007

* Since 2006, the interruption of type 1 polio has been the first priority of the Global Polio Eradication Initiative due to its higher paralytic rate and propensity towards international spread compared to type 3 polio.

-75%

infected districts

in 2007†

Afghanistan 329 9

Pakistan 132 9

India 594 56

Nigeria 774 117

TOTAL 191

decrease

-76%

-50%

-68%

-79%

in type 1-infected districts*

Countrytotal #

districts in country**

-59%

overall decrease in

infected districts

-47%

-51%

-50%

-51%1829

Afghanistan: Wild Poliovirus infected districts2006

2007*

17 districts infected

9 districts infected or 47% reduction

17 districts infected with WPV1

4 districts infected with WPV1 or 76% reduction

*Jan-Aug 07 - data in WHO/HQ as of 18 Sep 2007

district infected with wild polio virus type 1 district infected with wild polio virus type 3 district infected with wild polio virus type 1 and type 3

The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2007. All rights reserved

India: Wild Poliovirus infected districts2006

2007*








Nigeria: Wild Poliovirus infected districts2006

2007*117 districts infected or 50% reduction







Pakistan: Wild Poliovirus infected districts2006

2007*








Milestone 2: by end-2007, OPV coverage in the endemic transmission zones > polio-free zones in each country.Status: 7 of 9 endemic transmission zones on track

•Afghanistan: the proportion of zero-dose (never-vaccinated) children in the southern zone has increased from 4% in 2006 to 12% to date in 2007, due to deteriorating security.

•Nigeria: the proportion of zero-dose children in very high-risk, high-risk and medium high-risk transmission zones has declined from an average of 27% in 2006 to an average of 16% in 2007.

Source: 2007 NPAFP cases 6-35 months old. Data in HQ as of Sept 07. NPAFP cases with unknown OPV status excluded from analysis.

country transmission zone

endemic zones

polio free zones

endemic zones

polio free zones

Afghanistan Southern 12% 8

Eastern <1% 15

Pakistan Northern 1% 13

Southern 1% 11

Nigeria Very high 32% 2

High 9% 3

Medium high 6% 2

India West UP <1% 12

Bihar <1% 13

1%

<1%

10

11

4

9

0-dose children (never- vaccinated) Average doses/child

1%

<1%

Missedchildren by area, 2007

As of 21 Sep 2007

Nigeria

Very high High Medium high

32%

9%6%

6%

West UP

India

Bihar

<1%<1%

Pakistan

Southern Northern

1%

1%

Southern Eastern

Afghanistan

12%

<1%


* i.e. most recent case was before April 2007. ** 32 of 36 separate importations have been stopped in

the 13 countries.

Milestone 3: by end-2007, interruption of outbreaks in countries with circulation of imported poliovirus in 2006Status: outbreaks stopped* in 10 of 13 countries**

Circulating imported virus in 2006 Circulating imported virus in 2006, still ongoing in 2007New importation-associated outbreak in 2007

Source: WHO HQ as of Sep 2007


2006 2007

Status of Milestones – Reinfected countriesIntermediate report as of 11 Sept 2007

Data at HQ as of 11 Sept 07

Circulating imported virus in 2006 which has stopped Circulating imported virus in 2006, still ongoing in 2007

Country First case Last case # Cases Duration (in months) Country First case Last case # Cases Duration

(in months)

Bangladesh 23-Jan-06 22-Nov-06 17 1024-Jul-06 24-Jul-06 1 0 Angola 25-Apr-05 27-Jun-07 13 26

Cameroon* 22-Aug-06 22-Aug-06 1 0 Chad 02-Aug-03 29-Jun-07 48 4806-Dec-06 06-Dec-06 1 0 DRCongo 27-Feb-06 20-Jun-07 14 16

Chad 26-Nov-06 26-Nov-06 1 0 17-Dec-06 19-Jul-07 22 7DRCongo 05-May-06 13-Aug-06 3 3

20-May-06 07-Jun-06 2 1Ethiopia 21-Dec-04 01-Feb-06 17 14 New importation in 2007

01-Jul-05 07-Nov-06 8 1612-Feb-06 07-Nov-06 15 9

Indonesia 13-Mar-05 20-Feb-06 305 11

Kenya 17-Sep-06 13-Nov-06 2 2Namibia 08-May-06 26-Jun-06 19 2Nepal* 18-Mar-06 18-Mar-06 1 0 Angola 25-Apr-07 08-Jul-07 9 2

01-Aug-06 01-Aug-06 1 0 Chad 18-May-07 02-Aug-07 3 322-Oct-06 22-Oct-06 1 0 Myanmar 09-Mar-07 28-May-07 11 323-Oct-06 23-Oct-06 1 0 Niger 05-Mar-07 16-Aug-07 3 522-Dec-06 22-Dec-06 1 0

Niger* 14-Feb-05 14-Jan-06 2 1106-Apr-05 12-Jan-06 2 915-Oct-05 17-May-06 2 716-Jan-06 16-Jan-06 1 015-Apr-06 15-Apr-06 1 001-May-06 01-May-06 1 017-May-06 17-May-06 1 029-May-06 29-May-06 1 016-Jun-06 16-Jun-06 1 009-Jul-06 09-Jul-06 1 023-Aug-06 23-Aug-06 1 023-Oct-06 23-Oct-06 1 0

Somalia 12-Jul-05 25-Mar-07 228 21Yemen 27-Feb-05 02-Feb-06 479 11

*Niger, Nepal and Cameroon are facing sporadic importations$ Subject to change pending available sequencing data

Duration (in months)

Event$ Event$

Event$

Country First case Last case # Cases

Milestone 4: by mid-2007, sufficient funding for all planned eradication activities in 2007Status: missed, with US$ 60 million gap for 4th quarter 2007 activities*

* Essential activities may be postponed or cancelled if gap is not filled by November 2007.

Polio Eradication Initiative budget & funding gaps2007, 1st to 4th quarters

13271

150

27060

0

100

200

300

Q1 Q2 Q3 Q4

Bud

get i

n U

S$ m

illio

ns

funding available funding gap

polio eradication: progress against milestones · status of milestones – reinfected countries...

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