POLIO Public Health Emergency of International Concern (PHEIC); WHO/OCHA Emergencies

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 23 December 2020
:: The19th report of the Independent Monitoring Board (IMB) has been published. The IMB notes the strong resumption of polio campaigns following the temporary pause due to COVID-19 and commends the programme for supporting COVID-19 response efforts. The IMB points to several pivotal challenges which the programme must tackle with urgency to achieve success and offers a set of 17 key recommendations to capitalise on the momentum of resumed immunizations.

:: The GPEI has published a global cVDPV resource document aimed at providing a high-level overview of cVDPVs, their importance to the programme and strategy for responding to them, including nOPV2. Available here in various languages, this resource can be used at global, regional and country levels, for high-level advocacy with government counterparts, internal staff, donors or other partners, as appropriate.

:: On a wintery November day, vaccinators across Afghanistan wrapped up warm, checked that they had facemasks and hand sanitizer, and headed out into the cold morning. Their mission? To reach 9.9 million children with polio vaccines, before snowfall blocked their way. Read more

Summary of new WPV and cVDPV viruses this week (AFP cases and ES positives):
:: Afghanistan: two WPV1 and 23 cVDPV2 positive environmental samples
:: Pakistan: one WPV1 and 11 cVDPV2 cases
:: Benin: one cVDPV2 positive environmental sample
:: Burkina Faso: six cVDPV2 cases
:: Chad: two cVDPV2 cases
:: South Sudan: 10 cVDPV2 cases and one cVDPV2 positive environmental sample

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The World is Waiting :: 19TH REPORT – INDEPENDENT MONITORING BOARD – GLOBAL POLIO ERADICATION INITIATIVE
December 2020 :: 78 pages
Conclusions [excerpt]
The Polio Programme is at a pivotal moment in its history. The weaknesses and failures that led it backwards, over a period of two years, from a place that felt close to the global interruption of poliovirus transmission, to the current epidemiological debacle, are still present.

The Global Polio Programme: a failure of adaptation
The Global Polio Eradication Initiative was launched in 1988, with the passion, energy and fundraising tenacity of Rotary International behind it, together with fellow founding partners (WHO, UNICEF, CDC);
it has been hugely successful for most of its lifetime. Other generous donors (major governments, the Bill & Melinda Gates Foundation, Gavi) have become key partners in the endeavour.

This partnership, its organisational structure, its operating procedures, and its impressive infrastructure on the ground, has driven polio almost to extinction.

That this polio eradication endeavour has faltered over recent years should not come as a surprise. It has been tightly controlled and managed by a global entity, the GPEI. It stands or falls by how this global organisation operates. The GPEI is now 32 years old.

Outside the world of health, and well before 32 years are reached, there are many examples of successful businesses and corporations that have run into serious difficulties, and not just because of their longevity. Crucially, it is because their organisational structure, culture, and business model has not adapted to a changing external environment. Perhaps, also, they have looked back at past glories
and not accepted the need to change because they are “too good to fail.”

The GPEI seems to have reached a similar point in its history.

For some time, it has been clear that the world in which the Polio Programme is embedded has changed around it.

The humble drops of oral polio vaccine are given against a constantly fluctuating geopolitical backdrop. Political unanimity on the importance of polio is much more difficult to secure than it was 32 years ago.

The oral polio vaccine has greater value than its disease preventive potency: as a powerful bargaining tool for factional interests wanting something from their governments.

Some communities have become so hostile to the Polio Programme, and so opposed to letting their children have the vaccine, that negative attitudes may have reached the point of no return. Violence, territorial blockades, murders and intimidation, in some geographies, are directed against polio eradication activity, in marked contrast to most other humanitarian programmes.

Countries have received steady streams of external funding and extensive global involvement and facilitation. This has not always encouraged them to take absolute responsibility and regard polio as their country’s problem.

Finding solutions to these fundamental and deep-rooted barriers to eradication is what is now necessary in order to finish the job. This means the Polio Programme doing things very differently from how it made its name.

Its success came from operating as a technical, disease control programme and this took it a long way. It became overmedicalized in the way that it approached the tasks of eradication. It was not skilled in the tasks of modern management, such as: inspiring people; gathering soft intelligence; managing performance; quality improvement; and daily use of data to devise insightful metrics. In particular, social data were greatly undervalued compared to epidemiological data.

Until late in the day, there was no real belief in alternative delivery models, such as integration. There were regular and unsuccessful vertical programme dashes to try to reach the finishing tape.

These are all reasons why the GPEI – from global to regional to national to local level – needs to adapt and do things differently.

At last, the GPEI has started to talk about this. A six-month long strategy formulation process has been facilitated by external consultants with wide stakeholder involvement. It is set to produce “headlines”
in December 2020.

It is essential that this strategy goes beyond problem diagnosis and pointing out what needs to be done. The problems are already well-established and the steps that need to be taken are very clear.

The GPEI, at the request of polio donor countries, carried out and published a governance review. That has not yet been implemented.

There is a great deal of conversation at the moment, within the GPEI leadership and among the donors and wider polio partners, about these matters. It is using up much emotional energy. Some are saying that these reviews and discussions are not on the critical path to eradication.

The revision of the governance of the GPEI, the revision of the strategy of the GPEI, and the revision of the structure of the GPEI are well overdue.

It is important that there is a new, much more effective, and fully accountable GPEI.

Meanwhile, the task of helping the GPEI to move quickly to face, head-on, the task of finding and implementing definitive, transformational and sustainable solutions to its most intractable barriers to
eradication rests with the GPEI leadership and the leaders of the national polio programmes…

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WHO Grade 3 Emergencies [to 26 Dec 2020]

Democratic Republic of the Congo – No new digest announcements identified
Mozambique floods – No new digest announcements identified
Nigeria – No new digest announcements identified
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified
Syrian Arab Republic – No new digest announcements identified
Yemen – No new digest announcements identified

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WHO Grade 2 Emergencies [to 26 Dec 2020]
Afghanistan – No new digest announcements identified
Angola – No new digest announcements identified
Burkina Faso – No new digest announcements identified
Burundi – No new digest announcements identified
Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Ethiopia – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
Malawi Floods – No new digest announcements identified
Measles in Europe – No new digest announcements identified
MERS-CoV – No new digest announcements identified
Mozambique – No new digest announcements identified
Myanmar – No new digest announcements identified
Niger – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
HIV in Pakistan – No new digest announcements identified
Sao Tome and Principe Necrotizing Cellulitis (2017) – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

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WHO Grade 1 Emergencies [to 26 Dec 2020]

Chad – No new digest announcements identified
Djibouti – No new digest announcements identified
Kenya – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Tanzania – No new digest announcements identified

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UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic
:: Syrian Arab Republic: COVID-19 Humanitarian Update No. 22 As of 23 December 2020
:: Recent Developments in Northwest Syria – Situation Report No. 23 – As of 21 December 2020

Yemen – No new digest announcements identified

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UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
COVID-19
:: Coronavirus Disease (COVID-19): Weekly Epidemiological Update (22 December 2020)

East Africa Locust Infestation – No new digest announcements identified

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