Emergencies

Emergencies

POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 17 February 2021
:: “The polio programme brought women out into the workforce in an unprecedented way, says Dr. Olayinka. “Women were powerful mobilizers, particularly older, respected women and could enter any home. The polio programme was one of the first programmes bringing the women out, training them how to speak to other women and community members, which gave them a standing in the community. They also received some stipends which empowered them a bit financially.” Read more in our latest “Women Leaders in Polio Eradication” series.

Summary of new WPV and cVDPV viruses this week (AFP cases and ES positives):
:: Afghanistan: 1 cVDPV2 case and five cVDPV2 positive environmental samples
:: Pakistan: four WPV1 positive environmental samples
:: Côte d’Ivoire: one cVDPV2 case
:: Democratic Republic of the Congo (DR Congo): two cVDPV2 cases
:: Egypt: two cVDPV2 positive environmental samples
:: Ethiopia: three cVDPV2 cases
:: Kenya: one cVDPV2 positive environmental sample
:: Mali: one cVDPV2 case
:: Sudan: one cVDPV2 case and three cVDPV2 positive environmental samples
:: Tajikistan: one cVDPV2 case

::::::

Statement of the Twenty-Seventh Polio IHR Emergency Committee
19 February 2021 Statement
[Excerpts]
The twenty-seventh meeting of the Emergency Committee under the International Health Regulations (2005) (IHR) on the international spread of poliovirus was convened by the WHO Director-General on 1 February 2021 with committee members and advisers attending via video conference, supported by the WHO Secretariat.  The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine derived polioviruses (cVDPV).  The following IHR States Parties provided an update at the video conference on the current situation in their respective countries: Afghanistan, Burkina Faso, the Republic of the Congo, Côte d’Ivoire, Egypt, the Islamic Republic of Iran, Liberia, Madagascar, Mali, Sierra Leone and Pakistan and Tajikistan…

…COVID-19
The committee was concerned that COVID-19 continues to have an impact on polio eradication at many levels.  Many of the polio affected countries are currently experiencing a second wave of COVID-19, notably Malaysia, Pakistan and Nigeria. Although resumption of SIAs is now a major focus of the polio program the effect of the pause in 2020 and the current second wave will hamper this resumption. There are ongoing signs of the impact of COVID-19 on surveillance, particularly with slow shipment and handling and reporting of samples for polio testing.   All these factors serve to heighten the risk of polio transmission.

The committee noted that since the beginning of the pandemic, the value of polio-funded staff and assets contributed to the COVID-19 response in more than 50 countries is estimated at USD $104 million. In view of the overwhelming public health imperative to end the COVID-19 pandemic, the POB has committed to the polio program’s continued support for the next phase of COVID-19 response, COVID-19 vaccine introduction and delivery, through existing assets, infrastructure and expertise in key geographies.

Conclusion
The Committee unanimously agreed that the risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC) and recommended the extension of Temporary Recommendations for a further three months.  The Committee recognizes the concerns regarding the lengthy duration of the polio PHEIC, but concludes that the current situation is extraordinary, with clear ongoing and increasing risk of international spread and ongoing need for coordinated international response. The Committee considered the following factors in reaching this conclusion:

…Additional considerations
The committee welcomed the Emergency Use Listing of novel OPV2 but cautioned there was much to be done before the new vacccine could be expected to have a significant impact globally on the spread of cVDPV2. The phased replacement during 2021 of Sabin OPV2 with novel OPV2 is expected to substantially reduce the source of cVDPV2 emergence, transmission and subsequent risk of international spread.  Full licensure and pre-qualification of nOPV2 is not expected before 2022; therefore all countries at risk of cVDPV2 outbreak should consider preparing for novel OPV2 use under Emergency Use Listing procedure.

The committee welcomed the progress being made in individual countries that were facing huge challenges with both polio and COVID-19.  COVID-19 is also likely to continue to have a significant adverse impact on stopping polio transmission throughout 2021, with diversion of resources, barriers to successful polio campaign implementation and the consequential growing immunity gap.  However, the committee urged countries to look for where synergies can be built between polio and COVID -19 control, such as countering vaccine hesitancy, expanding and sharing testing resources, and vaccine management.  Countries also needed to make sure that local lockdowns and border restrictions were implemented in such a way as to avoid hampering specimen shipment and testing, particularly in West Africa where there are already constraints in lab capacity.  As testing for COVID-19 is strengthened, this should be done so as to strengthen lab capacity for other infectious diseases such as polio.  The committee urges affected countries to strengthen cross border cooperation as this appeared to be inconsistently carried out.

The committee also noted the risk of vaccine hesitancy could be exacerbated during the pandemic, so that adverse events during the development or future deployment of any COVID-19 vaccine could compound the existing issues around polio vaccines, particularly but not only in Pakistan.  Conversely, vaccine issues arising out of novel OPV2 or trivalent OPV use could adversely affect any future COVID-19 vaccine deployment.  The committee urged countries with particular issues around vaccine hesitancy to make preparations now to avert situations of greater vaccine refusals through education campaigns, activities to counter misinformation and rumors and wherever possible provide incentives to target populations such as multi-antigen campaigns and offering other health and wellbeing services (vitamins, anti-worming medication, soap etc).

The committee was also very concerned about the polio program funding gap which is developing in 2021 and beyond, noting several countries in Africa had been adversely affected by funding constraints.  The committee called on donors to maintain funding of polio eradication activities, as the potential for reversal of progress appears high, with many years of work undone easily and swiftly if WPV1 spreads outside the endemic countries.

Noting the serious situation in Afghanistan, the committee welcomed the recent agreement regarding mosque to mosque vaccination campaign activities but urged using multiple vaccines to avoid outbreaks of other vaccine preventable diseases such as measles.

Based on the current situation regarding WPV1 and cVDPV, and the reports provided by affected countries, the Director-General accepted the Committee’s assessment and on 19 February 2021 determined that the situation relating to poliovirus continues to constitute a PHEIC, with respect to WPV1 and cVDPV… 

::::::
::::::

WHO/OCHA Emergencies

Editor’s Note:
Continuing with this edition, we include information about the last apparent update evident on the WHO emergency country webpages, recognizing almost universal and significant interims since last update regardless of the level of the emergency listed.

WHO Grade 3 Emergencies [to 20 Feb 2021]

Democratic Republic of the Congo – No new digest announcements [Last apparent update: 12 Jan 2021]
Mozambique floods – No new digest announcements identified [Last apparent update: 3 November 2020]
Nigeria – No new digest announcements identified [Last apparent update: 29 Jun 2020]
Somalia – No new digest announcements identified [Last apparent update: 17 July 2020]
South Sudan – No new digest announcements identified [Last apparent update: 4 February 2020]
Syrian Arab Republic – No new digest announcements identified [Last apparent update: 24 October 2020]
Yemen – No new digest announcements identified [Last apparent update: 30 June 2020]

::::::

WHO Grade 2 Emergencies [to 20 Feb 2021]
Afghanistan – No new digest announcements identified [Last apparent update: 5 July 2020]
Angola – No new digest announcements identified [Last apparent update: 03 December 2020]
Burkina Faso – No new digest announcements identified [Last apparent update 04 février 2021]
Burundi – No new digest announcements identified [Last apparent update: 04 July 2019]
Cameroon – No new digest announcements identified [Last apparent update: 22 August 2019]
Central African Republic – No new digest announcements identified [Last apparent update: 12 June 2018]
Ethiopia – No new digest announcements identified [Last apparent update: 22 August 2019]
Iran floods 2019 – No new digest announcements identified [Last apparent update: 12 March 2020]
Iraq – No new digest announcements identified [Last apparent update: 16 December 2020]
Libya – No new digest announcements identified [Last apparent update: 7 October 2019]
Malawi Floods – No new digest announcements identified [Last apparent update: 09 October 2019]
Measles in Europe – No new digest announcements identified [Last apparent update: 16-12-2020]
MERS-CoV – No new digest announcements identified [Last apparent update: 8 July 2019]
Mozambique – No new digest announcements identified [Last apparent update: 03 November 2020]
Myanmar No new digest announcements identified [Last apparent update: :: 3 January 2021
Niger – No new digest announcements identified [Last apparent update: 11 février 2021]
occupied Palestinian territory – No new digest announcements identified [Last apparent update: 4 September 2019]
HIV in Pakistan – No new digest announcements identified [Last apparent update: 27 August 2019]
Sao Tome and Principe Necrotizing Cellulitis (2017) – No new digest announcements
Sudan – No new digest announcements identified [Last apparent update: 24 June 2020]
Ukraine – No new digest announcements identified [Last apparent update: 1 May 2019]
Zimbabwe – No new digest announcements identified [Last apparent update: 10 May 2019]

::::::

WHO Grade 1 Emergencies [to 20 Feb 2021]

Chad – No new digest announcements identified [Last apparent update: 30 June 2018]
Djibouti – No new digest announcements identified [Last apparent update: 25 novembre 2020]
Kenya – No new digest announcements identified [Last apparent update: 11 December 2020]
Mali – No new digest announcements identified [Last apparent update: 3 May 2017]
Namibia – viral hepatitis – No new digest announcements identified [Last apparent update: 20 July 2018]
Tanzania – No new digest announcements identified [Last apparent update: 21 October 2020]

::::::
::::::

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 Response Update No. 15 – 16 February 2021

Yemen – No new digest announcements identified

::::::

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.
East Africa Locust Infestation
:: Desert Locust situation update 16 February 2021

COVID-19 – No new digest announcements identified

::::::
::::::