Polio Endgame and Legacy
What Work Needs To Be Done?
With the world on the verge of eradicating wild poliovirus, GPEI developed the polio Post-Certification Strategy (PCS) to define technical standards and core activities to ensure the world remains polio-free after global certification.
PCS has three goals:
- Contain poliovirus: laboratories must ensure the destruction or safe storage of any WPV infectious and potentially infectious materials
- Protection populations: withdraw oral polio virus (OPV) from use and immunize populations with inactivated polio virus (IPV) to prevent the possible re-emergence of any poliovirus. Calculating the annual global cost savings attributed to discontinuing the use of OPV is extremely complicated, but savings are estimated to be $40 to $50 billion, underlying the critical importance of getting the job done.
- Detect and respond: High-quality global surveillance must promptly detect any poliovirus in a human or in the environment and rapidly respond to prevent transmission.
As the world gets closer to achieving eradication, GPEI will begin to transition key knowledge, infrastructure, and lessons learned from over three decades of operations. There are three principal aspects of this work:
- Mainstreaming essential polio eradication functions, such as immunization, surveillance, communication, response, and containment, into other ongoing public health programs
- Ensuring that the knowledge generated and lessons learned during 25 years of polio eradication activities are shared with other health initiatives
- Where feasible, desirable, and appropriate, transitioning the capacities, processes and assets that the GPEI has created to support other health priorities
* For the comparator, which assumes only routine vaccination for polio historically and into the future (i.e., no GPEI), we estimate poliomyelitis incidence using a dynamic infection transmission model and costs based on numbers of vaccinated children. Cost-effectiveness ratios for the GPEI vs. only routine vaccination qualify as highly cost-effective based on standard criteria. We estimate incremental net benefits of the GPEI between 1988 and 2035 of approximately 40–50 billion dollars (2008 US dollars; 1988 net present values). R.J. Duintjer Tebbens et al. / Vaccine 29 (2011) 334–343