As
2022 draws to a close, I wanted to thank
each and every one of you for the
incredible work and contributions you have made to the global effort to eradicate
polio once and for all. You are all far
too many to name individually, so I would ask
you to share this note with all of
your own respective networks to pass on my gratitude.
2022,
I believe, will go down as a
year of ‘contrasts’, in the global effort to eradicate polio. On the one hand, we saw polio re-emerge in
places such as New York and London, in south-east Africa, and an increase in
new cases in Pakistan. But on the other
hand, 2022 saw perhaps some of the most
significant and important progress that we have ever seen and this is setting up the global effort for
a unique opportunity for success in 2023.
While
detection of polio from anywhere that it had previously been gone is of course
a setback , the reality is that events
such as New York and London, and indeed elsewhere, are being appropriately
managed. We must focus our eye clearly
on those areas which hold the key to a polio-free world, namely in the endemics and
consequential geographies. And
here the news is actually really encouraging.
In
Pakistan, notwithstanding the
increase in new cases, the outbreak is
geographically confined, thanks to concerted emergency efforts led by
the government and supported by partners.
All cases are concentrated in just six districts of one province, out of
a total of 180 districts in the country.
And while virus has been detected outside of these areas it has not succeeded in re-establishing a foothold
outside the core endemic zone. I n 2020, the country was affected by 11
separate and individual chains of transmission . This was reduced to four in 2021, and in
2022, only a single chain remains. It
means individual virus lines are being successfully knocked out. It means the approaches being implemented in
the country are working.
In
Afghanistan too, an epidemiological
deep-dive reveals an
encouraging picture. Just over twelve months on from the political
and security transition in country, access to all children continues to
improve, including more than 3.5 million children who had not been reached for
almost five years, albeit against a
tragic backdrop of a severe and acute humanitarian crisis. Out of the country’s 34 provinces, just two
remain active with endemic transmission.
And where Afghanistan was
once affected by eight separate
transmission chains, in 2022 there now remains just two.
Such
epidemiological and virological progress
is similar to what epidemiologists
observed during the ‘end game’ efforts in other previous global polio reservoirs, notably Nigeria, India
and Egypt, all giving hope that these remaining two endemic countries
are on the right track.
In
terms of cVDPV outbreaks, almost 90 percent of the disease burden is in three
sub-national geographic areas, namely eastern
DR Congo, northern Yemen and northern Nigeria . These areas also overlap with some of the
highest proportion of ‘zero dose’ children,
ie those children who are either
un- or under-vaccinated. The situation
in northern Nigeria is particularly
encouraging: having seeded
outbreaks in more than 19 countries, Nigeria accounted for two-thirds of all
global cases in 2021. In the second half
of 2022, however, we have seen a dramatic decrease in new cases, with only nine
reported during that time. And although the
outbreaks in Yemen and DR Congo continue to expand, there is a clear plan for
early 2023 to urgently address these respective situations. T he new nOPV2 , a key tool in this fight, continues to be rolled-out at an accelerated
pace, with more than 530 million doses now administered.
This
brings us of course to the WPV outbreak in south-east Africa. Following detection of the outbreak in
February, a series of multi-country outbreak response campaigns were
immediately launched, in five countries of the subregion, to urgently stop this
outbreak. This effort is ongoing, and
quality of outbreak response continues to improve from campaign to
campaign. And as the case in the other
‘most consequential geographies’, the focus is entirely on reaching zero-dose
children, by concentrating technical capacity and support on those areas with
the highest proportion of underreached children and communities. No WPV1 detection have been recorded outside
a single province in northern Mozambique in 2022. We are not yet at the end but momentum
continues to be sustained and this
is extremely encouraging.
2022
was of course the first year of the new GPEI Strategy - Delivering on a Promise
and this very much takes the COVID-19 reality into account. In addition to adapting our polio operations,
cross-programmatic integration has been accelerated by the COVID-19
pandemic. Polio staff across the world
continue to contribute to the COVID-19 response and immunization recovery efforts,
together with the introduction and administration of COVID-19 vaccines, as
highlighted in this report. This provides clear evidence of the broader
value of the polio network and its work to align its priorities with broader
public health efforts, notably global vaccine and immunization strategies. It also speaks to the importance of
effectively transitioning this
infrastructure , to ensure that it will continue to benefit broader public
health, emergencies and pandemic response efforts, long after the disease is
gone.
As
2022 draws to a close, the
programme is on a
strong epidemiological, operational and virological footing. We are absolutely on the right track, and
this realization should motivate all partners and stakeholders into overdrive. Throughout 2022, we saw tremendous displays
of global support , ranging from the
World Health Assembly, to the Rotary International Convention in Houston, USA,
to the G7 and G20. Perhaps the most
significant signal of support came at the global GPEI Pledging Moment at the World Health Summit in October 2022,
in Berlin, Germany, co-hosted by the Government of Germany, where global
leaders pledged an incredible US$2.6 billion to the effort. As 2022
draws to a close, we have also received very positive signals of support from
the UK and the EU/EIB.
Challenges
remain ahead. Zero-dose children have to
be reached in the most consequential geographies. Remaining financial resources to achieve
success have to be mobilized.
But in spite of initial appearances, 2022 put the world on
a strong footing for success in
2023. And of course, that is the target
clearly listed in the GPEI Strategy 2022-2026:
to interrupt all remaining virus transmission by end-2023 and to achieve
global certification by no later than end-2026.
There
is a clear momentum as the year draws to a close, that must be carried into
2023 for a final concerted push. Success
is in our hands. And all of you have
brought us here: thanks to your
individual efforts, you have brought the world on the threshold of being
polio-free. Your efforts have saved
children from lifelong paralysis, have saved lives. On behalf of the GPEI, all I can say is: Thank you for all you have done for polio
eradication! If we all redouble our
efforts one final time, I am sure we will make it in 2023.
Allow
me to finish with a quote by our fellow polio eradicator, friend and GPEI
vaccinator Sadiya from Kano ,
Nigeria, who addressed the Pledging Event in Berlin by video. She told the gathering: “ Together , we can
end polio in the world. I will try my
best. I hope you will too.” Let us follow Sadiya’s
example, let us do our best as well.
Together , let us end polio.
I
wish all of you and your close ones a very happy, peaceful, healthy
and blessed festive season, and all the very best wishes for a
successful 2023.
Best
regards
Aidan
O’Leary
