Inactivated Polio Vaccine and Its Role in Eradication Plan
By Lois Privor-Dumm
It’s been just under a decade since the focus of my work shifted to resource-constrained countries. At the time, it seemed a far-off dream that so much progress could be made in protecting children from vaccine-preventable diseases. Eradication efforts had only ever succeeded against one disease – smallpox – and there were still many cases of polio in endemic countries (which at the time were Afghanistan, India, Nigeria, and Pakistan). Immunization was discussed, but never received the focus it does today. Now, on this World Polio Day, I reflect on where the world was and where it is today - closer than ever to reaching a goal of ending polio for good – AND doing it while strengthening immunization programs that have been all too weak in the past.
The rollout of IPV in the Philippines was marked by a ceremony attended by several health dignitaries including the Secretary of Health, Enrique Ona, the Undersecretary of Health, Jeanette Garin and the Assistant Secretary of Health Enrique Tayag among other high-ranking officials.
In 1988, when the Global Polio Eradication Initiative (GPEI) began, polio paralyzed more than 1,000 children worldwide every day. Today thanks to millions of volunteers more than 2.5 billion children have been immunized against polio. Global immunization campaigns have reduced polio by 99% worldwide. Eradication is within reach.
This year kicked off with a huge milestone, with India being declared polio-free in January, leaving just three countries with ongoing transmission. While Pakistan faces many challenges and has seen an increase in polio cases this year, Nigeria has had the fewest cases of wild poliovirus ever, with just six cases so far this year, and Afghanistan’s burden also remains low with just 12 cases this year.
Another important step forward was taken this year as countries began introducing inactivated poliovirus vaccine (IPV), an important milestone in the Polio Eradication and Endgame Strategic Plan, an ambitious but achievable plan endorsed by the World Health Assembly in 2013. The plan calls on countries to introduce at least one dose of IPV into routine immunization schedules and gradually withdraw all oral polio vaccines (OPV). Until now, OPV has been the primary tool in the global polio eradication effort, and has been instrumental to achieving the reach necessary to eliminate polio from all but three countries, and to reduce cases to a mere fraction of historic trends in Nigeria, Pakistan, and Afghanistan. However, new evidence now clearly demonstrates that adding one dose of IPV to multiple doses of OPV is the most effective method available to stop the virus and protect children.
The amazing part is that countries are introducing IPV along with other important new vaccines. In September, Nepal became the first country to introduce IPV with Gavi support. Gavi-supported rollouts will continue, as more than 90% of Gavi-eligible countries have applied for support. Next month, Nepal is also expected to introduce pneumococcal conjugate vaccine. Gone are the days when countries have to wait years between vaccine introductions. In fact, in 2014, five countries have introduced more than one vaccine already, and nearly 15 more multiple introductions are planned for next year, accelerating the path to reducing both child death and severe illness.
But it’s not only Gavi supported countries that are making strides. Middle-income countries, where most of the world’s poor reside, are also recognizing the importance of IPV and making the investment to introduce this and other new vaccines. Earlier this month, the Philippines became one of the first non-GAVI countries to start the transition from an all-OPV schedule to add one dose of IPV. The global rollout of IPV will continue across 126 countries through the end of 2015.
IVAC is proud to be part of the global efforts to help eradicate polio and support the introduction of new vaccines through targeted advocacy efforts in middle-income countries, helping to engage and sensitize civil society, and supporting communications activities of partners. It is a big job ahead, but with committed governments, partners and advocates, we now know it is possible. The hard part of our job as advocates is just beginning, but we look forward to more milestones in the fight against polio in the coming year, as the finish line gets closer.
Lois Privor-Dumm, MIBS, is Director of Policy, Advocacy & Communications