POLIOERADICATION:OVERSIGHTANDTRANSITION
Maintainingfocuswhilelookingtothefuture
ChrisMillardProgramManagerandResearchAssociate
GlobalHealthPolicyCenterCenterforStrategicandInternationalStudies
May17,2017
OVERVIEW
• Oversightandtransitionplanningtodate• Globalgovernanceandoversightstructure• IMB• EthiopiaandIndiaexamples
• Oversightandtransitionplanninggoingforward• Oversightchanges,includingnewIMBandTIMB• Transitionchallengesasweapproachzero• Sun-settingtheGPEI
• Questionsgoingforward
OVERSIGHTANDTRANSITIONTODATE
PROGRAM&OVERSIGHTOVERVIEW
WorldHealthAssembly
WHO Rotary CDC UNICEFGates
Foundation
PolioOversightBoardPPG
IMB GCC
SAGE
UNICEFRegionalOffices
WHORegionalOffices
PolioSteeringCommittee
TAGs
INDEPENDENTMONITORINGBOARD
• Eightmemberpanel,chairedbySirLiamDonaldson• Independent• Broadrangeofglobalhealthknowledge• Reportsareaccessibletoanon-technicalaudience
IMPACTOFTHEIMB
• Callingforemergencydeclarationforpolio• Focusingonmissedchildren• PushingforthedevelopmentofthePEESP• EngagingIHRtoaidpolioeradication• Honoringfront-linestaff• RetoolingGPEIcommunications• Promotingfinancialtransparencyandbetterdonorengagement• ExpandinguseofIPV
IMPACTOFTHEIMB:TRANSITIONPLANNING
“Sowhatistohappenwhenpoliohasbeeneradicated?Howwillallofthispotentialbeused?Orwillitslegacybescatteredtothefourwinds?”
-IMBJune2012Report
TRANSITIONINACTION:ETHIOPIA
• Poliofundingiscurrentlysupporting…
• Vehicles,laboratoryservices,training,andpersonnel• SalariesofkeyEPIpersonnel• Immunizationcoldchaincapacities• Technicalassistanceandsupervision• Surveillanceofficers• Newborntracking• Socialmobilizationefforts
TRANSITIONINACTION:ETHIOPIA
TRANSITIONINACTION:INDIA
• Overthepastseveralyears,Indianhealthofficialshave:
• Usedpolioprogramassetsandstrategiestoprovidehealthservicestohard-to-reachpopulations• Takenonfundingofthenationalpoliolaboratorynetwork• Expandedfunctionsofthepoliolabnetworktoincludemeaslesandrubella• Collaboratedwithinternationalpolioprogrampartnerstoraisechildhoodimmunizationrates• Includessocialmobilizationandmicro-planningtechniquesdevelopedforpolio
TRANSITIONINACTION:INDIA
OVERSIGHTANDTRANSITIONGOINGFORWARD
OVERSIGHTCHANGES
WorldHealthAssembly
WHO Rotary CDC UNICEFGates
Foundation
PolioOversightBoardPPG
NewIMB GCC
SAGE
UNICEFRegionalOffices
WHORegionalOffices
PolioSteeringCommittee
TIMB
TAGs
• Chair– SirLiamDonaldson,UK• Dr.JonAndrus,USA• Dr.SalahAlAwaidy,Oman• Dr.MohamedAbdiJama,Somalia• Dr.JeffreyKoplan,USA• Prof.YvonneMaldonado,USA• Dr.BjornMelgaard,Denmark• Ms.AnneMtonga,Zambia• Dr.MirtaRosesPeriago,Argentina• Dr.RomaSolomon,India• Ms.Meidemarie Wieczorek-Zeul,Germany
TransitionIMB
NEWMEMBERS
• Chair– SirLiamDonaldson,UK• Dr.TomFrieden,USA• Dr.MuhammadPate,Nigeria• Ms.SueGoldstein,SouthAfrica
NewIMB
• Howdoesthegloballevelbestsupportcountry-leveltransitionplanningandimplementation?
• Ramp-downinfundingwhileextendingthetimeframeuntil2020
• Potentiallyhinderingsurveillanceorimmunizationeffortsfrombudgetaryconstraints
• WHOstaffcuts• Countryorprogrammaticcomplacency• Securitycompromisedareasandinaccessiblepopulations
TRANSITIONCHALLENGES
PolioEradicationFundingTail
Estimated Costs for Polio Eradication by
Activity($USM, not
including India self-funded
costs)
Nigeriainterrupts
Pak/Afginterrupt
GlobalCert.
2013– 2019:$7.0B
Intermediateassumptions
2020– 2026:$0.9B
16
Pre-Certification Pre-Cessation
InterruptionbOPV
CessationCertificationToday
+3years +1year
2013 PolioEradication&EndgameStrategicPlan PolioPost-CertificationStrategicPlan 2030
Post-Cessation
(A)GPEI (C)Non-poliogroups(B)Overlapperiod-
GPEI&othernon-poliogroups(atleast12
months)
• Immunization• Surveillance• Vx Management• Campaigns• Outbreakresponse• Containment• Technicalassistance• Transitionplanning• Advocacy&RM• Communications• Certification• Research
• Immunization• Surveillance• Vx Management• Outbreakpreparedness• Containment• Research
• Immunization• Surveillance• Vx Management• Campaigns• Outbreakresponse• Containment• Technicalassistance• Transitionplanning• Advocacy&RM• Communications• Certification• Research
SunsetatCertification
GPEICURRENT&FUTUREFUNCTIONS
QUESTIONSMOVINGFORWARD• Whatwouldbethevalueaddedofmainstreamingsomeoftheseassets/bestpractices?• Howdoyoumainstreamtheseassets/bestpractices?• Whopicksuptheoperationsorfundingofassetspost-GPEI,oncethepoliolineitemisnomore?• HowdoyounavigatethecurrentpoliticalclimateintheUS?
THANKYOU
https://www.csis.org/programs/global-health-policy-center/polio-eradication
