polio emergency operations plan - who...feb 01, 2012 · 1. how should the gpei emergency...
TRANSCRIPT
Polio Emergency Operations Plan Context & major elements
SAGE
February 2012
"DECLARES polio eradication a
programmatic emergency for global
public health, requiring full strategy
implementation, strong national
oversight & accountability, and
vaccination recommendations for
travelers to & from infected areas "
21 January 2012
WHO Executive Board Resolution
3
15-16 Feb GPEI strategy/innovation review
17 Feb SAGE review of 'framework' for global plan
March Nigeria & Pakistan expert consultations to finalize national emergency actions plans.
Finalize international partner support/plans.
April SAGE review of Nigeria & Pakistan emergency action plans & consolidated global plan
May World Health Assembly debate on polio
Timeline
4
1. How should the GPEI emergency operations plan be
strengthened to help ensure infected countries, esp.
Nigeria & Pakistan, can get 'back on track' in 2012?
2. What guidance can SAGE give to national programmes
(esp. Nigeria & Pakistan) as they revise/refine national
emergency action plans?
3. Should new milestones be established before end-
2012 and the current strategic plan?
Questions to SAGE
Ensure all key areas of Nigeria, Pakistan, Afghanistan are reaching necessary coverage levels by end-2012
Sustain momentum in Chad, DR Congo, Angola to interrupt transmission in 2012
Heighten GPEI partner accountability & coordination to improve sub-national outcomes in these countries.
Goals
Endemic country
Wild virus type 3
Country with importation case
Wild virus type 1
India: >12
months with no
polio for 1st time
in history.
Context: polio cases last 6 months
0
20
40
60
80
100
120
140A
ng
ola
Chad
DR
C
Afg
han
Pak
ista
n
Nig
eria
Ca
se
s
Indigenous virus Re-established virus
Context: increasing polio cases 2nd half 2011
Nigeria & Pakistan
• type 1 & 3 WPV
• int'l exports
Context: poor program performance monitoring*
Correlation is 30% with LQAS!
Pakistan: district SIA monitoring coverage
Nigeria: district SIA monitoring coverage
Correlation is 17% with LQAS!
* analyses courtesy of the Global Good Fund
Immediately enhance accountability & management of core eradication strategies
Rapidly introduce & scale-up best practices/lessons learnt to improve strategy implementation
Accelerate innovation to address systemic problems
Operational Priorities
30 10 100 30 10 30 10 30 100 100
30 20 30 20 30 100 100
30 30 60
100 10 40 10 40
8 CHD 18 CHD 28 2 30 50
30 50
Sudan 50 50 50 50
South Sudan 50 50 50 50
West Africa
Horn of Africa
35 65 35
100
35 65 35 65
50 50 50 50
100
Central Africa
100 100 100
Southeast Asia
100
Myanmar
Europe
Russian Federation*
50 50 50 50
50 50 50 50
Georgia* 50
Ukraine
50 50 50 50
*self-financing and not included in the FRR costing
CHD 100
100
50
100 100
50
100 100
100 100
Djibouti 100
100 100
50
100
50
100 100
100
100100100 100
100
100 100
100
100
100
100 100100
100 100
100
100
100
100
100 100
100
100 100 50
100 50
100 100
100
50
100
60
50 50
60 60
100
30 30
100
Turkmenistan
100
100
Kazakhstan
Uzbekistan
50
50 50
100
CHD 75
CHD 89
CHD 75
100
Burundi
CHD 100
100
100 100
100 100 100
100
100 100
100
100
50
100
100 100
100
100
100 100 100
100
100
100
100 100
100
100
100
100 100
100
100
100
100 100
100 CHD 100
100
100 100 100 100
100
100 100
100
100
100
100
100
Chad CHD 100 100 100 100100 50 100 100 100
Angola 100
50
DR Congo 6
50
CHD 100
50 100 50 30
30
60
100 100
10040Afghanistan
Pakistan 100
100
Nigeria
India 100
100100
50
100
Liberia
100
Cote d'Ivoire
Niger 61
100
100Mali
Guinea
100
100
Ghana
Sierra Leone
100
100
Burkina Faso
Mauritania
Gambia
Senegal
Cape Verde
Kenya
Benin
Togo
Guinea Bissau
Ethiopia
Somalia CHD 100
Eritrea
Uganda
100Bangladesh
Cameroon
Rwanda
Central African Republic
11
100
Zimbabwe
CHD 25Nepal
Yemen
1Congo
5050
100
50
100 100 100100 30
100 60 100 100 100 30 30 30
60 60 60 30 10030
100
100
100
100
50 100 50 50
100 100 100 100
100 100 50 100 100
100
100 100
100 100
100
100
CHD 75
100
100 100 100
100
100
100 100
100 100 100 100
100
100 100
100
100
100 100 100
100 CHD 92
65 35
35 35
CHD 35 35
100 100 100
CHD 49 100 100
Gabon* 100
5050
CHD 100
CHD 100
100 100
Tajikistan 50 50
50 50
Kyrgyzstan
CHD 100
30 10 100 30 10 30 10 30 100 100
30 20 30 20 30 100 100
30 30 60
100 10 40 10 40
8 CHD 18 CHD 28 2 30 50
30 50
Sudan 50 50 50 50
South Sudan 50 50 50 50
West Africa
Horn of Africa
35 65 35
100
35 65 35 65
50 50 50 50
100
Central Africa
100 100 100
Southeast Asia
100
Myanmar
Europe
Russian Federation*
50 50 50 50
50 50 50 50
Georgia* 50
Ukraine
50 50 50 50
*self-financing and not included in the FRR costing
CHD 100
100
50
100 100
50
100 100
100 100
Djibouti 100
100 100
50
100
50
100 100
100
100100100 100
100
100 100
100
100
100
100 100100
100 100
100
100
100
100
100 100
100
100 100 50
100 50
100 100
100
50
100
60
50 50
60 60
100
30 30
100
Turkmenistan
100
100
Kazakhstan
Uzbekistan
50
50 50
100
CHD 75
CHD 89
CHD 75
100
Burundi
CHD 100
100
100 100
100 100 100
100
100 100
100
100
50
100
100 100
100
100
100 100 100
100
100
100
100 100
100
100
100
100 100
100
100
100
100 100
100 CHD 100
100
100 100 100 100
100
100 100
100
100
100
100
100
Chad CHD 100 100 100 100100 50 100 100 100
Angola 100
50
DR Congo 6
50
CHD 100
50 100 50 30
30
60
100 100
10040Afghanistan
Pakistan 100
100
Nigeria
India 100
100100
50
100
Liberia
100
Cote d'Ivoire
Niger 61
100
100Mali
Guinea
100
100
Ghana
Sierra Leone
100
100
Burkina Faso
Mauritania
Gambia
Senegal
Cape Verde
Kenya
Benin
Togo
Guinea Bissau
Ethiopia
Somalia CHD 100
Eritrea
Uganda
100Bangladesh
Cameroon
Rwanda
Central African Republic
11
100
Zimbabwe
CHD 25Nepal
Yemen
1Congo
5050
100
50
100 100 100100 30
100 60 100 100 100 30 30 30
60 60 60 30 10030
100
100
100
100
50 100 50 50
100 100 100 100
100 100 50 100 100
100
100 100
100 100
100
100
CHD 75
100
100 100 100
100
100
100 100
100 100 100 100
100
100 100
100
100
100 100 100
100 CHD 92
65 35
35 35
CHD 35 35
100 100 100
CHD 49 100 100
Gabon* 100
5050
CHD 100
CHD 100
100 100
Tajikistan 50 50
50 50
Kyrgyzstan
CHD 100
Core Strategies: intense OPV campaign schedule
Endemic
Re-established
Recurrent Importation Countries
Heightened national leadership & oversight
Dr Muhammad Ali Pate
Minister of State for Health
Nigeria
Dr Mamouth Nahor N'gawara
Ministre de la Santé Publique
Tchad
Ms. Shahnaz Wazir Ali
Prime Minister’s Special Assistant
Pakistan
Heightened oversight & emergency support
Heads of agency (quarterly)
Agency, NIE & PAK heads of programme (monthly)
Operational directors (weekly)
National heads of programme & partners (monthly/quarterly)
Coordinated country,
regional & headquarters
fora
13
Activation of emergency centres/procedures
Strategic Health Operations Centre (WHO)
Emergency Operation Center (CDC)
14
Activation of emergency centres/procedures
• 23 Jan: UNICEF Executive Director, established an inter-divisional Polio Emergency Coordinating Committee under Deputy ExD Geeta Rao Gupta
• Allows ExD to quickly identify &
resolve bottlenecks using UNICEF emergency procedures ExD Mr Tony Lake
Monthly in-depth
country analyses:
'what's not working?
why? adjustments?
Quarterly risk
assessments:
regional focus
"next problems?"
Weekly: active
WPV "what's
new? what to
do?"
Coordinated, focused country support
Real-time programme performance tracking
Nat'l plan progress
Surveillance
Broad analysis of
program determinants
Human Resources
Political Oversight
Security
SIA quality
Social Mobilization
Impact on transmission
Epidemiology & lab
Immediately enhance accountability & management of core eradication strategies
Rapidly introduce & scale-up best practices/lessons learnt to improve strategy implementation
Accelerate innovation to address systemic problems
Operational Priorities
Best Practices/Lessons Learnt
A) huge expansion of technical assistance
B) improved OPV campaign monitoring
C) expanded use of environmental surveillance
D) rapid scale-up of routine immunization services
E) enhanced access in conflict-affected areas
Accelerate Innovation
A) expanded age groups for outbreak response
B) GIS & GPS technologies to improve SIA quality
C) vaccination of travelers
D) new surveillance technologies (e.g. env surv)
E) IPV campaigns (with or without tOPV-bOPV switch)
Dates Target for infected districts*
Jan-Jun 2012 4 SIAs, at least 2 with >80% coverage
Jul-Dec 2012 3 SIAs with >90% validated coverage
Jan-Jun 2013 4 SIAs with >90% validated coverage
Jul-Dec 2013 3 SIAs with >90% validated coverage
Performance Targets
* LQAS-confirmed coverage targets
20
Importation country
Endemic country
Wild virus type 1
Wild virus type 3
Reported wild poliovirus cases, last 4 months
Polio today
Nepal
EC
Russian
Federation
UKUSCDC
Luxembourg
Monaco
Rotary
International
Bill and Melinda
Gates Foundation
Angola
World Bank
IFFIm
WHO
Australia
Unicef Regular
Resources
USAIDCanadaJapan
JICA Loan
Conversion
India
2012-13 Funding Gap:
US$1.09 B of $2.23 B budget
‘Other’ includes: the Gov'ts of Cyprus, Finland, Italy, Monaco, Nigeria, Nepal, and Romania; and other Institutions: CERF, Is lamic Development Bank, Shinnyo-en. As of 26 September 2011
Domestic
Resources
19%
Non-G8 OECD/
Other 2%
Multilateral
Sector
5%
Private Sector
14%
G8
10%
Budget & financing, 2012-13
22
1. How should the GPEI emergency operations plan be
strengthened to help ensure infected countries, esp.
Nigeria & Pakistan, can get 'back on track' in 2012?
2. What guidance can SAGE give to national programmes
(esp. Nigeria & Pakistan) as they revise/refine national
emergency action plans?
3. Should new milestones be established before end-
2012 and the current strategic plan?
Questions to SAGE