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

cmillard@csis.org

https://www.csis.org/programs/global-health-policy-center/polio-eradication