For the sake of clarity and consistency
in all Rotary publications and information, the International PolioPlus Committee has adopted the following set of
frequently reported statements, statistics, and terms concerning the PolioPlus Program and the global polio eradication
effort, and encourages all members in the global partnership for polio
eradication to adopt similarly consistent statements and figures. The Committee has also requested a wide
dissemination within Rotary for these statements. The Committee reviews these statements at
each meeting, to ensure that they remain current and appropriate.
1. A statement on the goal of the PolioPlus program:
“The goal of the PolioPlus
program is the global certification of polio eradication. By eradication, WHO, the Global Commission on
Certification and Rotary mean the interruption of the transmission of the wild
poliovirus.”
2. A statement on Rotary International's
contribution to the polio eradication
effort:
“By the time the world is
certified polio-free, Rotary’s contributions to the global polio eradication
effort will exceed US$1.2 billion. In
addition, millions of dollars of 'in-kind' and personal contributions have been
made by and through local Rotary clubs and districts for polio eradication
activities. Of even greater significance
has been the huge volunteer army mobilized by Rotary International. Hundreds of thousands of volunteers at the
local level are providing support at clinics or mobilizing their communities
for immunization or polio eradication activities. More than one million Rotarians worldwide
have contributed toward the success of the polio eradication effort to
date."
3. A
statement on the approximate dollar amount spent on the global polio
eradication effort each year:
“From 2012 through 2013, an
estimated US$1 billion per year from all sources is needed in donor
contributions to fully implement the activities of the Global Emergency Action
Plan Plans are being developed related to the funding needs for the polio
endgame strategy which is anticipated to extend to the end of 2018. This level
of expense is expected to decrease as wild polio virus transmission is
interrupted in the three remaining polio endemic countries . Rotary will have
contributed over US$1.2 billion to a program that is expected to total
approximately US$11 billion by the time that transmission is interrupted in all
countries,.”
4. A statement on how the budget for the Global Polio
Eradication Initiative is prepared:
“The budget for the Global Polio
Eradication Initiative is prepared by the WHO and UNICEF in consultation with
their country offices and ministries of health. It is reviewed and revised quarterly
to reflect changing epidemiology as well as new contributions and financial
commitments made by Rotary and other donors to the program. Complete information about the global polio
eradication budget is available to the public on the website: http://www.polioeradication.org/Financing.aspx.”
5. A statement on Rotary’s contribution to the Global Polio
Eradication Initiative:
“Rotary International’s
contribution to the Global Polio Eradication Initiative since 1988 accounts for
nearly 12 % of all contributions to the global budget through 2011 and
represents approximately 51 % of private sector contributions to the
Initiative. In addition, Rotary plays a leading role in soliciting financial
support from donor nation governments, an effort which since 1988 has achieved nearly
US$6 billion in contributions.”
6. A statement on what Rotary’s
contribution pays for:
“In the initial stages of PolioPlus , Rotary paid for oral polio vaccine and
supported start-up costs for Rotarians’ social mobilization efforts in endemic
countries. Since the mid-1990s, Rotary has conferred continuously with its
spearheading partners (WHO, UNICEF and CDC) to determine how to deploy PolioPlus funds to achieve the greatest impact on
global program needs. Currently, Rotary is funding the following areas:
salaries for technical advisers, operational support, surveillance, social
mobilization and stipends for the millions of volunteers who conduct NIDs and
perform house-to-house follow-up visits and research into new products and
approaches to facilitate eradication.”
7. A statement on the number of nations
benefiting from PolioPlus grants:
“To date, 122 nations around the
world have benefited from PolioPlus grants for polio immunization and
eradication efforts.”
8. A
statement on the number of polio cases prevented annually through immunization:
“From the launch of the global
initiative in 1988, more than 7 million people, mainly in the developing world,
who would otherwise have been paralyzed, will be walking because they have been
immunized against polio. More than 650,000
cases of polio are now prevented each year by the efforts of governments and the
partnership of the World Health Organization (WHO), Rotary International, the
United Nations Children’s Fund (UNICEF), the United States Centers for Disease
Control and Prevention (CDC), and the overseas development agencies of donor
nations.”
9. Statements on the number of children
immunized against polio:
a. Since 1985, when Rotary
implemented the PolioPlus program:
"As a result of the efforts
of Rotary International and its Foundation and those of our partners, more than
two billion children have received oral polio vaccine."
b. immunizations in 2011:
“As part of the global polio
eradication effort in 2011, more than 400 million children were vaccinated in 40
countries using more than 2.2 billion doses of oral polio vaccine.”
10. A statement on the percentage of the world’s children that
live in polio-free countries:
“In 1988, 10% of the world’s children lived
in polio-free countries; as of 1 January
2012, over 90 % are living in polio-free countries.”
11. A statement on the reduction of cases of
polio:
“The number of cases of polio has
declined by 99% since Rotary launched the PolioPlus program.”
12. A statement on the cost of vaccine per
child:
“A child can be protected against
polio for as little as US$ .60 worth of vaccine.”
13. A statement on the number of polio
endemic countries:
“Since Rotary began its PolioPlus Program, the number of countries which
continue to be polio endemic has declined from over 125 countries in 1985 to 3
countries in 2012. The number of polio cases has declined by more than 99%
since 1985.”
14. A statement on the number of countries that are polio-free and
the number of people who live in countries, territories, and areas that have
been certified polio-free by independent commissions:
“Two hundred and ten (210)
countries, territories and areas are now free of indigenous polio, and 134 of
these have been certified polio-free by independent commissions. In June 2002, the WHO European Region was certified
polio-free, joining the WHO Regions of the Americas
15. Statements on polio in Nigeria,
Afghanistan and Pakistan and polio in outbreak countries:
“At the start of 2012,
transmission of indigenous poliovirus had been interrupted in all but three
countries (Nigeria, Pakistan, and Afghanistan).
There is strong evidence that the
approaches in the current Strategic Plan 2010-2012 work, demonstrated in
particular by the absence of polio cases in India since January 2011, one of
the most technically challenging places from which to eradicate polio. However,
in October 2011, the Independent Monitoring Board (IMB), established at the
request of the World Health Assembly to independently monitor the progress
towards a polio-free world, expressed concerns regarding the risks to achieving
success. Challenges in particular remain in reaching sufficient number of
children in the endemic countries Nigeria, Pakistan and Afghanistan, and the
re-established transmission countries of Angola, Chad and the Democratic
Republic of Congo.
In response to the IMB’s report,
the Global Polio Eradication Initiative immediately initiated an extensive
program of work to strengthen its accountability processes, promote innovation
in managerial and tactical processes as well as eradication tools, ensure
critical real-time evaluation of eradication plans in key infected areas,
deepen stakeholder engagement, and reduce outbreak risks. Recognizing the IMB’s
assessment that there remains a high risk of missing the end-2012 milestone for
interrupting all wild poliovirus transmission globally, and particularly in
Pakistan, planning and budgeting for an extension of the intensified
eradication effort into 2013 is under way. The updated plan for 2012-2013 and
beyond will be informed by an independent program review drawing on the lessons
learned in 2010-2011, the findings of the IMB and the potential impact of additional
eradication tools and tactics.
In May 2012, the World Health
Assembly declared the completion of polio eradication a “programmatic
emergency” for global public health, requiring the full implementation of
strategies, and the application of appropriate vaccination recommendations for
all travelers to and from infected areas as necessary.
Statements on polio in outbreak
countries:
”As long as indigenous wild
poliovirus transmission remains anywhere in the world, the risk of
international spread of poliovirus will remain. Particularly vulnerable are
high-risk countries, i.e. those bordering endemic areas, those with close
socio-cultural-economic ties to endemic areas and those with low routine
immunization levels.
Experience since 2003 has shown
that outbreaks can be rapidly stopped, if internationally-agreed outbreak
response guidelines are fully implemented. However, failure to fully implement
these guidelines can result in persistent outbreaks, i.e. where transmission of
imported poliovirus persists for >12 months. In early 2011, persistent
outbreaks are ongoing in Angola, Chad and the Democratic Republic of Congo and
the border area of Kenya/Uganda. Additionally, certain high-risk areas are
prone to recurrent importations, notably in a band of countries across West
Africa, central Africa and the Horn of Africa. However, confirmation in August
2011 of a new outbreak in China (due to an importation from Pakistan)
underscores the dangers ongoing transmission continues to pose to polio-free
countries everywhere.
16. A
statement on the contribution of Rotary’s advocacy efforts:
Public Advocacy Efforts: “In 1995, Rotary International launched a task
force to advocate the cause of polio eradication to donor governments. The work of this task force, later to be part
of the Polio Advocacy Group, with additional partners, has resulted in more
than US$8.5 billion in contributions to the Global Polio Eradication
Initiative. These advocacy efforts are
ongoing and will be continued as necessary.”
17. Definitions of the terms Partners,
Spearheading Partners, Coalitions and Donors are outlined below:
“When
used as generic terms to refer to organizations who are also sharing in work
and funds to eradicate polio, either partners or partnerships is preferred.
Generally, coalition
should
be used to describe a specific group. Donor is a term to describe an entity which is providing funds to eradicate
polio and should be limited to those whose primary or exclusive role is in
providing funds. “Donor” should be avoided in describing Rotary
International or its Foundation.
Where partners is
used to delineate specific organizations engaged in global eradication of polio,
spearheading partners refers to the World
Health Organization (WHO), Rotary International (RI), the U.S. Centers for Disease Control and
Prevention (CDC), and the United Nations Children’s Fund (UNICEF).
Rotary is engaged in one specific coalition; that is
the coalition to advocate for
increased contributions by the U.S. Government to global polio
eradication. The coalition includes The Rotary Foundation of R.I., The United
Nations Foundation, The Task Force for Child Survival and Development, the U.S. Fund for UNICEF, the American Academy of Pediatrics and the March of Dimes Birth Defects Foundation. Rotary is the leader.
Rotary is the leading non-governmental
contributor. Whenever possible, most of the polio eradication costs are borne
by the polio-endemic countries themselves.
However, as the battle against polio is taken to the poorest,
least-developed nations on earth, and those in the midst of civil conflict, up
to 100 percent of the NID and other polio eradication costs must be met by
external donor sources.
Polio-specific contributions have been made by the
following governments: Andorra,
Australia, Austria, Azerbaijan, Belgium, Brunei Darussalam, Canada, Cyprus,
Czech Republic, Denmark, Finland, France, Germany, Hungary, Iceland, Ireland,
Italy, Japan, Kuwait, Liechtenstein, Luxembourg,
Malaysia, Malta, Monaco, the
Netherlands, New Zealand, Norway, Oman, Portugal, Qatar, Romania, Republic of Korea, the Russian
Federation, Saudi Arabia, Singapore, Slovak Republic, Spain, Sweden,
Switzerland, Taiwan, Turkey, the
United Arab Emirates, the United Kingdom and the United States of America. It is also important to note that the
following countries have all contributed domestic resources for polio
eradication: Angola, Bangladesh , Congo,
Gabon, Ghana, India, Indonesia, Namibia, Nepal, Nigeria, Pakistan, Rwanda and
Yemen..”
18. A
statement on global certification:
“Global Certification: An independent commission will consider
global certification when no wild polio virus associated cases have occurred
for at least three years, in the presence of certification-standard
surveillance, and all wild poliomyelitis stocks have been appropriately
contained.”
19. A statement on the cessation of polio
immunization with Oral Polio Vaccine:
"After interruption of wild
poliovirus transmission, appropriate containment of poliovirus stocks, and
establishment of sufficient polio vaccine stockpiles, immunization with routine
OPV can and should be stopped, resulting in substantial financial savings
(note: the magnitude of these savings will depend on national decisions on the
introduction of IPV). This stoppage
could be as early as three years following the global interruption of wild
poliovirus transmission.”
20. A statement on estimated annual global
savings after cessation of
immunization:
“Once polio has been eradicated,
the world will reap substantial financial, as well as humanitarian, dividends
due to foregone polio treatment and rehabilitation
costs. Depending on national decisions on the future
use of polio vaccines, these savings could exceed US$1 billion per year. A
study published in November 2010 in the leading medical journal Vaccine
estimates the economic benefits of the GPEI at between US$40-50 billion based
on activities from 1988 to 2035.”[1]
21. A statement on the annual cost of
immunization of U.S.
polio:
“The United States Centers for
Disease Control and Prevention (CDC) estimates that more than US$350 million
per year is spent on immunizing U.S.
22. A statement on type II wild poliovirus:
“Type II wild poliovirus has not
been found since October 1999, suggesting that transmission of one of the three
types of wild poliovirus may have been interrupted.”
23. A statement on the importations of the
poliovirus:
“Importations will continue to
occur until endemic transmission of the poliovirus (from where it originates)
is successfully interrupted. The key priority therefore is to rapidly stop the
remaining endemic transmission chains. At the same time, however, the new GPEI
Strategic Plan puts forth key activities to cement the gains of polio
eradication, by protecting polio-free areas. Past experience and mathematical
modeling can now largely predict areas at highest risk of importations and
outbreaks, and efforts will focus on boosting population immunity levels in
those areas to minimize the risk and consequences of potential importations.”
24. A statement on instances of
vaccine-derived polio:
"Since 2000, there have been
21 episodes of circulating vaccine-derived poliovirus (cVDPV) resulting in 547
polio cases including in the Island of Hispaniola (which includes Haiti and the
Dominican Republic), Cambodia, Democratic Republic of Congo, Ethiopia, Indonesia, the Philippines, Madagascar,
Myanmar, Nigeria, and China. During that period, over 15 billion doses of OPV
have been administered to more than 2.5 billion children, and as a result more
than 3.5 million polio cases were prevented.
Circulating VDPVs occur when high
proportions of children are susceptible to poliovirus infection, due to very
low vaccination coverage. If routine or supplementary immunization activities
(SIAs) are poorly conducted, the population is left susceptible to poliovirus,
whether from vaccine-derived or wild poliovirus. Hence, the problem is not with
the vaccine itself, but low vaccination coverage. If a population is fully
immunized, they will be protected against both vaccine-derived and wild
polioviruses.
In 2012 there were 51 cVDPVs
reported, compared with 178 cVDPVs in 2009 – a more than 70% reduction."
25. A statement on the Vitamin A distribution
during polio National Immunization Days:
“Since 1998, the inclusion of
Vitamin A supplements on NIDs has averted an estimated 1.5 million childhood
deaths. Vitamin A comes in liquid form in soft gelatin capsules that are opened
to give as drops. It is an essential
nutrient that is needed for healthy growth and development. Vitamin A deficiency can lead to blindness,
increased risk of infection, and a 25 percent greater risk of dying from
childhood diseases such as measles, malaria and diarrhea. The administration of Vitamin A during polio
National Immunization Days has resulted in fewer childhood deaths from measles,
diarrhea and other causes.”
The Committee further requests that the
General Secretary, in official and public releases and statements,
follow the above expressions. Finally,
the Committee requests that all other RI and TRF officials and spokespersons,
and all organizations which report to the Committee, adhere to the approved
statements and observe the recommended terminology.
UPDATE: July 2012
International PolioPlus Committee
