In its 41st meeting held in Geneva 1988, the World Health Assembly defined the year 2000 as a target for poliomyelitis eradication allover the world. And, in its 52nd meeting held in 1999 the WHA called upon the member states to accelerate the implementation of the eradication activities as well as containment.
In January 2004, a comprehensive plan was set to intensify activities in a serious and final attempt to put an end to the transmission of the polio virus (set by the end of 2004) and start implementing the new world strategy for the period 2004-2008 which aimed at poliomyelitis eradication and changing the timeframe for the international certification to be at 2008.
Globally, there are 3 WHO regions (135 countries) where certification of polio eradication was declared and surveillance process for their facilities was initiated for laboratory containment of poliovirus.
Global case load
Polio cases have decreased by over 99% since 1988, from an estimated 350 000 cases in more than 125 endemic countries then, to 1997 reported cases in 2006. In 2008, only parts of four countries in the world remain endemic for the disease - the smallest geographic area in history.
THE GLOBAL POLIO ERADICATION INITIATIVE
In 1988, the forty-first World Health Assembly, consisting then of delegates from 166 Member States, adopted a resolution for the worldwide eradication of polio. It marked the launch of the Global Polio Eradication Initiative, spearheaded by the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF. This followed the certification of the eradication of smallpox in 1980, progress during the 1980s towards elimination of the poliovirus in the Americas, and Rotary International’s commitment to raise funds to protect all children from the disease.
Overall, in the 20 years since the Global Polio Eradication Initiative was launched, the number of cases has fallen by over 99%. In 2008, only four countries in the world remain polio-endemic.
In 1994, the World Health Organization (WHO) Region of the Americas (36 countries) was certified polio-free, followed by the WHO Western Pacific Region (37 countries and areas including China) in 2000 and the WHO European Region (51 countries) in June 2002.
In 2007, more than 400 million children were immunized in 27 countries during 164 supplementary immunization activities (SIAs). Globally, polio surveillance is at historical highs, as represented by the timely detection of cases of acute flaccid paralysis.
Persistent pockets of polio transmission in northern India, northern Nigeria and the border between Afghanistan and Pakistan are key epidemiological challenges.
The epidemiologic picture of this disease in the GCC states is summarized in the following:
I. Discovered cases:
1. No single new polio case has been reported in the UAE since 1992.
2. No single new polio case has been reported in the Kingdom of Bahrain.
3. In the KSA, 6 polio cases were reported in 1994, 3 cases in 1995 and a single imported case in 1998, and one imported case in 2004. Since that date, no cases have been reported.
4. No new cases of polio were reported in Oman Since 1992 except 2 imported cases discovered in 1993.
5. No polio cases were reported since 1985 in Qatar, a single imported case from Pakistan was reported in 1990.
6. No single new case of polio was reported in Kuwait since 1985.
7. No currently available statistics in Yemen.
II. Epidemiologic Surveillance:
In the GCC States, national certification committee for eradication of Poliomyelitis was established comprising the highest and most prestigious people in this field.
A system for epidemiologic surveillance was developed to discover cases of acute flaccid paralysis. In addition specialized committees were established to check acute flaccid paralysis cases and make sure they are negative for polio tests.
Moreover, systems that help avoid importation of cases to GCC states were developed.
III. Routine Immunization Coverage for Newborns:
The percentage coverage ranges from 94-99%.
IV. National Immunization Campaigns:
These are carried out simultaneously in the GCC states since 1996. Some of the member states where they had no polio cases for more than 10 years started to abolish their campaigns.
V. Initiation of Laboratory Containment of Polio Virus.
VI. Mobilization of financial and human resources to continue the activities of polio eradication.
VII. Contributions to the support of the WHO/EMRO
Efforts toward maintenance of polio eradication activities as well containment of the virus in the countries of the region. This was demonstrated by responding positively to HE the Regional director of EMRO by donating 1.5 million as a support to EMRO to continue fully implementing the activities set to achieve success of the eradication plan, where KSA and Oman contributed $100,000 each, and the rest of the GCC states offered logistic support in the form of vaccines, packs, etc.
Rapid and significant progress towards the eradication of poliomyelitis is continuing in all countries of the Eastern Mediterranean Region. The number of cases shows relatively regular decrease to a minimum in 2002, in the light of a well developed and efficiently performing surveillance system. Poliovirus transmission had been interrupted in 15 countries of the Region for more than 3 years. Three countries, Sudan, Yemen and Somalia has been re-infected by virus originating from Nigeria, West Africa during 2004-2006.
Number of Confirmed Cases of Poliomyelitis
2002-2008 (as of 25 February 2008)
Current situation in Yemen
The Republic of Yemen has reported cases of polio with date of onset starting from February 2005. Most of the cases are from Hudeida governorate on the Red Sea coast. Prior to these cases, wild poliovirus has never been found in Yemen since AFP surveillance commenced in 1996. It seems like the epidemic has subsided with the last case detected on 02 February 2006 after more than two month with no cases.
For more detailed information check the weekly Yemen Polio Update.
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