Statement by the Eastern Mediterranean Ministerial Regional Subcommittee on Polio Eradication and Outbreaks

Delivering on a promise: achieving and sustaining a polio-free Eastern Mediterranean Region

Fifth Meeting of the Regional Subcommittee on Polio Eradication and Outbreaks

14 June 2022

Noting the progress achieved globally in eradicating wild poliovirus transmission since 1988, with virus transmission restricted to just two countries – Afghanistan and Pakistan;

Noting that one case has been reported in Afghanistan and eight in Pakistan since January 2022, and that detection of wild poliovirus cases in both countries so far has been contained within the southern corridor comprising the southeastern part of Afghanistan and southern districts of Khyber Pukhtunkhwa province in Pakistan;

Noting that Pakistan completed 15 months without reporting a case of wild poliovirus – the longest period that the country has reported no human cases;

Underscoring that the recent isolation of wild poliovirus from environmental samples in Pakistan and children in Afghanistan confirms continued poliovirus circulation in this joint epidemiological block;

Noting that the populations in this epidemiological bloc remain at high risk from polio due to low rates of routine immunization and supplementary polio vaccinations;

Underscoring the critical need for continued cross-border collaboration to reach children with polio vaccines, and for enhanced polio surveillance to detect the virus;

Noting the timely actions taken by the Prime Minister and Health Minister of Pakistan to respond to the current outbreak of cases in North Waziristan;

Highlighting the sustained commitment by leaders at all levels, notably by political leaders, community and religious leaders, civil society, Global Polio Eradication Initiative partners, especially Rotary International and individual Rotarians and health workers at the forefront in responding to the virus;

Recalling that the spread of poliovirus constitutes a Public Health Emergency of International Concern under the International Health Regulations (2005);

Appreciating and supporting the decision of the WHO Regional Director for the Easter Mediterranean to formally grade all polio emergencies and apply relevant emergency standard operating procedures to WHO operations to address polio emergencies;

We, the Eastern Mediterranean Regional Subcommittee on Polio Eradication and Outbreaks:

DECLARE:

1. The ongoing circulation of wild poliovirus in Afghanistan and Pakistan to be a Regional Public Health Emergency;

COMMIT TO:

2. Mobilizing all necessary engagement and support, by all political, community and civil society leaders and sectors at all levels, needed to fully resolve the Regional Polio Public Health Emergency;

3. Supporting the coordination of activities across borders to ensure synchronized and cross-border response activities between Afghanistan and Pakistan; and

REQUEST:

4. The international donor and development community to continue supporting the national polio programmes to facilitate implementation of national emergency action plans to end polio in Afghanistan and Pakistan;

5. Sustained and strengthened commitment from all leaders at all levels in Afghanistan and Pakistan, to capitalize on the current epidemiological window of opportunity through intensified eradication efforts, including by continuing to increase access to all children in previously inaccessible areas, implementing area-specific emergency action plans in known underperforming areas and responding to the detection of any new viruses from any source, acute flaccid paralysis case or environmental samples as an emergency;

6. Effective operational delivery by the polio programme to ensure administration of vaccine to the youngest and most vulnerable children who are persistently missed during routine immunization and polio vaccination campaigns, to seize the opportunity to build immunity levels and stop polio transmission;

7. The Regional Director to continue his tremendous leadership and support to Afghanistan and Pakistan in their efforts to eradicate polio, including by advocating for all necessary financial and technical support, coordinating WHO efforts with the wider regional GPEI partnership through the Polio Hub in Amman, reviewing progress, planning corrective actions as necessary, and regularly informing Member States of the aforementioned and of any eventual further action required, through the World Health Organization Executive Board, World Health Assembly and Regional Committee.

Statement by the Eastern Mediterranean Ministerial Regional Subcommittee on Polio Eradication and Outbreaks

Delivering on a promise: achieving and sustaining a polio-free Eastern Mediterranean Region

Fifth Meeting of the Regional Subcommittee on Polio Eradication and Outbreaks

14 June 2022

Noting the progress achieved globally in eradicating poliovirus transmission since 1988;

Noting with deep concern the ongoing and expanding outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2) in the Region, including an outbreak of cVDPV2 in Somalia and concurrent outbreaks of cVDPV1 and cVDPV2 in Yemen;

Recognizing the high risk of expansion of the polio outbreaks in these countries due complex emergency settings, limited access to high-risk populations, weak immunization services and gaps in coverage of supplementary vaccinations campaigns;

Recalling that the spread of polio is a Public Health Emergency of International Concern under the International Health Regulations (2005);

Recognizing the impact of prolonged conflict on disruption of health services, including disruption of house-to-house vaccination campaigns that ensure all vulnerable children can be reached with life-saving polio vaccines;

Observing with alarm the prolonged cVDPV2 outbreak in Somalia and increasing cases of cVDPV2 in Yemen;

Noting the fast-approaching timeline of the global Polio Eradication Strategy 2022–2026 – Delivering on a Promise to secure a lasting world free of all forms of poliovirus, including circulating vaccine-derived polioviruses, within the next 18 months;

Appreciating and supporting the decision of the WHO Regional Director for the Eastern Mediterranean to formally grade all polio emergencies and apply relevant emergency standard operating procedures to WHO operations to address polio emergencies;

We, the Eastern Mediterranean Regional Subcommittee on Polio Eradication and Outbreaks:

DECLARE:

1. The ongoing circulation of any strain of poliovirus in the Region is a Regional Public Health Emergency;

COMMIT TO:

2. Mobilizing all needed engagement and support by all political, community and civil society leaders and sectors at all levels to finally end polio as a Regional Public Health Emergency;

3. Advocating for increased access to all hard-to-reach populations, including inaccessible and nomadic communities and internally displaced persons who are most at-risk, to strengthen their immunity and enhance detection of poliovirus circulation;

4. Providing all needed resources and highest-level oversight to the Government of Somalia and Global Polio Eradication Initiative partners to fully implement the Somalia Polio Eradication Action Plan 2022 launched at the Somalia Summit in March 2022, in the context of competing health response priorities such as ongoing drought and the effects of the COVID-19 pandemic;

5. Supporting Yemen in mobilizing all necessary resources to fully implement outbreak response across the country, and advocating for all children to be reached through house-to-house or intensified site-to-site vaccination campaigns;

6. Helping to strengthen coordination with other public health and humanitarian efforts in Somalia and Yemen, to ensure closer integration in particular with routine immunization and delivery of essential health services to children; and

REQUEST:

7. The international humanitarian and development communities to scale up their support for providing essential services, including a robust response to the polio outbreaks in Somalia and Yemen;

8. The authorities and polio eradication partners in Somalia to accelerate high-quality and rigorous implementation of the Somalia Polio Eradication Action Plan 2002, to stop the longest-running outbreak in the country and prevent further spread of cVDPV2 by the end of 2022;

9. The national authorities and the Regional Polio Eradication programme to strengthen cross-border coordination for Somalia, Kenya, Ethiopia and Djibouti, considering the high risk of the cVDPV2 virus crossing international borders;

10. All authorities in Yemen to facilitate resumption of house-to-house vaccination campaigns in all areas to ensure delivery of vaccine to the youngest and most vulnerable children, who are likely to be missed by delivery of vaccine through health facilities alone. In areas where house-to-house vaccination is not feasible, all efforts should be made to implement intensified fixed-site vaccination to ensure high coverage;

11. The Regional Director to continue his tremendous leadership and efforts to support the cessation of polio outbreaks in Yemen, including by advocating for all necessary financial and technical support, reviewing progress, implementing corrective actions as necessary, and regularly informing Member States of the aforementioned and of any eventual further action required, through the World Health Organization Executive Board, World Health Assembly and Regional Committee.

13 May – Ramallah - On Monday 16 May, the Palestinian Ministry of Health will launch round one of a polio vaccination campaign targeting all children under age five in Bethlehem and Jerusalem.

The vaccination campaign is scheduled to run over three days: Monday 16 May through Wednesday 18 May 2022. Vaccination, using bivalent oral polio vaccine (bOPV), is free and will be offered at maternal and child centres and UNRWA centres throughout Bethlehem and Jerusalem.

Palestine has been polio-free for more than 25 years, thanks to a robust routine immunization programme and a strong culture of vaccine acceptance. But following the detection of circulating vaccine-derived poliovirus type 3 (cVDPV3) in sewage outflow in Wadi Alnar site, where there is a junction between wastewater coming from inside the green line with wastewater coming from Bethlehem and Jerusalem, the Ministry of Health has taken the decision to launch a preventative vaccination campaign to boost children’s immunity in the two areas deemed most at risk: Bethlehem and Jerusalem.

“It is all of our duty to keep Palestine polio-free by making sure that our children under the age of five receive the polio vaccine every time it is offered. I encourage every parent to make it a priority to vaccinate their children – for their sake, and for Palestine,” said Dr Mai al-Kaila, Minister of Health, Palestine.

The vaccination campaign is being carried out with support from WHO, UNICEF and UNRWA’s Palestine country offices.

“WHO’s Palestine office has provided technical support to the Ministry in planning and executing this campaign, drawing on the extensive expertise of our regional polio eradication programme. Palestine is in a strong position thanks to its routine immunization programme and to the value Palestinian parents put on childhood immunizations, but the regional risk of polio is increasing and it is absolutely crucial that we reach and vaccinate every child under age five in the target areas,” said WHO occupied Palestinian territory Representative Dr Rik Peeperkorn.

“It is critical that every child can access their right to a life free from polio and other vaccine-preventable diseases. UNICEF and its partners in this campaign are making every effort to ensure no child in Palestine will be affected by this debilitating disease. It is a duty upon all of us to keep Palestine polio free,” said UNICEF’s Special Representative to the State of Palestine Lucia Elmi.

Round two of the campaign will take place in June and will offer all children under age five a second two drops of polio vaccine, further boosting their immunity. Children living outside of Jerusalem and Bethlehem do not currently require an additional dose of oral polio vaccine. If their routine immunizations are up to date, they are well protected from poliovirus and other vaccine-preventable diseases.

Poliovirus primarily affects children under age five and can lead to lifelong paralysis. It can easily be prevented through vaccination. Parents are urged to accept polio vaccines every time they are offered.

The vaccination campaign in Palestine is part of the global effort to eradicate poliovirus, spearheaded by the Global Polio Eradication Initiative.

Media contacts

Damian Rance
UNICEF Palestine Chief of Communication and Advocacy (English)
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+972547787604

Mira Nasser
UNICEF Palestine Communications Specialist (Arabic)
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+972 598568428

Bisma Akbar
WHO occupied Palestinian territory Communications Officer
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+972 54-717-8959