Containment of polioviruses · 7 Global Polio Eradication Initiative Phases linked to achievements in global polio eradication Phase I: National facility survey and inventory (now)

Containment of

polioviruses

2 Global Polio Eradication Initiative

Scenario

August 15: Country X reports WPV3. First case in >2 years

Minister & DG WHO informed. Emergency Plan

August 16: Order 22 million doses of OPV; delivery in 3 days

August 18: Letters to district magistrates of 45 districts

August 20: Dispatch of 75 member outbreak response team

August 22: Campaign begins

REPORT FROM LAB OF CONTAMINATION


To minimize the risk of reintroducing

facility based wild and Sabin

polioviruses to post-eradication /

post OPV communities

Polio Eradication Containment Objective


GAPIII strategy

Risk elimination: destruction of

unneeded poliovirus materials

Risk Management: minimize the risk

and consequences of PV release

through effective management and

safeguards


GAPIII strategy – risk management

Reducing risk of facility associated poliovirus infection

Primary safeguards: Minimize risk through facility design,

management, and oversight

• BSL requirements/Annex 4 of GAPIII

• legal frameworks

• national and international accreditation


GAPIII strategy – risk management

Reducing consequences of poliovirus reintroduction

Secondary safeguards: facilities in areas of high immunity

WPV facilities: full national routine polio immunization policy (IPV)

Sabin facilities: post eradication routine polio immunization policy (as

per SAGE and WHO recommendations)

Tertiary safeguards: facilities in areas with low poliovirus

reproductive rates (R0)

WPV facilities: high standards of hygiene/sanitation (closed sewage)

Sabin facilities: tertiary safeguards not required


Phases linked to achievements in global polio eradication

Phase I: National facility survey and inventory (now)

Phase II: Establishment of national long-term poliovirus policy & regulation (after Phase I)

Phase III: Global destruction and containment of polio materials (one year after last WPV and at time of tOPV/bOPV switch)

Phase IV: Global destruction and containment of OPV/Sabin materials (at time of global OPV cessation)

Global Action plan to minimize poliovirus risk Implementation

>10 WPV facilities

5-10 WPV facilities

2-4 WPV facilities

1 WPV facility

Either no WPV facility or survey data not yet submitted

Countries with WPV facilities*, 2012

180

103

56

27

22 21

*Facilities may include institutions with multiple laboratories and

holding either WPV infectious or potentially infectious materials

17

15

11

~550 WPV facilities identified to date in 46 countries

10 countries have 85% of the facilities globally

Post-OPV surveillance

2013 2014 2015 2016 2017 2018 2019

Years

Last wild polio case

Wild Virus Eradication

Sabin Virus Elimination

WPV Phase 2 containment

WPV certification

Sabin 2 elimination & validation

Containment & Certification Wild virus

eradication

1-dose IPV introduction

Sabin 2 cessation

Sabin 1 & 3 cessation

WPV

Sabin Conta

inm

ent 1o containment

2o full national IPV policy

3o location in areas with hygiene standards

1o Type 2 control Containment

All Sabins 2o Post Erad IPV use

3o Not required

Phases 1 and 2 (inventory /regulations)

Phases 1 and 2 (inventory for Sabin 2 /

regulations)


Next steps / remaining issues

Continue completion of inventories in polio

free countries (particularly India)

Begin process of Sabin 2 survey and

inventory

Finalize GAPIII with governing body approval

Begin work with Member States on national

regulatory framework

Establish expert body for evaluating profile

of candidate vaccine seed strains


THANK YOU


All countries will have completed Phase I inventory and survey

GAP3 approved by World Health Assembly

WHO will have worked with Member States to review / guide development of national regulatory policy for retaining poliovirus materials

Discussions held with national authorities and facilities to determine fate of WPV materials – many unneeded WPV materials destroyed

Discussions held with national authorities who will be overseeing risk in facilities retaining WPV materials

Full primary, secondary, and tertiary safeguards achieved in facilities and countries with WPV materials

1 year after last case of WPV What will be in place in terms of containment?


All countries will have completed Phase I inventory and survey

GAP3 approved by World Health Assembly

All facilities with WPV2 and Sabin2 infectious or potentially infectious materials identified

WHO will have worked with Member States to review / guide development of national regulatory policy for retaining poliovirus materials

Discussions held with national authorities and facilities to determine fate of the type 2 materials – many unneeded materials destroyed

Discussions held with national authorities who will be overseeing risk in facilities retaining type 2 materials

tOPV / bOPV switch What will be in place in terms of containment?

Containment of polioviruses · 7 Global Polio Eradication Initiative Phases linked to achievements in global polio eradication Phase I: National facility survey and inventory (now)

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