Data as on 12/02/2014

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GLOBAL POLIO CASES
Global Polio Cases Year 2000 719 Year 2001
483 Year 2002 1918 Year 2003 784 Year 2004
1255 Year 2005 1979 Year 2006 1998 Year 2007
1315 Year 2008 1651 Year 2009 1604 Year
2010 1352 Year 2011 650 Year 2012 223 Year
2013 400 Year 2014 11
Data as on 12/02/2014
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INDIA POLIO STATUS SINCE THE BEGINNING OF THE
PROGRAMME
500 PER DAY BUT NOW 0 in 2014
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WILD POLIO CASES IN INDIA
Data as on 14.02.2014
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Rotarys India National PolioPlus Committee
The India National PolioPlus Committee in india
plays the following roles

• Advocacy
• Political
• Bureaucratic
• Religious
• Corporate
• Financial
• Social Mobilisation
• Operational support

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Financial Contribution towards GPEI

US 9 billion
US 1.2 billion
US 178 Million
Raised From Donors
Worldwide Contributions
INDIA CONTRIBUTION
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POLIO ERADICATION STRATEGY
ROUTINE OPV IMMUNISATION
MOPPING UP OPERATIONSIN HIGH RISK AREAS
PPINID/SNID
REPORTING ALLAFP CASES (Surveillance)
Each of these components is essential for the
complete eradication of Polio.
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• Mop Up Immunization
• Outbreak Response Immunization (ORI)

• Acute Flaccid Paralysis (AFP) Surveillance
• The number of AFP cases reported each year is
  used as an indicator of a countrys ability to
  detect polio-even in countries where the disease
  no longer occurs. A countrys surveillance
  system needs to be sensitive enough to detect at
  least one case of AFP for every 100 000 children
  under 15 even in the absence of polio.

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Reaching every child during mass polio
vaccination campaigns
500
2013
250
2013
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2014
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
2015
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Nationwide campaigns
Sub-national campaigns
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Routine Immunization

• Current level of Routine Immunization is 60-61.
  To protect our children against wild polio virus
  it is more important to increase the vaccine of
  Polio under R.I.

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High risk areas identified in India, April 2012
411,000 HRAs
High risk areas in settled population
Migrant sites
257,000 Migrant sites
154,000 HR areas in settled population
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Intensification of Routine Immunization

• 9 priority states 239 districts with weak RI
  identified for focused attention

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Strengthening Routine Immunization

• Fourth pillar for polio eradication - Helps
  sustain population immunity against polio
  reduces risk of circulation of poliovirus
• Important component of the polio endgame strategy
  before after withdrawal of OPV
• Protects children against other vaccine
  preventable diseases

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Preparing for India to be Certified as Polio Free
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Certification Process

• The Goal of the GPEI is the Global Certification
  of the eradication of polio.
• Global certification of eradication will be
  reached when all countries demonstrate the
  absence of wild poliovirus transmission for at
  least three consecutive years in the presence of
  excellent surveillance.

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Certification Committee Structure

• Global Commission for the Certification of the
  Eradication of Poliomyelitis
• Six Regional Certification Commissions for Polio
  Eradications
• Every country has a National Certification
  Committee for Polio Eradication (NCCPE)
• India NCCPE established on Aug 7, 1998

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Process of Regional Certification

• NCCPEs to prepare detailed documentation as per
  standard format.
• These are reviewed by the regional Commission and
  it will recommend to the Global Commission
• Only Global Commission can certify a region as
  polio free
• Only WHO regions and NOT individual countries
  certified as polio free
• (26-27 March, 2014)

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3 of the 6 WHO Regions Already Certified Polio
Free

• 1994 - North, Central and South America (PAHO
  region)
• 2000 - Western Pacific region (that includes
  China)
• 2005 - European region in 2005.
• 2014 WHO South East Asia region that includes
  India is the next region to be certified as polio
  free. Preparations are underway 

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Importation

• Recently Govt of India has issued the
  notification
• A dose of oral polio vaccine (OPV) for all
  travellers to and from India from polio endemic
  countries Afghanistan, Nigeria and Pakistan and
  countries with poliovirus circulation following
  importation Ethiopia, Kenya, Somalia and Syria.
  In the absence of which VISAS will not be issued.
• Govt of India has set up immunisation booths
  across borders.

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The geographical distribution of children with
poliomyelitis associated with wild-type
poliovirus shown by serotype for 2012 and (inset)
the total number of children with poliomyelitis
globally by serotype reported each year during
20012012.
93 polio cases in Pakistan, 53 in Nigeria and 14
in Afghanistan . The Horn of Africa
Somalia-190, Kenya-14, Ethiopia-9 , Cameroon-4
and An outbreak of cases in Syrian Arab Republic
23 (Syria reported polio case after 1999) in
the year 2013. Still Pakistan is reporting fresh
cases of Polio during the current year numbering
to 9 and Afghanistan is following up with 2 cases
reported till date.
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Continuous vaccination of children at border
crossing points
5 vaccination posts along Indo-Pak border since
Sep 2011
88 vaccination posts along Indo-Nepal border
since Apr 2011
PAKISTAN
NEPAL
INDIA
BANGLADESH
MYANMAR
Vaccination post
2 vaccination posts along Indo-Bangladesh border
since Mar 13 2 vaccination posts along
Indo-Myanmar border since April 13
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Lessons

• Its not over until its over everywhere
• 'The price of freedom is eternal vigilance'

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Challenges

• Maintaining immunity
• Maintaining surveillance
• Readiness to respond
• Reducing risk
• Building on polio
• Preparing for the endgame

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POLIO NOW A PUBLIC HEALTH EMERGENCY

• 194 member states to fully fund the GPEI fill
  945M gap in budget for 12-13.
• All remaining infected countries to declare polio
  to be a NATIONAL PUBLIC HEALTH EMERGENCY
  requiring the implementation of emergency action
  plans monitored at the highest levels

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POLIO A PUBLIC HEALTH EMERGENCY

• New approaches to tackle persistent challenges
  and improve polio vaccination campaign
  performance
• Heightened accountability, coordination, and
  oversight to ensure success at every level of
  government and within every partner agency and
  organization

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POLIO A PUBLIC HEALTH EMERGENCY

• A surge of technical assistance and social
  mobilization capacity
• If any child in the world is permanently
  paralysed by Polio it is now a Global Emergency
• If any child in the world is not reached by Oral
  Polio Vaccine it is now an emergency.

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Emergency Preparedness and Response Plan 2011
The Govt. of India has constituted a Central
Emergency Preparedness and Response Group to
ensure adequate preparedness for a rapid response
and manage the actual response to the detection
of a wild poliovirus anywhere in India.
Rotarys Role in Emergency Preparedness and
Response Plan
Advocacy at state and district levels for
quaility implementation of polio eradication
activities. Support IEC/Social mobilization
activities media management in coordination
with Govt.. UNICEF and NPSP. Any other essential
emergency support activities.
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Step II response
Mop up conducted
Vaccine other logistics reach blocks

• National level partners meeting
• Media plan operationalized
• Vaccine arrived in district

• State District Task Force Meetings
• 14 additional SMOs arrive in districts
• IEC plan developed
• Marker pens other logistics procured

• RRT members arrive in districts
• Meeting with key distt officials and partners
• Mop up planning meeting with health officials

• Convene State EPRG
• Depute RRT members to districts

Wild Polio virus notified to GoI and State
Day 0
Day5
Day 10
Day 9
Day 8
Day 7
Day 6
Day 4
Day 3
Day 2
Day 1
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Emergency Preparedness Response
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Switch Over- Preparing for Polio Endgame Strategy

• Withdrawal of oral polio vaccine to minimize
  risks associated with use of OPV in the post
  eradication phase
• Switch from tOPV to bOPV in 2016
• Withdraw all OPV from programme in 2018/2019
• Before switch over IPV will be introduced in
  2015. The introduction will also protect the
  occurrence of vDPV cases.

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End Game Strategic Plan 2013-18
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Funding Gap

• The Total funding requirement from 2013-2018 is
  5.5 billion.
• Committed - 4 billion
• Deficit - 1.5 billion

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World Polio Day 24 October
2013 India on World Polio Day illuminated iconic
sites across the country including historic
monuments India Gate, Red Fort with End Polio Now
message.
India Gate
Red Fort
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India Celebrated 3 years of last case reported in
the country on 13 January 2014
India Gate
Red Fort
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Celebrations on Indias Victory over Polio on 11
February 2014 in New Delhi by Govt of India
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Towards a polio-free India
Rukhsar. Let's ensure she is the last polio case
in India!
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Rotarys Continued Engagement Very Crucial.

• Thank and appreciate those who have been working
  so hard.
• Continued advocacy in high risk areas against
  complacency
• Respond to local problems with local solutions
• You started the race and so you better be there
  at the finishing line when celebrations start