Key result
Global Polio Eradication Initiative cuts polio burden ~99%, though vaccine-derived cases now outpace wild poliovirus.
Why the study?
Polio remains endemic in 2 countries with threats of resurgence in low-coverage regions and circulating vaccine-derived poliovirus outbreaks, warranting a review of eradication strategies.
A country-specific modified strategy is required to eradicate wild poliovirus and circulating vaccine-derived poliovirus simultaneously, particularly in endemic countries.
May warrant tailored strategies in endemic regions; leaves open optimal simultaneous eradication approaches for both virus types.
Background: The Global Polio Eradication Initiative (GPEI) promised to eradicate polio by 2000, yet the disease remains endemic in 2 countries. The current threat of resurgence in countries with low vaccine coverage and circulating vaccinederived poliovirus (cVDPV) outbreaks due to oral polio vaccine warrants a strategy review. Aims: To review the performance of the GPEI from a context based in Pakistan, identifying threats to success and suggesting strategy modifications to help achieve eradication. Methods: This was a desk review of the effectiveness of GPEI that was launched in 1988 to eradicate polio by 2000. Subsequent failure to eradicate led to multiple iterations in strategy and planning documents. These documents were reviewed alongside relevant literature to explore the reasons for failure and emergence of cVDPV. Results: GPEI has been effective in reducing the global polio disease burden by > 99%, but it remains endemic in Pakistan and Afghanistan. cVDPV has caused multiple outbreaks since 2000, and caused 7 times more cases than wild poliovirus (WPV) globally in 2020. The Polio Eradication and Endgame Strategic Plan 2013-2018 aimed to eradicate WPV and cVDPV simultaneously. In 2019, Pakistan saw an upsurge in WPV amid an outbreak of cVDPV infection that continued throughout 2020. Wild polio eradication was not realized and the country was unable to transition to inactivated polio vaccine as predicted in the strategic plan. Conclusion: Over 20 countries now report cVDPV outbreaks and many others are at risk. A country-specific modified strategy is required to eradicate WPV and cVDPV simultaneously, more so in endemic countries.
No takes yet. Share an insight, caveat, or question.
Sultan M A (2022) conducted a review in Poliomyelitis. Global Polio Eradication Initiative (GPEI) was evaluated. The Global Polio Eradication Initiative reduced the global polio disease burden by over 99%, but the disease remains endemic in Pakistan and Afghanistan with cVDPV causing 7 times more cases than wild poliovirus globally in 2020.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: