POLIO ERADICATION: OVERSIGHT AND TRANSITION Maintaining focus while looking to the future Chris Millard Program Manager and Research Associate Global Health Policy Center Center for Strategic and International Studies May 17, 2017
OVERVIEW Oversight and transition planning to date Global governance and oversight structure IMB Ethiopia and India examples Oversight and transition planning going forward Oversight changes, including new IMB and TIMB Transition challenges as we approach zero Sun-setting the GPEI Questions going forward
OVERSIGHT AND TRANSITION TO DATE
PROGRAM & OVERSIGHT OVERVIEW World Health Assembly WHO Rotary CDC UNICEF Gates Foundation PPG IMB WHO Regional Offices Polio Oversight Board Polio Steering Committee UNICEF Regional Offices SAGE GCC TAGs
INDEPENDENT MONITORING BOARD Eight member panel, chaired by Sir Liam Donaldson Independent Broad range of global health knowledge Reports are accessible to a non-technical audience
IMPACT OF THE IMB Calling for emergency declaration for polio Focusing on missed children Pushing for the development of the PEESP Engaging IHR to aid polio eradication Honoring front-line staff Retooling GPEI communications Promoting financial transparency and better donor engagement Expanding use of IPV
IMPACT OF THE IMB: TRANSITION PLANNING So what is to happen when polio has been eradicated? How will all of this potential be used? Or will its legacy be scattered to the four winds? -IMB June 2012 Report
TRANSITION IN ACTION: ETHIOPIA Polio funding is currently supporting Vehicles, laboratory services, training, and personnel Salaries of key EPI personnel Immunization cold chain capacities Technical assistance and supervision Surveillance officers Newborn tracking Social mobilization efforts
TRANSITION IN ACTION: ETHIOPIA
TRANSITION IN ACTION: INDIA Over the past several years, Indian health officials have: Used polio program assets and strategies to provide health services to hard-toreach populations Taken on funding of the national polio laboratory network Expanded functions of the polio lab network to include measles and rubella Collaborated with international polio program partners to raise childhood immunization rates Includes social mobilization and micro-planning techniques developed for polio
TRANSITION IN ACTION: INDIA
OVERSIGHT AND TRANSITION GOING FORWARD
OVERSIGHT CHANGES World Health Assembly TIMB WHO Rotary CDC UNICEF Gates Foundation PPG Polio Oversight Board SAGE New IMB WHO Regional Offices Polio Steering Committee UNICEF Regional Offices GCC TAGs
NEW MEMBERS Transition IMB Chair Sir Liam Donaldson, UK Dr. Jon Andrus, USA Dr. Salah Al Awaidy, Oman Dr. Mohamed Abdi Jama, Somalia Dr. Jeffrey Koplan, USA Prof. Yvonne Maldonado, USA Dr. Bjorn Melgaard, Denmark Ms. Anne Mtonga, Zambia Dr. Mirta Roses Periago, Argentina Dr. Roma Solomon, India Ms. Meidemarie Wieczorek-Zeul, Germany New IMB Chair Sir Liam Donaldson, UK Dr. Tom Frieden, USA Dr. Muhammad Pate, Nigeria Ms. Sue Goldstein, South Africa
TRANSITION CHALLENGES How does the global level best support country-level transition planning and implementation? Ramp-down in funding while extending the timeframe until 2020 Potentially hindering surveillance or immunization efforts from budgetary constraints WHO staff cuts Country or programmatic complacency Security compromised areas and inaccessible populations Estimated Costs for Polio Eradication by Activity ($USM, not including India self-funded costs) Polio Eradication Funding Tail 2013 2019: $7.0B 2020 2026: $0.9B Nigeria interrupts Pak/Afg interrupt Global Cert. Intermediate assumptions
GPEI CURRENT & FUTURE FUNCTIONS 2013 Polio Eradication & Endgame Strategic Plan Polio Post-Certification Strategic Plan 2030 Today Interruption Certification bopv Cessation +3 years +1 year Pre-Certification Immunization Surveillance Vx Management Campaigns Outbreak response Containment Technical assistance Transition planning Advocacy & RM Communications Certification Research Pre-Cessation Immunization Surveillance Vx Management Campaigns Outbreak response Containment Technical assistance Transition planning Advocacy & RM Communications Certification Research Post-Cessation Immunization Surveillance Vx Management Outbreak preparedness Containment Research (A) GPEI (B) Overlap period - GPEI & other non-polio groups (at least 12 months) (C) Non-polio groups Sunset at Certification 16
QUESTIONS MOVING FORWARD What would be the value added of mainstreaming some of these assets/best practices? How do you mainstream these assets/best practices? Who picks up the operations or funding of assets post-gpei, once the polio line item is no more? How do you navigate the current political climate in the US?
THANK YOU cmillard@csis.org https://www.csis.org/programs/global-health-policy-center/polio-eradication