From the Global Polio Eradication Initiative (GPEI), the Global Polio Emergency Action Plan (EAP) aims to boost vaccination coverage in Nigeria, Pakistan, and Afghanistan, the 3 remaining polio-endemic countries. It builds on India's success in stopping polio transmission and outlines a range of new strategies and initiatives to better support eradication efforts, including:
- Intensified focus on worst-performing areas of Nigeria, Pakistan, and Afghanistan to increase vaccination coverage by end of 2012 to levels needed to stop transmission;
- New approaches tailored to each country to tackle persistent challenges and improve polio vaccination campaign performance;
- Heightened accountability, coordination, and oversight at government levels and within partner agencies and organisations;
- Surge of technical assistance and social mobilisation capacity.
The EAP emerges from a decision made in the first 3 months of 2012, when steps were taken to restructure the GPEI to address what was defined as a public health emergency. As part of that process, national emergency plans in Nigeria, Pakistan, and Afghanistan (as well as other priority countries: Chad and the Democratic Republic of the Congo, or DRC) were updated, augmented, and strengthened (See details in Section 7). "All polio-affected countries have already announced, or will announce, that polio is an emergency and they will develop national and subnational communication plans to drive home the message that these are country priorities of utmost urgency." The EAP is built on the 2012-2013 national emergency plans of the countries listed above, as well as the joint commitments of the 4 spearheading partners of the GPEI: Rotary International, the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC), and the United Nations Children's Fund (UNICEF). Also supporting the EAP is the Bill & Melinda Gates Foundation. To optimise international and national collaboration, an emergency programme coordination architecture was put in place, overseen by governments of affected countries and leadership of partner agencies, with support by technical expert groups and other stakeholders.
As detailed within the plan, the EAP incorporates a combination of actions, such as: "rapid detection of poliovirus in all areas and communities; immediate responses to local problems and risks based on quality monitoring data; complete and accurate micro-planning; greater community support and demand for polio vaccination; enhanced political commitment and accountability at all levels; and, improved selection, motivation and performance of vaccinators. The EAP also emphasizes a number of approaches that have been tailored to the specific circumstances of each country such as:
- New vaccinator team composition....Pilots [in Nigeria] suggest this approach can reduce the number of missed children.
- Improved access in insecure areas - in Afghanistan, low-visibility 'permanent polio teams' are conducting house-to-house vaccination in conflict-affected districts on an ongoing basis, to provide every eligible child in the catchment area with at least one dose of OPV [oral polio vaccine] every three months.
- Better micro-planning and maps - in Nigeria, new micro-planning templates, supplemented by new GIS [geographic information system] maps, are helping to solve the problem of incorporating locations that in the past have been completely missed.
- Enhanced attention to routine immunization - synergies with the polio planning, social mobilization and supervision activities are being exploited; in Pakistan routine immunization is also being boosted in health camps.
- Closer tracking of vaccinators - in Nigeria, GIS/GPS [global positioning system] technology is being used to monitor vaccination activities more accurately and help identify gaps where teams are not visiting areas or communities.
- Scale-up of strategies for special populations - In Pakistan and Nigeria, special mapping and tracking strategies have been developed to reach migrant, mobile and nomadic populations.
- New communications tactics - in Pakistan, a Nomadic Children's Festival and in Nigeria a Volunteer Community Mobilizer Network are increasing community participation and building trust among parents to vaccinate their children against polio."
The document includes, amongst other things, a look at best practices and innovations to address systemic problems, such as: the role of community-level communication and social mobilisation focusing on high-risk areas/populations needs to be intensified and scaled-up to help secure local engagement, address community concerns, and create demand to improve overall quality of activities.
In addition to the plan, annexes include a list of innovations from the India programme. Sample strategy insight from this document: Engage the private sector to increase visibility and reach. This sector "had a comparative advantage in advertising broadly across multiple mediums and geographic locations an outreach campaign was created with the help of a facilitating foundation to expand messaging to critical target groups like migrants and mobile populations. Through this initiative a number of key communication mediums were sponsored by businesses such as IEC [information, education, and communication] booths at major transit location, mobile vans displaying communication materials, city buses with the new campaign slogans and photos, SMS [text message] and voice messaging services, public service announcements on polio in cinema halls and local theatres, magic shows, street theatre and wall paintings, etc. Public spaces like railway stations; buses, bus stops, markets, dairy booths, banks and schools have been successfully negotiated for maximum visibility of messages."
The annexes also include national emergency plans for Nigeria (for example, one area focuses on "intensified advocacy, behaviour change communication and mobilization at all levels"), Pakistan, Afghanistan, Chad, DRC, and Angola. There are also descriptions of: (i) inter-agency groups to promote cross-agency alignment on priority-setting and support to priority polio countries; and (ii) GPEI partner accountability and management: activities of WHO, UNICEF, CDC, and Rotary International.
Editor's note: This document is no longer available online.
GPEI website, accessed February 10 2015.