Last updated: 28 November 2024

Terms of reference

Full Terms of Reference in PDF format

Since the launch of the Polio Eradication and Endgame Strategic Plan, significant progress has been made towards Wild Poliovirus eradication and achievement of withdrawal of oral polio vaccine type 2 (OPV2) and introduction of IPV in routine immunization. Nevertheless, challenges remain, in particular the persistence of Wild Poliovirus circulation in the last endemic areas; and emergence of outbreaks due to circulating vaccine-derived poliovirus type 2 (cVDPV2). The Strategic Advisory Group of Experts (SAGE) on Immunization working group on polio was established in August 2008 to review the available scientific evidence and provide SAGE and the Global Polio Eradication Initiative (GPEI) with technical guidance on the Polio Eradication and Endgame Strategy.

Planned scope of work for the SAGE working group on polio for the coming years:

• Prepare SAGE for the development of comprehensive policy guidance on Polio Eradication Initiative, including by:
• Reviewing long-term Polio Risks & Risk Management Strategies:
  reviewing the long-term risks associated with use of live poliovirus vaccines after wild polio transmission is interrupted globally, and reviewing the range of strategies for mitigating those risks in low-income settings (e.g. coordinated OPV cessation, mOPV stockpiles and response mechanisms, novel OPV formulations).
• Assessing Current & Future of OPV and IPV Products:
  reviewing the existing range of OPV/IPV products, in terms of supply capacity, production cost, price, presentations, etc. and their appropriateness and suitability for low-income settings.
• Establishing long-term IPV Policies:
  establishing the range of IPV vaccination schedule options that could be utilized in a post-eradication world, given the difference in polio immunization objectives and poliovirus importation and circulation risks; and identifying and characterizing the programmatic implications, economics and opportunity costs of those policy options and availability of different IPV products, for both IPV stand-alone and combination formulations.
• Identifying and prioritizing knowledge gaps that should be addressed to facilitate SAGE decision-making on the role(s) and options for IPV use in the post-eradication era in low-income settings.
• Propose key recommendations to SAGE, supplementing the WHO position paper published in 2022 on Polio vaccines based on the progress of polio eradication efforts and new scientific evidence.
• Advise SAGE on technical guidance to WHO and the GPEI for the development and finalization of the overall polio strategy to reduce long-term risks associated with OPV and to accelerate wild poliovirus eradication, including:
• Establishing long-term IPV Policies:
  the range of IPV vaccination schedule options that could be utilized in a post-eradication world, given the difference in polio immunization objectives and poliovirus importation and circulation risks; and identifying and characterizing the programmatic implications, economics and opportunity costs of those policy options and availability of different IPV products, for both IPV stand-alone and combination formulations, in low-income settings
• Strategy and priorities in the related areas of outbreak response, surveillance, containment, risk assessment (esp. Vaccine Derived Polio Viruses), research and product development, and vaccine supply.

Composition

SAGE Members

• Shabir Mahdi, Professor of Vaccinology at the University of the Witwatersrand, Johannesburg, South Africa (Chair of the Working Group)
• Gabriel Leung, University of Hong Kong, Hong Kong, People's Republic of China

Experts

• Guillaume Chabot-Couture, Director of research, global development, Institute for Disease Modeling, Seattle, WA, USA
• Shelley Deeks, Deputy Chief Medical Officer of Health for the province of Nova Scotia, Canada 
• Jeffrey Mphahlele, Vice President for Research, South African Medical Research Council, Pretoria, South Africa
• Jean-Marc Olivé, Chair of the Technical Advisory Group (TAG), Pakistan, Afghanistan, Horn of Africa and Lake Chad
• Kathleen O’Reilly, Assistant Professor in Mathematical Modelling, the London School of Hygiene & Tropical Medicine, UK
• Sonia Resik, Professor of Microbiology at Havana Medical University and director of polio laboratory, IPK, Havana, Cuba
• Ali Faisal Saleem, Assistant Professor, Aga Khan University, Karachi, Pakistan
• Khalequ Zaman, Scientist and Epidemiologist, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh

WHO Secretariat

• Diana Chang-Blanc
• Ondrej Mach 
• Ann Ottosen (UNICEF Supply Division)

Declaration of interests for WHO experts

All members completed a declaration of interests. Six members reported any relevant interests. It was concluded that all members could take part in full in all of the discussions. The reported relevant interests are summarized below:

Kathleen O’Reilly

• Her institution receives grant from BMFG for the Polio Global Eradication Initiative (PGEI). This interest was assessed as non-personal, non-specific and financially significant*. 
• She is paid as technical advisor for peer-review for the Lancet journal. This interest was assessed as non-personal, non-specific and financially insignificant*.

* According to WHO's Guidelines for Declaration of Interests (WHO expert), an interest is considered "personal" if it generates financial or non-financial gain to the expert, such as consulting income or a patent. "Specificity" states whether the declared interest is a subject matter of the meeting or work to be undertaken. An interest has "financial significance" if the honoraria, consultancy fee or other received funding, including those received by expert's organization, from any single vaccine manufacturer or other vaccine-related company exceeds 5,000 USD in a calendar year. Likewise, a shareholding in any one vaccine manufacturer or other vaccine-related company in excess of 1,000 USD would also constitute a “significant shareholding”. As per WHO assessment of conflicts of interests, “Institution” relates only to the expert’s research/or work unit, as subdivision of the department.