At the 154th World Health Organization (WHO) Executive Board in January, Member States convened to discuss the post-2023 strategic framework for polio transition.
In their remarks, Member States commended progress so far and urged WHO to support countries to gradually transition and integrate the polio programme functions of immunization, surveillance, outbreak response and containment, which are vital to sustain a polio-free world. The objective is clear – to utilize the investments made in polio eradication to sustain progress and build strong, resilient and equitable health systems.
Sustaining the essential functions of immunization, surveillance, outbreak response and containment
Action on several fronts is necessary to achieve the three goals of the post-2023 strategic framework: to keep the world polio-free, minimize the burden of vaccine-preventable diseases, and rapidly detect and control disease outbreaks. Building upon lessons learned from the Strategic Action Plan for Polio Transition (2018-2023), the framework aims to tailor the process of polio transition to country context, considering local epidemiology and the ability of governments to fully finance their health systems.
On the first goal, Member States overwhelmingly reiterated their support for a polio-free world. This will require concerted efforts in the countries where the virus remains and sustaining capacities to ensure that the world remains polio free, once eradication is achieved. Statements from Member States of the African and Eastern Mediterranean Regions, the two regions where the polio programme maintains the highest footprint, endorsed the tailored approach set out in the post-2023 framework.
On the second goal, Member States emphasized the need for the closer alignment of polio eradication and essential immunization goals as we approach the post-polio world. Member States urged greater programmatic integration at the country level, to reach the hardest to reach communities and broaden service delivery. Reinforcing routine immunization is a crucial step to close immunity gaps, which will in turn will help strengthen the overall health system.
Regarding the third goal, experience shows that countries will need continued support from WHO and partners to detect and respond to disease outbreaks. Germany observed, “polio infrastructure has been a major asset in many countries; therefore we need to ensure that current monitoring and surveillance systems have sustained national financing in place, even after successful polio eradication”. France noted that sustaining strong surveillance, especially environmental surveillance, will be vital to protect vulnerable populations. In addition, several countries urged continued work to ensure that poliovirus materials are safely and securely contained after eradication, which forms one of the four strategic outcomes of the post-2023 transition framework.
Monitoring, evaluation and accountability
The post-2023 framework is designed to drive progress across these goals. To achieve the overarching global vision to use polio investments to build strong, resilient and equitable health systems, the Eastern Mediterranean, African and South-East Asia regions are developing tailored Regional Strategic Plans to support action in each priority country. Outcomes and milestones to achieve the goals will be regularly monitored through a robust monitoring and evaluation framework.
Member States also reiterated the need to clarify accountability arrangements to prepare for the sunset of GPEI, commending the work WHO has started in this regard. Member States called for the close involvement of relevant actors across the global health architecture in this process.
Echoing other Member States, Canada commended the work done far, and urged efforts to continue: “As we move through eradication, transition and certification, we encourage Member States and GPEI partners to support country-led processes, alongside strong, effective leadership from the WHO, to set countries up to succeed as they look to preserve historic polio systems and infrastructure.”