Polio transition

Transition planning is a critical part of preparing for the polio-free world. As we come closer to achieving eradication, the Global Polio Eradication Initiative (GPEI) will scale down its operations, and will come to a close soon after certification of eradication.

Over three decades of operation, GPEI funding has helped build significant infrastructure for disease surveillance, social mobilization, and vaccine delivery; developed in-depth knowledge and expertise; and learned valuable lessons about reaching the most vulnerable and hard-to- reach populations on earth.

Some of the key functions, infrastructure, and knowledge supported by GPEI will need to be transitioned into other programme areas, either within the national governments or at WHO. Essential polio functions needed at the country-level for implementing the polio post–certification strategy, that are currently financed by GPEI, will also need to be transitioned to national governments or supported by WHO in the medium term.

The Polio Eradication and Endgame Strategy identifies three main aims of transition planning:

Keep the world polio free

After polio has been eradicated, some activities and functions of the polio programme will need to continue to make sure the world stays polio-free. These include:

• Proper containment of the virus in essential facilities so it isn’t accidentally or intentionally released
• Disease surveillance, to rapidly detect the re-emergence of the virus
• Outbreak response capabilities, for quick and effective response to any polio events
• Continued vaccination, so that people are protected in the event of an outbreak
• A governance and management structure for these ongoing essential functions

National governments, WHO and other GPEI partners must plan for some essential functions and activities to be incorporated into existing public health programs in order to keep the world polio-free. In consultation with key stakeholders, GPEI is developing a polio Post-Certification Strategy to define, at a global level, the technical standards that will be needed in order to maintain a polio-free world.

Transition polio assets to support other health priorities

GPEI funds have established an extensive infrastructure of global disease surveillance systems, vaccine supply and logistics networks, and a network of more than 140 polio laboratories. These capacities help reach populations in areas with little to no infrastructure.

Given that GPEI-funded infrastructure already supports a wide range of health initiatives like routine immunization, measles campaigns, maternal and child health programmes, humanitarian emergencies and disease outbreak, and sanitation and hygiene programmes, the closure of the polio programme therefore presents a potential risk to these programmes.

Capture and transfer the lessons learned

The polio programme, over many decades, has learned many valuable lessons on reaching hard-to-reach and high-risk populations, working in conflict affected areas, harnessing global commitment to a cause, and other challenging areas. A key component of transition planning is to capture and share these lessons for the benefit of the broader development community.

Transition planning is a process of analysing the infrastructure, knowledge, and functions of the polio programme, and managing their scale down or transfer to other health programmes.

The process involves mapping these assets at country, regional and global levels, and conducting an analysis against national and global health and development needs.

At the country level, within the 16 polio priority transition countries (Afghanistan, Angola, Bangladesh, Cameroon, Chad, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Myanmar, Nepal, Nigeria, Pakistan, Somalia, South Sudan and Sudan), significant efforts are under way to ensure government ownership of the national polio transition planning process, systematic mapping of all polio assets, identification of key public health priorities that could benefit from the polio infrastructure, engagement of stakeholders, development of a costed national polio transition plan, and the development of a financing strategy for implementing the transition plan. WHO, at all three organizational levels, and partners in the Global Polio Eradication Initiative have been extensively involved in this process.

Within WHO, polio transition planning is a corporate, WHO-wide priority. Polio transition planning will have to address the risks and opportunities facing the organization. It will need to deal with managing the significant human resources, financing, country capacity, and programmatic risks faced by the organization as a result of the scaling down of the polio programme. It will also be an opportunity for the organization to integrate the polio assets and capacities to strengthen health systems in countries to help achieve the goals of the 13th General Programme of Work of WHO and the SDGs.

An effective and strategic polio transition plan will ensure that essential functions are maintained in countries, either through national systems or other WHO programme areas, in order to sustain a polio-free world. The plan will also endeavour to strengthen immunization services and emergency preparedness and response capacities in polio transition countries through the integration of polio assets and functions.