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Call to action to support COVID-19 response: Polio Oversight Board statement on COVID-19

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The COVID-19 pandemic response requires worldwide solidarity and an urgent global effort. The Global Polio Eradication Initiative (GPEI) stands ready to respond.

GPEI’s response to COVID-19 is driven by two principles. The first is our public health imperative to ensure that the polio programme fully plays its part in the COVID-19 response, supported by our second, underlying principle that when the emergency ends we will be ready to end polio with urgency and determination.

GPEI assets at service of COVID-19 response

The Polio Oversight Board (POB) has agreed that for the next four to six months, GPEI programmatic and operational assets and human resources, from global to country level, will be made available to enable a strong response to COVID-19, while maintaining critical polio functions, such as surveillance and global vaccine supply management.

GPEI will continue to deploy polio-funded personnel to the COVID-19 response and make available coordination mechanisms, such as emergency operations centers, and physical assets such as transportation or IT hardware. Through our extensive front-line worker networks in many countries, we will ensure the collection of information to provide evidence-informed guidance in line with WHO recommendations. At country level, the polio surveillance network is being trained on COVID-19 case detection, case and contact tracing, laboratory testing and data management. Our data management systems and front-line staff are already ramping up action in many countries, and wherever the polio programme has a presence we will continue to serve the response.

GPEI will also seek assurances that when GPEI staff is supporting COVID-19 front line activities, they will be provided with the necessary training, materials, equipment and logistics support to do so safely, in line with infection prevention and control measures. The GPEI is conscious that women, who make up most caregivers and health workers, are likely to bear a heavier burden as the pandemic plays out in polio-affected countries. Their health and safety are a priority and we are working on ways to mitigate impact including making sure that their voices are heard in management and leadership positions.

Pause in immunization campaigns

All countries planning to conduct poliovirus preventative campaigns are advised to temporarily postpone these campaigns until the second half of 2020. Countries which were planning to conduct poliovirus outbreak response campaigns are advised to postpone these campaigns until 1 June 2020 and then reevaluate based on the status of the COVID-19 pandemic.

The final decision to proceed with outbreak response rests with countries, who will need to evaluate the risks of a delayed response to detection of poliovirus against the risks of an immediate response, which could contribute to further spread of SARS-CoV-2 and more cases of COVID-19. Should an outbreak response campaign be pursued, countries should ensure measures needed to uphold infection prevention and control, protect health workers and safeguard the public are in place.

We take this decision with deep regret, knowing more children may be paralyzed by polio as a result. Nonetheless, GPEI believes it is the correct decision, given the imperative to save lives in the current emergency and not contribute to the further spread of COVID-19.

To mitigate the risks of lower immunity levels and to protect children from paralysis, GPEI will continue to work to the extent possible on strengthening essential immunization in the highest-risk areas for spread of poliovirus. This will be carried out under relevant WHO recommendations including the recommendation to prioritize vaccines for outbreak prone diseases such as polio, measles, diphtheria and yellow fever.

To more effectively meet communities’ health needs, the polio network will support delivery of basic services where it has the capacity to do so, including in Afghanistan, for example, through advocating for the establishment of health facilities in the most high-risk areas. We believe that the delivery of such basic services would contribute both to a successful COVID-19 response in these areas and to build trust and valuable engagement opportunities. As soon as it judged safe to do so, GPEI will support countries in conducting the appropriate catch-up vaccination campaigns.

Maintain surveillance

GPEI will place the highest priority on the continuation of poliovirus surveillance (acute flaccid paralysis and environmental) to closely monitor the circulation of wild and vaccine-derived polioviruses. GPEI will provide guidance and active support for countries on issues such as managing disruptions to shipping of stool samples, use of community surveillance and digital platforms and expanding environmental surveillance, where acute flaccid paralysis surveillance cannot be carried out.

Ready to end polio

GPEI will keep momentum on strategic areas to minimize loss of ground. We will ensure that we will come back stronger and faster when the COVID-19 emergency subsides, driven by our determination to achieve a polio-free world.

To prepare for this scale-up GPEI will work over the coming months to ensure the availability and readiness of polio vaccines with the goal of rapidly vaccinating at-risk communities as soon as the situation allows. Work will continue at full speed on the development and use of novel Oral Polio Vaccine type 2, with the aim of rolling out the new vaccine by the third quarter of 2020.

Over the coming months, continued partnership and support from donors and stakeholders will be critical to ensure GPEI continues driving progress toward polio eradication, given the likelihood that postponement of vaccination campaigns will lead to lengthened eradication timelines and increased resource needs. GPEI commits to keeping our donors and other stakeholders updated as the polio programme adjusts to the evolving COVID-19 global emergency.

Solidarity with the most vulnerable.

Eradication is about reaching the unreached and the most vulnerable. GPEI has been able to focus resources and strategies on how best to reach these communities, how to build trust and how to engage with them. These are also relevant challenges for implementing a successful COVID-19 response in the highest risk communities. All those working on and investing in a polio-free world should be proud of their contribution to the challenge of COVID-19. They are providing an important input into stronger health systems and global health security. They are supporting the ability of countries to prepare for and respond to emergencies, and ultimately to serve their most vulnerable.

Now, more than ever, is the time for solidarity and service above self.