CDC REPORTS ON FIGHT AGAINST POLIO IN PAKISTAN AND AFGHANISTAN

FROM:  CENTERS FOR DISEASE CONTROL AND PREVENTION 

Progress and Challenges Fighting Polio in Pakistan and Afghanistan
Not reaching every child jeopardizes progress and risks re-introduction in other parts of the world

Both Pakistan and Afghanistan saw an overall decrease in wild poliovirus (WPV) cases from January – September 2013 compared with the same time period in 2012 according to data published in the Morbidity and Mortality Weekly Report (MMWR) released today by the Centers for Disease Control and Prevention (CDC).  Since 2012, transmission of indigenous WPV has been limited to three countries: Afghanistan, Pakistan, and Nigeria.  Results for Nigeria will be released in December.

Both countries still face significant challenges in reaching unvaccinated children.  Afghanistan is fighting a polio outbreak in the Eastern Region while Pakistan continues to see polio increases in the conflict-affected Federally Administered Tribal Areas (FATA), where there is a ban on polio vaccination, and in security-compromised Khyber Pakhtunkhwa Province. The potential risk of transmission to other countries highlights the need for strong ongoing global efforts to eradicate this disease.

“Although there have been setbacks, we are making progress towards global polio eradication,” said CDC Director Dr. Tom Frieden, M.D., M.P.H. “There is encouraging progress in Afghanistan, but, as long as transmission is uninterrupted in Pakistan and Nigeria, the risk for spread to other countries continues because polio anywhere presents a threat of polio everywhere."

In Afghanistan, confirmed cases of WPV dropped from 80 in 2011 to 37 in 2012.  The downward trend continues for 2013 with only eight cases confirmed during January–September 2013, compared with 26 during the same period in 2012.  All eight polio cases in 2013 were in the Eastern Region and originated from the wild poliovirus in Pakistan.

This week Afghanistan achieved a significant milestone - 12 months without any recorded cases of wild poliovirus in the traditionally polio-endemic provinces of Kandahar and Helmand, long recognized as Afghanistan's epicentres of polio.  This unprecedented progress is an endorsement of the effectiveness of the polio eradication programs and their implementation in the Southern Region.    

akistan reported a decrease from 198 WPV cases throughout the country in 2011 to 58 in 2012 in selected areas.  Fifty-two cases were reported during January–September 2013, compared with 54 cases during the same period in 2012.   However, because of additional cases since September, 2013 Pakistan has now surpassed the 2012 numbers, thus reversing the downward trend.   Eighty-four percent of cases reported since January 2012 occurred in the FATA and Khyber Pakhtunkhwa Province.

Approximately 350,000 children in the FATA have not received polio vaccines during immunization campaigns conducted since mid-2012 because local authorities have banned vaccination. In other areas of Pakistan, polio vaccination teams have encountered increased security threat-levels, hindering immunization programs.  Further multi-pronged efforts to reach children in conflict-affected and security-compromised areas will be necessary to prevent WPV re-introduction into other areas of Pakistan and other parts of the world.  This situation requires all countries to take additional public health actions to strengthen detection and strengthen protection by enhancing polio surveillance programs and intensifying vaccination efforts.

SECRETARY OF HEALTH AND HUMAN SERVICES KATHLEEN SEBELIUS SPEAKS ON ERADICATING POLIO WORLDWIDE

SEC. OF HHS KATHLEEN SEBELIUS

FROM: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
The Legacy of a Polio-Free World

September 27, 2012
New York, NY
Thank you, Senator Wirth. Excellencies and distinguished guests, on behalf of President Obama and the American people, I want to begin by saying how proud we are to be part of the international effort to eradicate polio.

When I was born, polio was still a feared disease in the United States. It was still common to see Americans stricken with the disease on crutches and in wheelchairs. In 1952, when I was four, our country suffered its worst outbreak yet. More than 21,000 people were paralyzed and 3,000 died, most of them children.

Three years later, the Salk vaccine was introduced. And over the course of the next decades, I got to witness a modern miracle: a disease that once struck fear into the heart of every American parent disappearing completely.

This January, I was fortunate to be in New Delhi as we marked the latest milestone in the world’s effort to eradicate the disease: a full year since India’s last case of polio. A decade ago, India accounted for 85 percent of new polio cases worldwide. Today, India is the latest proof that when a country makes polio eradication a social movement and creates an inescapable accountability process, we can eliminate polio anywhere.

I want to commend the governments of Pakistan, Afghanistan, and Nigeria for establishing their own emergency action plans. And I want to reiterate the United States’ continuing support for global eradication. We must get over the finish line. And that means strengthening systems down to the most remote village so that every child benefits from the protection vaccines can offer.

Over the last 20 years, the US has invested more than $2.1 billion in polio eradication, in partnership with WHO, UNICEF, Rotary International, additional donor nations, affected countries, and the Gates Foundation.

But if we are going to wipe out polio once and for all, now is the time to redouble our efforts. As long as the polio virus survives, there is risk of resurgence. And the longer we take to eradicate the disease, the longer we will have to wait to free up resources that can be devoted to other urgent health needs.

That’s why the United States has significantly increased our financial support for polio eradication over the last four years. And it’s why in December, we committed our full scientific capabilities to the effort as well, activating the CDC’s Emergency Operations Center, which allows for better coordination in our international efforts.

Now, we need all donors and partners to do their part, with affected countries in the lead. A future in which polio is a childhood memory for the people of every country is within reach. But we will only get there if each of us fully commits to the final push.

Thank you.

PRESIDENTS OF BRAZIL AND U.S. WANT TO STRENGTHEN HEALTH SYSTEMS WORLDWIDE

FROM:  U.S. STATE DEPARTMENT
The United States and Brazil: Health Cooperation
Fact Sheet
Bureau of Western Hemisphere Affairs
April 9, 2012
President Obama and President Rousseff are united in their desire to strengthen public health systems and to advance science and technology research, both in their own countries and around the world. For several decades the United States and Brazil have participated in a bilateral dialogue that provides a formal venue for discussing our mutual interests in medical research, disease surveillance, and improving public health. President Obama and President Rousseff have further advanced our bilateral health cooperation through the U.S.-Brazil Working Group on Public Health, under the U.S.-Brazil Joint Commission on Science and Technology.
The U.S. and Brazilian governments have a strong and fruitful relationship on health cooperation including key collaborations such as:

Field Epidemiology Training Program (EPI-SUS): EPI-SUS trains Brazilian field epidemiologists to improve disease detection and response capacity and the exchange of information globally. In addition, EPI-SUS epidemiologists participate with U.S. Centers for Disease Control and Prevention (CDC) in Stop Transmission of Polio (STOP) activities in Angola.

Global HIV/AIDS: CDC has had an in-country office in Brazil since 2003 and is co-located within the Brazilian Ministry of Health (MOH). Through collaboration with the MOH and other in-country partners, CDC activities focus on HIV/AIDS program monitoring and evaluation within the national program.

Chronic Diseases: The United States and Brazil are working together to strengthen chronic disease surveillance and evaluation. The collaboration has resulted in the establishment of a risk factor surveillance system and expansion of national physical activity programs;

Immunizations: For the past four years, the United States and Brazil, together with the Pan American Health Organization, have supported Rubella Elimination in the Americas and other immunization-related objectives.

Influenza: CDC supports increased capacity for influenza surveillance, improved laboratory sampling and testing, and enhanced rapid response capability and training through a cooperative agreement with the Brazilian MOH. In collaboration with CDC, Brazil developed the fourth version of their pandemic influenza plan in 2010, which is based on lessons learned from the 2009 H1N1 pandemic.

Research: As of 2010, Brazilian research institutions receive more National Institutes of Health (NIH)-supported international research funds than any other country in Latin America – one indicator of the high quality of their research. CDC and NIH are also partnering with Brazil in the “Science without Borders” initiative.

Cancer: Brazil is one of five member countries (also Argentina, Chile, Mexico, and Uruguay) of the U.S.-Latin America Cancer Research Network, an effort to involve regional academic laboratories, research institutes and centers, and hospital systems are developing the infrastructure to conduct and sustain high-quality cancer research throughout Latin America.

Advancement of Women’s Health: Under our joint US-Brazil Memorandum of Understanding on the Advancement of Women, we are also focusing on women’s health. Examples include a new partnership with the What to Expect Foundation to improve maternal health and literacy. The Institute for Training and Development and Smith College will partner with a Brazilian network of 53 non-government organizations (NGOs) in 16 Brazilian states, to send 20 women for six-week internships at U.S. women’s health NGOs. Our two governments are also in the early stages of considering bilateral engagement opportunities to promote women’s health in prisons.

Racial and Ethnic Disparities in Health Access and Care: Another high priority activity is the exchange of information and experts in furtherance of the Joint Action Plan to Eliminate Racial and Ethnic Disparities, which shares best practices between CDC, HHS, and the Brazilian MOH and civil society experts on racial disparities in access to health, data collection and hereditary diseases and blood disorders.

Regulatory Public Health Activity: Both the U.S. Food and Drug Administration (FDA) and ANVISA (the FDA counterpart agency within the Brazil Ministry of Health) have enjoyed a very productive and long relationship with informational exchange on processed food, medications and medical devices, and firm inspections being done by ANVISA in the U.S. and by FDA in Brazil. This relationship was further strengthened with the signing of a confidentiality commitment document by both Agencies. At this point, FDA and ANVISA are involved in pre-decisional as well as post-market assessment of regulated products and capacity-building events. With respect to the Brazil Ministry of Agriculture (MAPA which covers raw produce, fish and seafood), FDA has a close relationship with joint activity in the regulated food categories of interest and there are FDA firm inspections being conducted in Brazil.