Polio Eradication: Global Update 17June 2014 There is extraordinarily good news, and there are some extraordinary challenges. Over the next 15 minutes, I’ll provide a brief update on where we are, what we/you are doing, and what it will take to End Polio Now. Rotary is the organization that first had the vision of a polio-free world. And Rotarians know well what is at risk if we fail and more importantly, what we will gain when we succeed.

Progress in Polio Eradication When Rotary launched the PolioPlus program in 1985, 125 countries were endemic for the poliovirus and over 350,000 children each year were being paralyzed or dying from polio. That’s 1000 each day. In 2013, only three countries, Pakistan, Afghanistan and Nigeria had never stopped the transmission of the wild polio virus.

Southeast Asia: Certified Polio-Free 27 March 2014 11 countries 189 polio immunization campaigns 189 polio immunization campaigns 13 billion doses of vaccine 1.8 billion people 143,000 Rotarians The most exciting news is that India, once considered the country that could never stop the transmission of polio because of its dense population and poor sanitation succeeded in stopping polio and celebrated three years of no polio in January 2014. This paved the way for the entire Southeast Asia region of the World Health Organization to be certified polio-free—having proven that the 11 countries in the region have stopped transmission of the virus. The numbers are staggering. In India alone during a National Immunization Day, 172 million children under the age of 5 are targeted with the polio vaccine.

More good news is that of the three types of polio—it appears that two of the types have been eradicated, leaving only one virus type that continues to circulate.

Polio Endgame Plan 2013-2018 Budget: US$ 5 Polio Endgame Plan 2013-2018 Budget: US$ 5.5 billion Funding gap: US$1 billion The Polio Endgame Plan that was launched in 2013 is a comprehensive plan to build on these successes and secure a polio-free world—forever. There are many new strategies within the plan. The budget for the 6-year period is US$5.5 billion, much of which has been committed over the past year or so.

Inactivated Poliovirus Vaccine (IPV) Bivalent OPV (bOPV) The plan calls for the use of bivalent vaccine to target type 1 and ensure that type 3 polio is really gone. It also plans for the introduction of one dose of inactivated polio vaccine into the routine immunization systems of countries that use only oral polio vaccine.

Islamic Advisory Group (IAG) Further, the plan calls for new partners to help address the challenges in the remaining polio affected countries and to help with he introduction of the inactivated vaccine.

$4.3B pledged for Polio Endgame Plan As noted earlier, a significant portion of the Us$5.5 billion budget has been committed at the first ever Vaccine Summit in Abu Dhabi last year. On stage here you can see many representatives from the region, as well as Rotarian Deepak Kapur from India who was asked to speak about the success in India, the lessons learned and Rotary’s role therein.

Polio-paralyzed children, 2013 406 Polio-paralyzed children, 2013 So where are we today? Last year, 406 cases of polio were reported in the three endemic countries AND in five countries that are suffering outbreaks of polio. Outbreaks of polio are expected as long as endemic virus continues to circulate in Pakistan and Nigeria, and the strategic plan has provided budget for these occurrences. But that budget is being tested with the extent and duration of the outbreaks.

Polio cases, 2012 vs. 2013 In 2013, polio cases in the outbreak countries outnumbered the polio cases in the endemic countries. Nigeria and Afghanistan showed tremendous progress, while Pakistan continues to be off track for ending polio transmission. I will talk a little it more about that in a minute.

International Spread of Polio All of the virus in the world can be traced back to either Nigeria or Pakistan. Which is why special attention needs to be paid to these two countries. As you can see form the arrows, virus from Nigeria spread to Cameroon and the Horn of Africa, and virus from Pakistan spread to Egypt, Israel and the West Bank and Gaza, and as you all know too well, to Syria, putting the region at risk.

PolioPlus Grants: Responding to the Outbreak US$500,000 Rapid Response Grant to WHO for outbreak response PolioPlus Partners grants for Social Mobilization and Lab Support Rotary was one of the first responders to the outbreak by providing what we call a “Rapid Response” grant. We provided funds to the World Health Organization such that they could quickly mount a response. This is a unique feature of Rotary as no other donor is able to deploy funds as quickly as we do. It helps get activities moving very quickly which is critical for an effective response, and acts as a catalyst for other donors. The funds were used in Turkey, Palestine, and Iraq. In addition, through PolioPlus Partners, Rotary has provided funding to Rotarians in the region to implement activities to raise awareness of the importance of vaccinating children against polio as well as providing lab support.

Pakistan 2013 > 500,000 children unreached with polio vaccine In Pakistan, over 500,000 children weren’t reached with the polio vaccine in 2013.

Access and security issues continue to plague the country and must be resolved in order to keep more children from being paralyzed. Pakistan newspapers report daily some crisis related to polio eradication efforts.

Access and Security Issues Yet Rotary and some government officials are working hard to turn the situation around by actively participating in vaccinating campaigns, often at very significant personal risk. Vaccinators need to be protected by armed security guards while carrying out vaccination campaigns. Innovative strategies are being developed, such as polio Sundays, one day of highly intensive polio immunization activities to mitigate risk and ensure children are vaccinated. Or the opposite strategy of not publicizing NIDs.

All Rotarians are invited to participate in history by supporting our Make History today campaign. Every US$1 dollar that Rotary commits in direct support for polio immunization (up to US$35 million per year) will be matched by an additional US$2 dollars from the Gates Foundation through 2018. This means contributions to Rotary’s PolioPlus program will have three times the impact. Rotary’s fundraising, paired with continued advocacy to donor governments will help secure the financial resources necessary for the success of the Strategic Plan.

Thank you! Thank you for what you have done and what you will continue to do to make polio immunization activities a priority in your countries.