Polio Legacy Planning discussion On behalf of Dr Salla Mbaye AFRO MR TAG meeting , June 2015

Outline Background Objectives and activities GPEI assets Progress in AFR Draft Global legacy framework Next steps

Polio Eradication & Endgame Strategic Plan 2013-2018 Poliovirus detection & interruption (by 2014) Immunization systems strengthening & OPV withdrawal (OPV2 by 2016) Containment & Certification (by 2018) Legacy Planning

Polio Eradication & Endgame Strategic Plan 2013-2018

Polio Legacy Planning: Objectives & activities Aim: Develop a plan to ensure polio investments contribute to future health goals, through documentation and transition of lessons learnt, processes and assets of the GPEI Major activities: Mainstreaming polio functions continued integration of polio immunization (utilizing IPV) and communications polio surveillance and response activities into national and global disease alert and response mechanisms appropriate containment of polioviruses according to agreed international and national standards, regulations and protocols Leveraging the knowledge and lessons learnt Share lessons of more than 20 years of polio eradication with other health initiatives Transitioning the assets and infrastructure to support other health priorities

GPEI Assets Human resources: Teams and individuals at global, regional, & country levels Knowledge: experience and expertise on a wide range of issues of public health value, documentations Systems: Networks, systems & processes, AFP surveillance, Polio laboratory network, partner coordination, governance, GIS/GPS Physical: Vehicles, communication & information technology equipment, work locations, etc Financial resources: Governments, local and GPEI partners funds

Immunisation Human Resources, 2014 CORE STAFF POLIO FUNDED STAFF, 93% (n=855) SURGE NON-POLIO FUNDED STAFF (n=66) *Kenya, Niger, Tanzania, Uganda

Partners Contribution 2014 Polio Funding: $321,929,065 Partners Contribution By Activity By Country

Progress in AFR RC 63 in Sep 2013 favoured scenario 2: transition of the lessons, assets and resources to benefit other existing and relevant national, regional and/or global public health programmes Regional inter-cluster working group established to: Document best practices Develop a regional framework Elaborate regional legacy plan Workshop held to develop protocol for documenting polio best practices in countries Documentation conducted in 2014/2015 in 8 countries: Angola, Chad, Cote d’Ivoire, DRC, Ethiopia, Togo, Nigeria and Tanzania Working group not functional for several months due to EVD outbreak response

Using Polio Infrastructure Establishment of zones, hubs, sub-regions with appropriate staff and resources in priority countries Surveillance of other diseases - Measles, Yellow Fever Capacity building Data management Supplemental Immunisation Activities Measles Vitamin A and other pluses Communication Routine Immunisation Micro-planning Nigeria EOC helps response to Ebola Emergency responses Certification committees identified for tOPV/bOPV switch validation

EB January 2015- Legacy Planning Reinforced conclusions of RCs in 2013 should benefit existing health priorities to be driven and led by countries A draft global legacy planning framework and transition guidelines are being prepared to guide legacy planning at country level through a three-phase approach planning and decision-making, preparation, and execution.

Proposed process, roles and responsibilities Three key stages for Legacy rollout in each country, ideally completed by 2018 Given asset base and current epidemiology, legacy planning may require more time for completion in certain geographies Should be a country-level and -led process, bringing together GPEI agency offices, government and key donors/other stakeholders Phase of Transition Planning & Decision Preparation Execution Definition of project oversight structure Selection of transition opportunities, cost assessment Creation of operation and communication strategies Formation of project oversight team MoUs with recipient institutions Revision of contracts Capacity building Donor engagement Implementation of revised contracts Transfer of assets / capabilities Monitoring & Evaluation Ongoing monitoring of transitioned assets / capabilities Activities Leadership Country government Transition Assistance Donor Consortium Project management Professional Project Management Team Roles and responsibilities Asset recipients Technical assistance Agencies and other stakeholders Recipients

Next steps AFR has now nominated members to the Global Polio Legacy Management Group Regional inter cluster working group to be reactivated Legacy planning should be led at country level Planning process should start now With local and global partners support Develop the Regional legacy plan

Anticipated effect to the measles elimination goal in AFR ? The polio legacy plan intends to reduce resources 93% of staff funded by Polio financing will have implications to the regional measles elimination targets unless Resources are rationalised either by member states or identification of alternative source Transition is well thought through in advance to sustain the support to countries with alternatives of preparing countries Costed measles elimination strategic plans could be used for advocacy at country level Other upcoming opportunities need to be immediately thought of Background of reduced resources of traditional partners like MRI & other partners – already reduced resources observed Cost of surveillance will increase as most countries move to elimination mode measles surveillance WHO traditionally to assist with surveillance but with limited funding

Question for TAG Between 2015 to 2018, what can be advocated for to the Region, and member states so that the assets from the Polio Eradication benefit the measles elimination as one of the beneficiaries ? This in background of reduced financial support that is currently faced

Thank you!