NVAC

The Global Certification Commission declares the world polio-free when: No wild poliovirus has been found for at least 3 consecutive years All laboratories have adopted appropriate measures of containment

Appropriate measures of containment assume that: Global polio immunization recommendations remain in force. Immunization rates will likely decrease in the absence of disease.

WHO Global Action Plan for Laboratory Containment GOAL: To minimise the risk of reintroduction of wild polioviruses from the laboratory to the community 2nd edition 2002

Global Action Plan links biosafety measures to polio eradication progress

Laboratory inventory When Regions become polio-free. Encourage Institutions/labs to dispose of unneeded wild poliovirus infectious and potential infectious materials. Establish National Inventories of laboratories retaining such materials.

Update on US National Inventory October 2002: Letters from ASH and inventory packages were mailed to >31,000 institutions with biomedical laboratories. December 31, 2002: Target date for replies

National Laboratory Inventory response rate/category in database 95% of 104 state/local government 93% of 14 federal government 78% of 684 industry/biotech 77% of 865 academic institutions 66% of 5,171 hospitals 57% of 20,717 private laboratories 53% of 4,800 other categories = 59% of 32,355(01/31/03)

National Laboratory Inventory No. institutions with WPV among those reporting 44 of 665 academic institutions 19 of 3,419 hospitals 18 of 535 industry/biotech 13 of 2,561other categories 13 of 11,835 private laboratories 13 of 99 state/local government 05 of 13 federal government = 131 with WPV materials (01/31/03)

National Laboratory Inventory No. labs with WPV of no. surveyed 82 of 53,626 academic institutions 30 of 1,831 federal government 25 of 7,837 industry/biotech 17 of 8,289 hospitals 15 of 254 state/local government 14 of 7,314 private laboratories 12 of 3,609 other categories = 195 of 82,760 (01/31/03)

Next Steps Reminder letters to all non-responders (February and again March) Validate and reconcile database information Telephone follow up (April and May)

Global Certification w hen one year has passed with no evidence of wild poliovirus transmission worldwide. Labs on inventory have one further year to: -dispose of wild poliovirus materials or -implement biosafety measures

BSL-3/polio Activities involving poliovirus permissive cells or animals BSL-3/polioAll activities, including storage BSL-2/polio (within a class II Biosafety Cabinet) Other activities (including bacteriology, etc laboratories) Potential WPV infectious: Clinical Environmental Laboratory Products WPV Infectious: Clinical Environmental Laboratory Products Biosafety Level Laboratory Activity Type of Material Certification phase biosafety measures

Global Certification w hen two years have passed with no evidence of wild poliovirus transmission worldwide. Nations have one further year to: - ensure national containment is complete and -submit documentation to WHO.

Global Certification of Poliovirus Eradication

Post global certification: At some time after certification, international bodies will consider future immunization policies. Potential increased containment will be one of several factors influencing decisions to: continue IPV and OPV or discontinue OPV, with/without switching to IPV