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MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT. 1999 Jun 25; 48(24):513-8.This report outlines progress toward polio eradication from 1998 through April 1999 in the African region (AFRO). WHO accelerated various strategies to annihilate poliomyelitis in the region of Africa. A highlight of supplementary vaccination activities [i.e., National Immunization Days (NIDs) and acute flaccid paralysis (AFP) surveillance] was conducted in the region, and plans for program acceleration--such as intensified NIDs and mopping-up vaccinations to meet the 2000 eradication project--were developed. However, intense wild poliovirus transmission continued to occur in Angola, DR Congo, and western and central Africa. Thus, high-quality house-to-house vaccination campaigns were launched to help eliminate wild poliovirus transmission quickly in these parts of AFRO. Although civil conflict, economic decline, and the high burden of HIV-related diseases have strained public health infrastructures leading to a decline in routine vaccination coverage and low health staff morale in Africa, an intensely focused effort to eliminate the virus, if it is adequately supported, will allow WHO to achieve its goal of polio eradication by 2000.
Adverse events monitoring as a routine component of vaccine clinical trials: evidence from the WHO Vaccine Trial Registry.
Bulletin of the World Health Organization. 2000; 78(9):1167.This article assesses whether and how investigators are monitoring adverse events following immunization (AEFI) in vaccine trials, using evidence from the WHO Vaccine Trial Registry. It is noted that the Registry includes all vaccine trials sponsored since 1987 by the WHO Expanded Programme on Immunization, Global Programme for Vaccines and Immunization, and Department of Vaccines and Biologicals. For each trial, records include internal documents, reports of visits to trial sites, and publications. Based on the records from 68 trials, completed or in progress, analysis indicates that only few investigators included detailed AEFI monitoring in their study reports and publications. However, an increasing trend to include AEFI monitoring in vaccine clinical trials was noted. Since many vaccine trials are conducted by independent investigators, and AEFI monitoring methods and results deserve to be included in any publication, along with vaccine efficacy methods and results, it should be the responsibility of the study investigators, rather than of the vaccine manufacturer and the national control authority, as suggested. Several practical points for monitoring AEFIs in vaccine clinical trials are cited.
Lancet. 2003 Jul 12; 362(9378):159-164.This is the third paper in the series on child survival. The second paper in the series, published last week, concluded that in the 42 countries with 90% of child deaths worldwide in 2000, 63% of these deaths could have been prevented through full implementation of a few known and effective interventions. Levels of coverage with these interventions are still unacceptably low in most low-income and middle-income countries. Worse still, coverage for some interventions, such as immunisations and attended delivery, are stagnant or even falling in several of the poorest countries. This paper highlights the importance of separating biological or behavioural interventions from the delivery systems required to put them in place, and the need to tailor delivery strategies to the stage of health-system development. We review recent initiatives in child health and discuss essential aspects of delivery systems, including: need for data at the subnational level to support health planning; regular monitoring of provision and use of health services, and of intervention coverage; and the need to achieve high and equitable coverage with selected interventions. Community-based initiatives can extend the delivery of interventions in areas where health services are hard to access, but strengthening national health systems should be the long-term aim. The millennium development goal for child survival can be achieved, but only if strategies for delivery interventions are greatly improved and scaled-up. (author's)
CMAJ: Canadian Medical Association Journal. 2004 Jan 20; 170(2):189-190.As of Oct. 29, 2003, Nigeria gained the dubious honour of having the highest number of reported cases of polio (217 new cases) in the world, surpassing the previous leader, India. The resurgence of poliomyelitis in northern Nigeria poses a threat to neighbouring countries and further postpones the goal of the World Health Organization (WHO) to eradicate the disease globally. This is by no means an impossible goal: humans are the only natural reservoir, an inexpensive and effective vaccine is available, immunity is life-long, and the virus can survive for only a very short time outside the human host. (excerpt)
Report on country experience: A multi-sectoral response to combat polio outbreak in Namibia. Draft background paper.
[Unpublished] 2011. Draft background paper commissioned by the World Health Organization for the World Conference on Social Determinants of Health, Rio de Janeiro, Brazil, 19-21 October 2011.  p. (WCSDH/BCKGRT/19/2011; Draft Background Paper 19)Namibia witnessed an outbreak of Wild Polio Type 1 virus in 2006. A total of 323 suspected cases of Acute Flaccid Paralysis were reported, of which 19 were confirmed as Wild Polio Virus Type 1. The outbreak affected mostly the older population and thirty-two of the suspected cases died. The country mounted an immediate response that enabled the whole population to be vaccinated against polio virus. The outbreak of the epidemic witnessed an unprecedented response with the country coming together in the spirit of one Nation facing a common enemy. The reported deaths in some communities engendered fear among the populace and motivated the people to seek early treatment and prevention from further spread of the outbreak. The key to the successful response to the outbreak included: Political commitment; Resource mobilization and availability; Support of international community; Good community mobilization and cooperation from the communities; Commitment and dedication from the Health Care Providers and the volunteers; Team work and delegation; Good communication and support from the media. (Excerpt)