Polio commission calls on Europe to improve surveillance and reporting

On the basis of evidence provided by the Member States in the WHO European Region, summarizing their efforts for poliomyelitis (polio) surveillance, monitoring and immunization, the European Regional Commission for the Certification of Poliomyelitis Eradication (RCC) reaffirmed the Region’s polio-free status at its 27th annual meeting in Copenhagen, Denmark on 30–31 May 2013.

Nevertheless, the RCC called for significantly greater engagement in the Region to maintain polio-fee status until global eradication is achieved. Professor David Salisbury of the United Kingdom, RCC chair, expressed its concern that national programmes are “not sustaining the level of quality needed”.

Progress in Member States

An independent panel of 5 international public health experts, the RCC is responsible for monitoring the polio-free status of the WHO European Region. During its 2013 meeting, the RCC reviewed annual reports submitted by Member States to WHO on their work:

• to maintain high immunization coverage;
• to maintain high-quality surveillance for acute flaccid paralysis (AFP) and/or supplemental surveillance systems; and
• to plan national responses to poliovirus importation.

National preparedness plans for a potential outbreak of imported wild polio revealed not only significant progress by many countries but also issues requiring further attention. These included identifying the types of vaccines to be used in immediate response (after detection of an initial case) and their sources/suppliers, and securing funds for their procurement.

The RCC commended countries that had improved their preparedness by participating in WHO-facilitated polio outbreak simulation exercises in the past year (Armenia, Azerbaijan, Georgia, the Russian Federation, Ukraine and the United Kingdom). It called on others to take all available opportunities to increase their preparedness.

WHO/Europe described the surveillance data received regularly from countries over the previous year. The main challenges identified included some gaps in surveillance and insufficient vaccination coverage rates.

Outcome

Based on the available national reports and data on surveillance and immunization, the RCC concluded that there was no circulation of wild or vaccine-derived poliovirus in the Region in 2012, but expressed increasing concern about:

• the reduced quality of surveillance in the Region;
• challenges to immunization programmes in some countries;
• the increased number of countries that did not submit an annual update on polio;
• the absence of a national certification committees (NCCs) in some Member States; and
• incomplete information or delays in NCC reports.

In conclusion, the RCC repeated the need for Member States to achieve the highest immunization coverage and to have high-quality surveillance systems in place, so that they could rapidly detect any poliovirus transmission and respond with control measures.