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Honourable
Ministers,
Other
Delegates,
Welcome and thank you for being here at this
important meeting – I am more than aware of the pressures on your
time this week, but this meeting reflects the importance and urgency
of the issue before us – rapidly finishing the job to eradicate
polio.
Your response to the World Health Assembly’s
resolution in 1999 to accelerate polio eradication activities has been
extraordinary. All of the polio-endemic countries here today have
increased the number of national immunization days they conduct each
year. All of the countries here have introduced a house-to-house
strategy to reach more children during those NIDs. More than 550
million children have been reached in the last year alone, the
majority as a result of efforts in the 8 countries you represent.
All of you have seen dramatic progress as a result.
The global polio burden has been cut by more than half, despite an
increase in surveillance sensitivity. In some of the countries here
today, progress was particularly remarkable. Only one polio virus was
found in Bangladesh last year. India, which had nearly 200 000 cases
in 1988 when we began this initiative, has had only 9 cases so far
this year. Surveillance for the virus has improved dramatically. We
can finally say that a polio-free world is truly in sight.
Your work towards this goal is commendable. As the
number of endemic countries plummeted from 50 at the beginning of 1999
to only 20 at the beginning of this year, I have been able to follow
individual countries progress much more closely. I am impressed to
learn of your extraordinary efforts to reach children even in
extraordinary circumstances. The accomplishments in the Democratic
Republic of the Congo in reaching over 10 million children during NIDs
has been an inspiration to everyone. Almost all of us have been
personally involved in launching National Immunization Days –
ensuring health workers and families are even more motivated to
immunize every child under five. Many of you have also taken a
personal interest in ensuring higher quality immunization activities
and improved disease surveillance.
Today, I would like to congratulate you on this
progress and ask your advice on how we can all do more. Combined, the
eight countries represented here account for 80% of the remaining
global polio burden. Substantial work must be done urgently if we are
to stop transmission of the virus within the next 24 months. I believe
that working together, as in fora like this one, we can achieve zero
polio in every country. I believe this will be achieved only if a
renewed sense of urgency is applied to finishing the task at every
level.
Just last week, the Global Polio Technical
Consultative Group re-affirmed the feasibility of polio eradication
and reiterated the urgency of overcoming the major challenges to this
initiative. The biggest threat is a funding gap of US$400 million
dollars. At a global level, we are working with our partners to fill
this gap. However, we must mobilize more resources at country level.
Discussions with donors and partners clearly indicate that the
largest potential for pursuing additional support is to be
found at a national, not a multilateral, level. Securing these
funds, whether from donor governments, development banks, the private
sector – or indeed your own governments, will require a clear
message from national health authorities. I encourage you to examine
every possible funding source within your countries and engage them in
discussions to support our goal. WHO is firmly committed to
facilitating these discussions.
As you know, the circulation of wild poliovirus in
these eight countries poses a risk to our children, children in
neighbouring countries, and in fact, to children everywhere.
Increasingly, genetic sequencing demonstrates that much of the
remaining wild poliovirus in the world originates in these countries.
Events of this past year illustrate this all too clearly. Importations
into longstanding polio-free countries as varied as Cape Verde and
Bulgaria caused new outbreaks. Children in these countries suffered
permanent paralysis and even death – from a disease that we had
promised to eradicate by 2000.
This cannot continue. We must further improve all
polio eradication activities if we are to break the final chains of
transmission and protect children everywhere. This requires reaching
more children than ever, using a house-to-house strategy. High quality
surveillance tells us which houses to target. Improvements in
surveillance in Ethiopia identified a genetically unique poliovirus
reservoir just last year, demonstrating that at least an additional 2
years of NIDs and mop-ups will be required. It is only with
certification standard surveillance that we can accurately identify
the last areas with polio, and add aggressive, targeted mop-ups to our
NIDs.
We know that the quality of national immunization
and surveillance activities can improve dramatically when you, the
leaders in public health, personally monitor their progress and help
to find solutions to the inevitable obstacles along the way, if
necessary by engaging your Heads of State and Cabinet colleagues. In
Nigeria for example, the active involvement of President Obasanjo has
helped to ensure that even more children were reached during national
immunization days. In Pakistan, the increasingly visible roles of
Chief Executive Musharraf and President Rafiq Tarar are having a
similar impact. In other areas, especially Sudan and Angola, polio
eradication activities have clearly shown that children thought to be
completely inaccessible can actually be reached when communities are
directly engaged and government authorities provide logistical support
either directly or through UN agencies or NGOs.
Eradicating polio is a global priority. It is our
priority. It must be your priority if the funding and access obstacles
are to be overcome. WHO is firmly committed to finishing the job. To
ensure WHO is resolving any internal issues, I meet every month with
my Executive Director Dr Yasuhiro Suzuki and the polio eradication
team to review progress. I know some of you hold similar meetings in
your countries or agencies. The polio eradication partners represented
here today, including UNICEF, Rotary International and CDC, and our
major donors of the past year of Canada, Japan, the Netherlands, the
United Kingdom and the United States of America, are equally
committed.
The past year saw great progress but it also
brought new challenges, providing stark reminders of the need for
urgency in our task. For example, I am sure most of you are aware of
the ongoing outbreak of polio in the Caribbean Island of Hispaniola,
after more than 10 years of being polio-free. It is a sad irony that
these children were paralysed by a vaccine-derived polio virus. Last
week the Technical Consultative Group reviewed the Hispaniola outbreak
in detail and stated that the overriding lesson was the need for
urgency – urgency to finish the job and to stop using this vaccine
as soon as it is safe to do so. This can only happen after polio
eradication.
Recognizing this need for urgency, I suggest we
show just a few slides on the status of the programme, then I invite
you to tell me what more we can do together to solve funding and
access issues at a country level, to achieve zero polio by the end of
2002.
Thank you. |
