Abstract
The requirements under objective 2 of the Polio Eradication and Endgame Strategic Plan 2013–2018—to introduce at least 1 dose of inactivated poliomyelitis vaccine (IPV); withdraw oral poliomyelitis vaccine (OPV), starting with the type 2 component; and strengthen routine immunization programs—set an ambitious series of targets for countries. Effective implementation of IPV introduction and the switch from trivalent OPV (containing types 1, 2, and 3 poliovirus) to bivalent OPV (containing types 1 and 3 poliovirus) called for intense global communications and coordination on an unprecedented scale from 2014 to 2016, involving global public health technical agencies and donors, vaccine manufacturers, World Health Organization and United Nations Children’s Fund regional offices, and national governments. At the outset, the new program requirements were perceived as challenging to communicate, difficult to understand, unrealistic in terms of timelines, and potentially infeasible for logistical implementation. In this context, a number of core areas of work for communications were established: (1) generating awareness and political commitment via global communications and advocacy; (2) informing national decision-making, planning, and implementation; and (3) in-country program communications and capacity building, to ensure acceptance of IPV and continued uptake of OPV. Central to the communications function in driving progress for objective 2 was its ability to generate a meaningful policy dialogue about polio vaccines and routine immunization at multiple levels. This included efforts to facilitate stakeholder engagement and ownership, strengthen coordination at all levels, and ensure an iterative process of feedback and learning. This article provides an overview of the global efforts and challenges in successfully implementing the communications activities to support objective 2. Lessons from the achievements by countries and partners will likely be drawn upon when all OPVs are completely withdrawn after polio eradication, but also may offer a useful model for other global health initiatives.
Highlights
In May 2012, the World Health Assembly (WHA) declared the completion of poliovirus eradication to be a “programmatic emergency for global public health” and called on the Director General of the World Health Organization (WHO) to develop a comprehensive polio endgame strategy [1]
A deadline of December 2015 was set for the introduction of inactivated poliomyelitis vaccine (IPV) in the 126 countries that were not already using this vaccine in routine immunization programs
As a result of significant efforts around the world, almost all countries have since added IPV into their routine immunization schedules within this time frame, because of a global shortage of IPV, approximately 50 countries at low risk for polio transmission are experiencing delays in resupply or stockouts that are likely to persist until 2018
Summary
At the beginning of preparations for both IPV introduction and the OPV switch, a detailed communications plan was generated. One approach that proved to be effective in generating momentum for IPV introduction was the organization of region-specific workshops and consultant trainings in late 2014, followed by full-day sessions during regional immunization manager meetings in early 2015 These forums brought together multiple stakeholders, including program managers, senior staff from ministries of health and regional partner agencies (eg, from the WHO, UNICEF, and the Centers for Disease Control and Prevention), and national and regional technical experts, and resulted in the formation of networks for the sharing of evidence, guidance, and experiences. The discussions that took place were pivotal for offering a platform for voicing concerns and collective problem solving, cultivating an understanding of the rationale for IPV introduction and steps to implementation, exchanging relevant lessons learned from vaccine introductions to date, and informing the refinement and future directions of all communications materials and guidance produced by the CWG These opportunities for dialogue often served to stimulate local innovations, in some cases shaped by global guiding principles, and further encouraged regional and national ownership and leadership. While the initial phases of work were dedicated to raising awareness and informing decision-making, the accelerated timelines required that efforts rapidly move to focus on planning and preparations for implementing IPV and the OPV
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