Polio Eradicators Use Integrated Analytical Models to Make Better Decisions

Abstract

Achieving global polio eradication requires that global stakeholders coordinate and cooperate to invest human and financial resources in interventions that prevent virus transmission. Reaching this goal depends on effective tools and interventions, and their optimal use. Poliovirus transmission occurs in a complex global system with rapidly evolving viruses that readily cross international borders. The U.S. Centers for Disease Control and Prevention, one of four spearheading partners of the Global Polio Eradication Initiative (GPEI), initiated a collaboration with Kid Risk, Inc. to develop and apply integrated analytical models to answer high-stakes policy questions related to managing the risks of polioviruses with consideration of human health and economic outcomes. Over the last decade, the collaboration innovatively combined numerous operations research and management science tools, including simulation, decision and risk analysis, system dynamics, and optimization to help policy makers understand and quantify the implications of their choices. These integrated modeling efforts helped motivate faster responses to polio outbreaks, leading to a global resolution and significantly reduced response time and outbreak sizes. Insights from the models also underpinned a 192-country resolution to coordinate global cessation of the use of one of the two vaccines after wild poliovirus eradication (i.e., allowing continued use of the other vaccine as desired). Finally, the model results helped us to make the economic case for a continued commitment to polio eradication by quantifying the value of prevention and showing the health and economic outcomes associated with the alternatives. The work helped to raise the billions of dollars needed to support polio eradication. The investments will prevent devastating cases of polio and realize an estimated $40–$50 billion in net benefits by the countries covered by the GPEI, while protecting the significantly larger net benefits enjoyed by the countries that stopped wild poliovirus transmission without support of the GPEI.