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Post00241 Polio + NIDS 11 April 2000 CONTENTS 1. SUGGESTIONS FOR IMPROVING PERFORMANCE DURING NIDS + TIP SHEET 2. MASSIVE EFFORT TO DELIVER ONE BILLION DOSES OF POLIO VACCINE IN INDIA 3. FINAL PUSH IN CAMPAIGN TO ERADICATE POLIO 4. WHEN AND HOW TO STOP POLIO VACCINATION AFTER THE DISEASE IS ERADICATED? 5. POLIO NEWS 1. SUGGESTIONS FOR IMPROVING PERFORMANCE DURING NIDS + TIP SHEET Ellyn Ogden, USAID, has kindly posted a distillation of field thoughts on improving NIDs. The Tip Sheet is a living document. People can add to it to reflect their own experience. If you add suggestions, please add your name and date after the entry and continue to circulate it. Action, comments and additions please: [email=technet@acithn.uq.edu.au]technet@acithn.uq.edu.au[/email] or use your reply button ___________________________________________________________________________ Date: Wed, 9 Feb 2000 16:17:39 EST To: From: "Ellyn Ogden" Subject: Suggestions for improving performance during NIDs Allan: Based on my observations in NIDs and house-to-house immunization in India, Nepal, Nigeria, Angola, and Ethiopia and from my participation in surveillance reviews in India and Egypt, I've drafted the attached "Tip Sheet" to help disseminate suggestions/best practices for conducting NIDs. Many of these suggestions are of the "small kind", but taken together could help make a very good NID into an excellent NID. Please let your readers know that I consider this to be a "living document" and one that needs to take the local context into consideration. I learn more each time I go somewhere, and I would encourage people to send in their own tips. Regards, Ellyn ___________________________________________________________________________ TIP SHEET FOR POLIO ERADICATION First Issued: December 1, 1999 Revised January 30, 2000 Drafted by: Ellyn Ogden Efforts to date have succeeded in immunizing the majority of children (80-90%) against polio, a remarkable achievement in many countries and not easily done - country teams deserve a lot of credit for their accomplishments so far. Extraordinary attention to details and understanding the supply and demand barriers to reaching zero dose children is essential if we are to interrupt virus transmission by December 2000. In addition, we must all be mindful of the need to minimize any negative impact polio eradication may have on health systems and use all opportunities to improve overall immunization and health services whenever possible. This Tip Sheet is a living document. People can add to it to reflect their own experience. If you add suggestions, please add your name and date after the entry and continue to circulate it. I. WHO IS BEING MISSED: Despite several years of intensive efforts, enough children are being missed to maintain virus circulation. We must intensify efforts to reach "zero-dose" children - those children who have not been reached through the routine system or through previous NIDs. These children are typically: - less than 6 months old - those too young or sick to walk to the booth - from ethnic or religious minorities - in geographically hard to reach areas - in urban slums - areas in conflict or inaccessible to the government - in families when immunization has been refused, or the family is unconvinced of the need to immunize. - Unregistered children e.g. families who don't live in "residences", nomads, refugees, people moving from rural to urban areas, people in transit from other countries - Children in the workplace - Children of elites (often opinion leaders) and their staff e.g. housekeeper's or gardener's children - Children on upper floors of high-rise buildings/apartment houses II. TIPS for IMPROVING the Quality of NIDs/SNIDs and Mop-ups: A. During child-to-child (house-to-house) immunization: 1. Vaccinator must ENTER every household, apartment, slum dwelling, church, and school. Only going street to street, or stopping at the entrance to communities or high-rise buildings is not sufficient during these intensified NIDs/SNIDs. 2. Stop using "House-to-house" as a term - too often a house is a place with a stove: USE "child-to-child" instead. 3. Entering every business, market stalls and other workplaces should be considered. 4. Vaccinators should ask how many children under age 5 live in that place; AND, how many children usually live in the place but are away at present. 5. Stopping cars, buses and other vehicles/animals should be considered at porous borders. Vaccinators should be visible and enough warning given to drivers to permit time to slow down e.g. setting up gateways; use police/military (if appropriate) to help screen vehicles and direct traffic. 6. Use community guides (e.g. TBA, school children, community leader) to help assure safe passage for vaccinators, to facilitate access into every household and to help convince reluctant caretakers. 7. Vaccinators should specifically ask for all children under five, and in particular the children under 6 months (who may be sleeping under a table.) 8. Vaccinator should note on the tally sheet (if appropriate) any child who is "zero-dose" meaning children who had not previously been vaccinated with OPV during routine immunization services or past NIDs. Ask if there are any other eligible children who are not at home. 9. Every individual location visited by a team should mark the site to identify if all children were covered or if the team needs to return. It is best if the date and number of children covered is also included. 10. Mark each child's finger with gentian violet after receiving OPV (nail polish and printer's ink also seem to work). The child should be able to show a supervisor the mark. In the event that the mark wears off, the child or mother should still be able to hold up the finger that was marked. 11. If applicable, AFP cases should be noted on the tally sheet. 12. Vaccinators should have a positive attitude, thus encouraging participation and building trust in the health system. 13. Vaccinators should remind caretakers about the need to fully immunize a child and advise when the next rounds of NIDs will take place and their need to keep participating in every round. 14. Vaccinators should be prepared to provide information if necessary: the vaccine is provided free to all eligible children, the vaccine is safe and effective, the vaccine does not cause sterility, polio eradication activities will continue until the last case is found plus a few years as a precaution, need to report AFP cases, etc. B. During every planned NID/SNID/Mop up using a combination of fixed/static sites and/or mobile teams: 1. Use realistic estimates of the target population. Avoid over- reliance on census data. Build on previous coverage if this is reliable. 2. Do not use registries to determine target population - focus on reaching every child. 3. Assure vaccinators and supervisors have sufficient transportation to cover their mapped area in the time allowed and while maintaining vaccines in good condition per VVM. 4. Focus on district level performance 5. Good interpersonal communication is essential: Plan to meet with local, religious and community leaders to enlist their support and advocacy on behalf of the program for this round and for the future. 6. Microplanning: should incorporate these suggestions into the plans and budgets. 7. Supervision: Supervisors should receive separate training to assure they can appropriately monitor implementation and solve problems (see attached). Supervisors should be empowered by the MOH and partners to take corrective action if needed without fear of punishment. VVMs need to be used as a stock management tool. 8. Define specific roles and activities for Rotary and commercial sector. 9. Increase use of NGOs, volunteers, and resources from other sectors (e.g. teachers, students, military if appropriate, commercial businesses). 10. Posters are the least effective method of informing or convincing people to participate in NIDs. If posters must be used, they should not contain time-sensitive information but rather they should inform people about the longer-term plan of action for polio eradication, routine EPI and AFP reporting. 11. Use radio, town criers/miking, religious/community leaders and TV to spread time sensitive information. If possible, enlist the support of local celebrities, sport stars or other influential people. Messages should address a variety of program needs (announce dates, locations, types of supplemental immunization, target the unreached or unconvinced, lay out the long term program). Message development should be done based on rapid research and finalized after testing or focus group review. 12. Special efforts may be needed to convince private practitioners to participate and encourage their patients to receive OPV during NIDs as well as to monitor the cold chain in their offices. 13. Problems must be brought into the open and solved. 14. Provide some recognition and feedback to the vaccinators on their performance - keep motivation high. (e.g. list their names in the newspaper or on the radio) III. TIPS for IMPROVING THE QUALITY OF SURVEILLANCE 1. Sensitization of clinicians regarding the need to report AFP cases rather than "suspected polio" cases takes repeated efforts. One workshop is not enough - don't underestimate the time and difficulty needed to internalize the case definition. 2. Recognize the cultural barriers to timely AFP reporting and stool collection and develop communication messages that target these barriers. 3. Consider the role of rehabilitation in AFP surveillance. Refresher training for clinicians; linking with Rotary or other local resources to assist paralyzed children; and more media messages are not only the right thing to do but it should help encourage reporting once caretakers know that something can be done to help the child. 4. Increase the use of community-based organizations and networks to identify, report and immediately transport the paralyzed child and a family member to a facility where stools samples can be taken and stored. 5. Focus on district level performance. 6. Rapid communication and coordination with border countries is critical. 7. To accelerate AFP surveillance and to more rapidly improve quality of all indicators, consider assigning one surveillance officer for every 2-5 districts - depending on geographic size and population density of the districts. 8. Assure adequate transportation and communication capability for surveillance officers. 9. Vehicles should be painted with AFP reporting slogans. ____________________________________*______________________________________ 2. MASSIVE EFFORT TO DELIVER ONE BILLION DOSES OF POLIO VACCINE IN INDIA ___________________________________________________________________________ Press Release WHO/21 25 March 2000 PRESIDENT CLINTON JOINS MASSIVE EFFORT TO DELIVER ONE BILLION DOSES OF POLIO VACCINE IN INDIA GENEVA/INDIA -- Taking part in the massive public health initiative to eradicate polio, President Clinton gave polio vaccine to an eight-month- old girl at a hospital in Hyderabad, India (24 March), demonstrating his support for the global campaign to eradicate the disease, billed 'Every Child Counts'. Just days before a National Immunization Day was launched (26 March) as part of an intensified phase of the campaign in India, Clinton congratulated India on its enormous success to date. This year India doubled the number of monthly National Immunization Day rounds from two to four throughout the country and added in two more rounds in eight high-risk states. As a result, one billion doses of polio vaccine have been delivered to the nation's children in the last year. Historically India has accounted for more than half of the world's polio. Clinton paid tribute to the organizations spearheading the campaign: the World Health Organization, Rotary International, the U.S. Centers for Disease Control and Prevention and the United Nations Children's Fund (UNICEF), as well as the U.S Agency for International Development. In addition he singled out the contribution made by the Bill & Melinda Gates Foundation and the efforts of its Co-Chair and President Patty Stonesifer. Now concentrated in parts of Africa and the Indian sub-continent, polio will be the second disease ever to be eradicated after smallpox. The challenge now in India is in eight densely populated states, in particular Uttar Pradesh, Bihar, West Bengal and the city of Delhi. There is currently a shortfall of US $300 million out of a total of US $1 billion needed to complete the task through certification of eradication in 2005. With the eradication of polio and the eventual cessation of polio immunization, the world will save US $1.5 billion per year. Significant achievements have been made since the launch of the polio eradication initiative in 1988: - The number of polio cases has fallen from an estimated 350,000 in 1988 to some 6,700 reported cases in 1999; - The number of polio-endemic countries has fallen from 125 to 30; - Polio has been eradicated from the Americas, Europe, the countries of the Western Pacific, and much of the Middle East and disappeared from most of northern and southern Africa. Other major partners in the polio eradication initiative include private foundations (United Nations Foundation, Bill & Melinda Gates Foundation); development banks (World Bank); donor governments (Australia, Belgium, Canada, Denmark, Finland, Germany, Italy, Japan, UK and USA), and corporate partners including De Beers and Aventis Pasteur. Press Release WHO/01 6 January 2000 ____________________________________*______________________________________ 3. FINAL PUSH IN CAMPAIGN TO ERADICATE POLIO ___________________________________________________________________________ FINAL PUSH IN CAMPAIGN TO ERADICATE POLIO WHO AND UNICEF ISSUE YEAR 2000 APPEAL TO LEADERS OF 30 AFFECTED NATIONS NEW DELHI/GENEVA/NEW YORK ? In a strong turn-of-the- millennium appeal, the World Health Organization (WHO) and UNICEF today urged leaders of countries where the final battle to eradicate polio is being waged to give full co- operation to the global effort. "We are on the verge of an historic public health victory--the eradication of poliomyelitis--a disease that has caused untold suffering to millions of children in all parts of the world," stated Dr Gro Harlem Brundtland, Director-General of WHO, and Ms Carol Bellamy, Executive Director of UNICEF, in a New Year's letter to 30 heads of state in sub-Saharan Africa and South Asia. They said the ultimate success of the drive to eliminate the disease now hinges on efforts underway in those 30 countries, many of which are affected by conflict or are 'reservoirs' of poliovirus where transmission remains particularly intense. Begun in 1988, the global initiative to eradicate polio by the end of the year 2000 is spearheaded by WHO, Rotary International and UNICEF. To win the battle against the disease, Dr Brundtland and Ms Bellamy urged heads of state in the 30 countries to provide leadership for extra immunization activities, to allocate sufficient resources to support National Immunization Days and routine immunization and surveillance activities, to mobilize support for these efforts from the national to the community level and to facilitate truces in areas affected by conflict. In New Delhi, on her first official visit of the new century, Dr Brundtland said India, which hosts 70 per cent of the world's remaining polio cases, was key to successfully eradicating the disease world-wide by the end of the year 2000. Dr Brundtland paid tribute to India's phenomenal efforts towards polio eradication at the launch of the final campaign to eliminate the disease. "In the year 2000 the target for polio eradication we have a window of opportunity to defeat this disease forever," said Dr Brundtland at the launch of the Final Push for Polio, attended by over 300 delegates including Dr Shanmugham, India's Union Minister for Health, ambassadors from key polio-endemic countries and representatives from core agencies in the initiative. Dr Brundtland was joined by 30 children who have polio representing each of the 30 remaining polio-endemic countries who each lit a lamp of remembrance for polio victims. In New York, Ms Bellamy urged a renewed international effort to wipe out the last traces of the disease. "As long as a single new case of polio exists, children everywhere are at risk of this disease," she said. "We must all work together to bequeath to our children a polio-free world in the 21st century." Rotary International President Carlo Ravizza reiterated the support of 1.2 million Rotarians world-wide to the eradication effort. In India alone, Rotary mobilized 150,000 volunteers for national immunization days. In their New Year's letter to the 30 heads of state, Dr Brundtland and Ms Bellamy said important obstacles had already been overcome in the fight against polio: "Countries and territories have set aside their differences for the sake of the health of their children." "Warring factions have laid down arms and allowed administration of polio vaccine to all children, irrespective of their origins and affiliations. What is most needed now is the personal commitment of political leaders in the 30 remaining polio-infected countries to see the effort through to a successful conclusion." Dr Brundtland and Ms Bellamy also noted significant achievements since the launch of the polio eradication initiative in 1988: The number of polio cases has fallen from an estimated 350,000 in 1988 to some 5,200 reported cases in 1999; The proportion of the world's children living in polio-infected areas has dropped from 90 per cent to less than 50 per cent; Polio has been eradicated from the Americas, Europe, the countries of the Western Pacific, and much of the Middle East and it has disappeared from most of northern and southern Africa. With the eradication of polio and the eventual cessation of polio immunization, the world will save US $1.5 billion per year. Major partners in the polio eradication initiative include technical agencies (U.S. Centers for Disease Control and Prevention); private foundations (United Nations Foundation, Bill & Melinda Gates Foundation); development banks (World Bank); donor governments (Australia, Belgium, Canada, Denmark, Finland, Germany, Italy, Japan, UK and USA), and corporate partners including De Beers and Aventis Pasteur. ____________________________________*______________________________________ 4. WHEN AND HOW TO STOP POLIO VACCINATION AFTER THE DISEASE IS ERADICATED? Comments and additions please: [email=technet@acithn.uq.edu.au]technet@acithn.uq.edu.au[/email] or use your reply button ___________________________________________________________________________ Press Release WHO/24 7 April 2000 SCIENTISTS DEBATE WHEN AND HOW TO STOP POLIO VACCINATION AFTER THE DISEASE IS ERADICATED As the worldwide polio eradication campaign enters its final stages, a debate is growing among scientists about when and how immunization against poliomyelitis should be stopped after the disease has been eradicated. The key issues of the debate are in the latest issue of the Bulletin of the World Health Organization, dated March 2000. The largest disease eradication initiative ever launched is now moving towards its final phase. "This collective human endeavour?will take its rightful place as one of society's most significant achievements", an editorial in the journal says. Since 1988, when WHO's World Health Assembly adopted a resolution to eradicate polio by the year 2000, the wild poliovirus has been eliminated from three of the five continents. Cases worldwide have fallen by over 95% to an estimated 20 000 last year. Most of these occur in Bangladesh, Ethiopia, India, Nigeria and Pakistan. There has been much progress in these countries, as well as in others which pose enormous challenges. Many of the countries where war and conflict have contributed to the disintegration of health systems are managing to immunize their children against polio. Last year, health workers in the Democratic Republic of the Congo immunized over 8 million children during special days of tranquillity brokered by the United Nations. Angola, Afghanistan, Somalia and Southern Sudan also reached millions of children during National Immunization Days. This progress strengthens hopes that polio will be declared eradicated by the campaign's "certification" deadline of 2005. However, polio- related problems are certain to continue beyond that date ? including the possible re-emergence of the disease years later. This is a potential problem with any eradication effort. In the case of polio, it has long been known that polioviruses in the vaccine can be transmitted between vaccinated individuals and their contacts. A question troubling some researchers is the extent to which these viruses could persist in people after all vaccination has stopped. Studies in several countries, however, have shown no evidence of vaccine virus circulating after immunization stopped. Despite these studies, some experts express concern. "The susceptibility of the population to poliovirus will gradually increase following the discontinuation of the vaccination ? eventually to an extent when widespread epidemic transmission could take place," the three authors of one paper in the journal write. "The most important issue is to safeguard the population, so that when and how to stop the administration of polio vaccines may be the most critical and potentially far-reaching decision of the entire eradication initiative," they write. The authors are Dr D.J. Wood, of the National Institute for Biological Standards and Control, London, UK, Dr R.W. Sutter, of the Vaccine Preventable Disease Eradication Division at the Centers for Disease Control and Prevention, and Dr W.R. Dowdle, of the Task Force for Child Survival and Development, both in Atlanta, Georgia. Dr Barry Schoub, director of the National Institute for Virology in Sandringham, South Africa, writes: "The ultimate indirect benefit from the eradication of a vaccine-preventable disease is the ability to make the decision to stop vaccinating and reap the resultant cost and safety gains." "However, the spectre of a vulnerable population, progressively increasing in its vulnerability with each new generation of people who have not been exposed to either wild-type or vaccine virus, makes the decision to stop vaccinating a particularly awesome one." In another article in the journal, Dr Paul Fine, of the Department of Infectious and Tropical Diseases at the London School of Hygiene and Tropical Medicine, writes: "The cessation of oral poliovirus vaccine will introduce an epidemiological situation which has never before been experienced, and will require intense and imaginative implementation and monitoring to ensure its success." After eradication, the only source of wild polioviruses will be laboratories. WHO has issued a global action plan and timetable for the safe handling and maximum containment of these and other potentially infectious materials. Laboratories are being asked to impose rigorous safety procedures and eventually to destroy their stocks or have them transferred to WHO-designated repositories. Dr Vincent Racaniello, professor of microbiology at Columbia University College of Physicians and Surgeons, New York, warns of the "mind- boggling scale of tracking down all the poliovirus stocks." For example, he writes that some laboratories may not have adequate inventories of all their stocks, and that it will take more than "goodwill" on the part of nations to get a clear picture of the existing laboratories holding poliovirus. Summarizing the debate over how and when to stop immunization after eradication, authors Wood, Sutter and Dowdle write: "Because of the potential risks and benefits inherent in such a decision, the best available science, a risk-benefit analysis, contingency plans, a stock pile of poliovirus vaccines, and the endorsement by the global policy- making committees will all be needed before vaccination can be discontinued." ____________________________________*______________________________________ 5. POLIO NEWS + Selected news items and press releases reprinted under the fair use doctrine of international copyright law: http://www4.law.cornell.edu/uscode/17/107.html ___________________________________________________________________________ "Expert Warns of Possible Poliomyelitis Vaccine Shortfall in 2000" Lancet (http://www.thelancet.com) (02/26/00) Vol. 355, No. 9205, P. 728; Wunsch, Hannah The annual American Association for the Advancement of Science meeting, held recently in Washington, D.C., highlighted the remaining two reservoirs of wild poliomyelitis. They are southeast Asia and sub-Saharan Africa, according to Stephen Cochi of the Centers for Disease Control and Prevention. The 10 "hot spots" for polio are countries with mostly large, dense populations or ones enduring internal strife. Cochi noted, however, that efforts to eradicate the disease this year could result in a vaccine shortage. "In 1999," he said, "147 million doses of polio vaccine were given. That's a phenomenal figure." ---- "UN Polio Drive Needs an End to Civilian Bombings in Sudan" Agence France Presse (03/14/00) Carolyn McAskie, the United Nations' emergency relief coordinator, has called for an end to attacks on civilians in Sudan, where a polio immunization campaign is scheduled to resume. U.S. presidential envoy Harry Johnston accused the Sudanese government of violating the Geneva convention by bombing relief planes and civilians last week. According to U.N. officials, the Sudanese government's involvement has not been confirmed. McAskie called for the bombings to desist hurting innocent people, as agencies gear up to start a second round of polio shots in the country. The first round took place in mid-February. ---- "2.5 Million Children Vaccinated Against Polio in Nepal" Agence France Presse (02/27/00) Over 2.5 million children under age five in Nepal were scheduled to receive the polio vaccine on Sunday as part of the eradication of polio campaign. The mass vaccination campaign, targeting a number of districts, will involve 16,000 health worker and 80,000 volunteers, according to a public health official. --- "Importation of Wild Poliovirus Into Qinghai Province--China, 1999" Morbidity and Mortality Weekly Report (http://www2.cdc.gov/mmwr) (02/18/00) Vol. 49, No. 6, P. 113 A case of acute flaccid paralysis in a 16-month-old Chinese boy was reported on October 13, 1999, in Xunhua Autonomous County in the Qinghai Province, China. The boy, who was unable to walk or stand, is a member of the Sala group, who trade widely with Tibet, Nepal, India, and Pakistan. No family members reported traveling outside Xunhua County two months before the paralysis, and no additional polio cases have been found since October. Experts believe the wild poliovirus strain came from India, where polio is endemic. After confirmation of the index case, a vaccination round was performed in Xunhua County in November, followed by a mop-up round in December, and a second round last month. Surveillance activities have increased since the case was reported, and good coverage of the vaccine is reported. An estimated 26 million children will be targeted in two additional multiple-province vaccination rounds, to be held in March and April. --- Iraq Launches Anti-Polio Campaign 10:24 AM ET 03/28/00 By DONNA BRYSON, Associated Press Writer, BAGHDAD, Iraq (AP) _ Iraq launched a nationwide polio vaccination campaign Tuesday, struggling to combat the re-emergence of a disease it had conquered before the Persian Gulf war and sanctions undermined its medical and sanitation systems. Using vaccines purchased under the U.N. oil-for-food program that allows Iraq to skirt trade sanctions to help its people, the government planned to target 3.5 million children under the age of 5. Vaccinations were offered free at state-run clinics across the country starting Tuesday and ending Saturday. A second round will be administered over another five days beginning April 25. At a clinic in a working-class Baghdad neighborhood Tuesday, parents slung their babies and toddlers onto a cot. Then nurses held the children's mouths open and trickled in the vaccination drops, their bitterness in most cases bringing instant tears. Soon, the clinic was filled with the wails of angry children. UNICEF, which along with the World Health Organization was helping Iraq in the vaccination campaign, had declared Iraq polio free in 1990, meaning it had seen no trace of the disease for three years. Then Iraq invaded Kuwait and precipitated the 1991 Gulf war. The disease that causes childhood paralysis began to reappear in the mid-1990s _ last year, 77 cases were diagnosed. UNICEF, as the United Nations Children's Fund is known, blamed an infrastructure weakened by both war and international trade sanctions imposed to punish Iraq for the invasion of Kuwait. The sanctions have pushed millions of Iraqis into poverty and malnutrition, which affects their ability to fight infectious disease. Homemaker Salwa Kazam, who brought her youngest son, 11-month-old Mohammed, to be vaccinated Tuesday, said life was much different when her oldest son was born 11 years ago. ``Then, everything was so easy. The sanitation system was better, everything was better,'' she said. ``Polio vaccinations then were just a precaution, but there was no serious concern.'' Parents alerted by an intensive advertising campaign on radio and television, in newspapers and at mosques in recent weeks brought their children to the clinic scrubbed and in their best clothes. Polio is highly infectious. It usually strikes children under 5, affecting the spinal cord and brain and causing paralysis and sometimes death. -- Press Release WHO/18 23 March 2000 WHO'S GOODWILL AMBASSADOR FOR POLIO ERADICATION MARTINA HINGIS PLAYS TO WIN THE MATCH POINT AGAINST POLIO GENEVA/MIAMI-- Martina Hingis, the world's number one ranked women's tennis player, today accepted the title of World Health Organization (WHO) Goodwill Ambassador for Polio Eradication. In her new role, she launched "Match Point Against Polio," a campaign to raise awareness and funds to help eradicate polio from the face of the earth. Polio is a highly infectious disease which can cause total paralysis in a matter of hours. "As WHO Ambassador, I will do everything I can to smash this frightening disease off the planet," said Hingis. "I think all children should have the chance to be active, to use their legs to run around the playground, to swim, kick a ball, or play tennis," she said at a press conference on the opening day of the Ericsson Open, a world-class tennis tournament in Miami, Florida, United States. "Match Point Against Polio" will promote polio eradication and encourage large public support and participation throughout the year, particularly at the Grand Slam tennis tournaments. These include the French Open, Wimbledon and the US Open. As part of her campaign, Ms Hingis will travel to a polio- endemic country where she will help immunize children against the disease. The international polio eradication effort, launched in 1988, is spearheaded by WHO, Rotary International, the U.S. Centers for Disease Control and Prevention and the United Nations Children's Fund (UNICEF). Its ultimate aim is to certify the world as polio-free by the end of 2005. Owing to substantial progress towards eradication, polio is now concentrated in 30 countries in South Asia and sub-Saharan Africa. Before the press conference, Ms Hingis was joined by 30 children, each one representing the 30 remaining polio-endemic countries. She lobbed signed tennis balls out to the 2000 children in the audience, who were attending the Ericsson Open's "Kids Day." "Ms Hingis is a world champion. Her enthusiasm, determination and commitment to achieve perfection are the qualities which will bring success in polio eradication. She will make a difference in this worldwide effort," said Dr Ciro de Quadros at the press conference. Dr de Quadros is Director, Division of Vaccines and Immunization, Pan American Health Organization, WHO's Regional Office for the Americas. He was at the forefront of successfully eradicating polio from the Americas. The last case of polio was found in the Americas in 1991, following a massive campaign involving international organizations, national and local governments, citizens, sports clubs, educators, local health workers and countless volunteers. The region was certified polio-free in 1994. "Success against polio in the Americas indicates the disease can be eradicated worldwide, " said Dr de Quadros. "WHO's European region has been polio-free for over one year. We are on the verge of polio-free certification in the Western Pacific region which includes China, whose population exceeds one billion. Now, we are increasing the momentum to wipe polio out of Africa and the Indian sub-continent," he reported. Major partners in the Polio Eradication Initiative include technical agencies (e.g. U.S. Centers for Disease Control and Prevention); private foundations (e.g. United Nations Foundation, Bill & Melinda Gates Foundation); development banks (e.g. World Bank); donor governments (e.g. Australia, Belgium, Canada, Denmark, Finland, Germany, Italy, Japan, UK and USA), and corporate partners (e.g. De Beers and Aventis Pasteur). --- Rotary Presents Polio Eradication Champion Award to Ted Turner and Kofi Annan NEW YORK--(BUSINESS WIRE)--March 16, 2000 via NewsEdge Corporation - In recognition of their contributions to the polio eradication initiative, media magnate R. E. (Ted) Turner and United Nations (UN) Secretary General Kofi Annan, were today presented with Rotary International's Polio Eradication Champion Award. Rotary's Polio Eradication Champion Award established in 1995, recognizes world and regional leaders who have made outstanding contributions toward the goal of global polio eradication. Rotary International past President Herbert G. Brown congratulated both for their dedication. "It is a great honor to present these awards to Kofi Annan and Ted Turner," said Brown. "The generous commitment of their leadership and resources are making significant contributions to the victory over polio." Within the last decade, the number of polio cases has been reduced by 90 percent. Though worldwide polio eradication is in sight, the final years of the effort will be the most difficult because many nations affected by years of war and civil unrest require substantial financial support to rebuild damaged infrastructure and conduct national immunization campaigns. Among many of his contributions as UN Secretary General, Kofi Annan successfully brokered "days of tranquility" in several countries amid civil unrest, enabling health officials and volunteers to get the vaccines through to the children, sometimes across the front lines of combatants. "I am honoured to receive this award," said Annan. "Tremendous progress has been made in recent years in controlling and eradicating some of the most terrible diseases facing humankind. Polio, for example, is being wiped out steadily. But we would not be making these gains without the dedication of Rotary Clubs and other groups around the world that show such ready solidarity in the face of human need. There can be no clearer example of the interdependence of nations than the risks posed by the spread of infectious diseases. And there can be no clearer example of how much can be done when concerned citizens --international organizations, private businesses and volunteer groups -- join hands to get a job done. Let us now finish that job." R.E. (Ted) Turner demonstrated his commitment to the eradication of polio by donating US $28 million through his United Nations Foundation (UNF). This donation will primarily be used to strengthen the vaccine delivery infrastructure and to track where the disease is occurring. Turner's contribution will help to create a lasting legacy of better disease surveillance, well-functioning virology laboratories, improved capacity to deliver vaccines, and greater public awareness of the value of immunization. "It is a great honor to receive this award from Rotary International, which has provided crucial leadership in the effort to create a 21st century that is free from the threat of polio," said Turner. "The public-private partnership established by Rotary and the UN is a model for addressing global challenges in the future. All of us at the UN Foundation look forward to continuing to follow Rotary's leadership to finish the job of eradicating polio and to make the world a better place." Other leaders who have been honored with the Champion award include United States President William Jefferson Clinton, Prime Minister of the United Kingdom Rt. Hon. John Major, the First Lady of Egypt Mrs. Suzanne Mubarak, and the President of Nigeria Olusegun Obasanjo. "These kinds of contributions are precisely why we will be successful in eradicating polio from the face of the earth," said Brown. "We believe that this type of leadership and commitment will inspire other private sector sources and public entities to join us in the battle against polio." Endemic on five continents in 1988, polio today strikes children in sub- Saharan Africa and South Asia. The fight against polio is particularly important is Africa, a continent affected by years of war and civil unrest where damaged infrastructure makes vaccinations especially difficult. For example, since 1996 Rotarians in Angola lead an annual campaign to solicit corporate jets, helicopters and vehicles to move vaccine through Angola's land-mine infested countryside. Additional volunteers mobilized by a single Rotary club help the government reach its target population of children under five years of age. Rotary International is one of world's largest volunteer service organizations with 1.2 million members in 162 countries. The PolioPlus program is the most ambitious program in Rotary's history. The initiative is an aggressive public/private partnership to assist international health agencies and governments in eradicating polio and certifying the world polio-free by 2005, Rotary's centennial. To date, Rotary has contributed $340 million to the protection of more than one billion children. By 2005, Rotary's financial commitment will reach nearly a half billion US dollars. Rotary in the volunteer arm of the global polio eradication partnership comprised of the World Health Organization (WHO), UNICEF, and the U.S. Centers for Disease Control and Prevention (CDC) and national governments around the world. CONTACT: Rotary International | Vivian Fiore, 847/866-3234 | e-mail: fiorev@rotaryintl.org Copyright ? 2000, Individual.com, Inc.TM This content is for your personal use only, subject to Terms and Conditions. No redistribution allowed. ____________________________________*______________________________________


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