Friday, 31 October 2008
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POST 01344E: POLIO ERADICATION VS CONTROL—ADDITIONAL ASPECTS TO CONSIDER FOLLOW-UP ON POSTS 01339E, 01341E, 013342E & 01343E 31 OCTOBER 2008 ****************************************** CONTROL MORE EXPENSIVE IN THE LONG RUN Hans, I agree with you. You may recall that I was seconded from CDC to WHO/SEARO 1995-98, where I spearheaded the Region's AFP surveillance system; then moved to WHO Nepal 1998-2003 as WHO MO-EPI for polio eradication and EPI. There I saw the AFP surveillance/EPI efforts undertaken really increase interest in and enthusiasm for improving routine immunization, and especially for tackling measles and MNTE. In addition, the capacity building, in my opinion, really advanced the understanding and knowledge of national staff at all levels; following the last endemic case of polio (2000), the team built on the AFP surveillance infrastructure to add, over time, surveillance for measles, neonatal tetanus, AEFI, and JE, and they continue to add on. It may also have been the success of the country's polio eradication activities that led the Ministry of Health to submit a proposal to GAVI (the Global Fund), which was accepted for introduction of hepatitis B vaccine and cold chain/routine immunization strengthening. Although it has been discouraging that polio eradication has taken/is taking much longer than what was originally envisaged, I agree with you that in the long run a "control strategy" will not only not work, but would be more expensive. Jean ([[email protected]][email protected][/email]) Jean Clare Smith, MD, MPH Centers for Disease Control & Prevention Atlanta -------- IS THERE AN INDEPENDENT ADVISORY BOARD TO GUIDE ERADICATION? Hans, I did not argue for or against the present methods of trying to eradicate polio. I would not dare to do that, because I am not a medical doctor, have no degree in public health, and particularly not in epidemiology. I wanted to be informed, and therefore requested information on 4 points and in addition asked you the following question: Eradication efforts have now become disease control efforts, i.e. the present efforts that originally were meant to eradicate polio, are now efforts to contain it and without much hope to eradicate it? Am I correct? You did not answer that question. You have only replied to my point 3, where I asked about the impact of polio eradication efforts on routine immunization coverage. Thank you! The moderator guided me to the website: http://www.polioeradication.org/casecount.asp, and from there I could go to other websites and found answers to my questions about: (1) the money spent on polio eradication (result: if not billions of dollars, at least millions. Who provides funds?), and (2) about the numbers of wild polio cases. This reading did not leave me in an optimistic mood. Finally, you did not reply to my point # 4, and I could not find any answer to it in the websites: Is there not an independent advisory board to guide the polio eradication efforts? Does SAGE have a role? Regards, Mogens ([[email protected]][email protected][/email]) Post generated using Mail2Forum (http://www.mail2forum.com)
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