Adapting Nepal’s polio eradication programme
Introduction National immunization systems are important for reducing vaccine preventable diseases.1 However, in many resource-constrained countries, such systems need to be improved. This paper describes how Nepal’s polio eradication programme expanded its work to aid efforts to control other vaccine- diseases and improve Nepal’s disease surveillance and immunization systems. Local setting Nepal eliminated indigenous polio in 2000 and controlled outbreaks caused by polio importations between 2005 and 2010. The country participated in the certification of wild poliovirus elimination in the World Health Organization (WHO) South-East Asia Region in 2014.2 Nepal’s polio eradication programme, created in 1998, is funded by the Global Polio Eradication Initiative and is affiliated with WHO’s Nepal country office. The original aim of the programme was to conduct active surveillance for possible polio cases and to provide technical assistance and support on polio vaccination to the country’s Expanded Programme on Immunization (EPI), which is the national immunization programme. In 2002, the polio eradication programme had 14 field-office based surveillance medical officers, who actively searched for people with acute flaccid paralysis (AFP), i.e. suspected polio cases.3 The programme used these surveillance data to guide polio immunization activities, especially mass campaigns with oral poliovirus vaccine.