Global Polio Eradication Initiative (GPEI)
www.polioeradication.org Purpose
The WHO Global Polio Eradication Initiative (GPEI) is a surveillance and response system dedicated to prevention and control of polio. GPEI monitors pediatric populations for cases of acute flaccid paralysis and vaccinates those who are at risk for polio.40 History and operational characteristics
The Global Polio Eradication Initiative was launched in the Americas in 1985. The principles of the initiative were those developed for smallpox eradication (case finding and vaccination), modified to reflect the differences in the natural history of polio. The strategy was developed by the Cuban government, who successfully used high immunization coverage and held nationwide immunization days to eradicate polio in 1962. GPEI operates in polio-endemic areas of the world. Participating countries must actively conduct clinical surveillance for cases of flaccid paralysis in children under 15 years old.41 GPEI field staff identifies possible clinical cases of polio, collects diagnostic specimens from patients, and sends specimens to GPEI laboratories for analysis. For quality assurance, the polio network laboratories are evaluated for proficiency and recertified every 1–2 years. When a case of polio is identified, GPEI sponsors poliovirus vaccination campaigns. These campaigns are organized by polio surveillance officers with the assistance of trained schoolteachers and community volunteers who aid healthcare providers in the administration of oral poliovirus vaccine. During these campaigns, independent monitors document vaccination rates. As of March 2007, four countries remain officially polio-endemic: India, Nigeria, Afghanistan, and Pakistan. However, poliovirus is highly contagious, and every clinical case is thought to represent 200 subclinical cases. Reemergence is a constant threat: Between 2003 and 2005, 25 previously polio-free countries were reinfected due to importations. As a result, GPEI remains active in a region until it is certified polio-free. Before a WHO region can be certified polio-free, three conditions must be satisfied: (1) 3 years without incident cases caused by wild poliovirus, (2) excellent certification-standard surveillance, and (3) each country in the region must demonstrate the capacity to detect, report, and respond to “imported” polio cases.42 Region/countries served
Global; operates in 90 countries; about a third of the current efforts are focused on Southeast Asia, and the other two-thirds are concentrated in Africa and the eastern Mediterranean. Funding/budget/staff
WHO’s budget for GPEI is U.S.$600 million this year; the Rotary International contributes about $100 million annually to the initiative. The initiative has 145 laboratories and a staff of approximately 3,000 people. | 
