Strengthening Surveillance to Maintain Namibia’s Polio-Free Status
Poliovirus surveillance is one of the key pillars of the global poliovirus eradication effort. The primary system to detect poliovirus transmission is surveillance for polio cases among individuals with acute flaccid paralysis (AFP), supplemented by environmental surveillance (ES).
In October 2008, Namibia was certified polio free and continued to maintain its polio free status since then. However, the country remains at high risk of importations of vaccine derived polio viruses (VDPVs) and other vaccine preventable diseases due to sub-optimal immunization coverage.
In accordance with the recommendations of the Global Polio Surveillance Action Plan 2022-2024, countries are required to strengthen Polio surveillance including other vaccine-preventable diseases (VPDs). The polio eradication program within the World Health Organization (WHO) Regional Office for Africa (AFRO), supported by the global surveillance network, conducted an external surveillance review in Namibia from 17-27June 2024.
The main objective of this review was to evaluate the sensitivity of Namibia's existing Vaccine Preventable Disease surveillance system in promptly detecting any poliovirus circulation and other VPDs. This will ensure timely response to prevent and limit the spread of these diseases.
The review included 7 regions and 15 districts, selected based on a risk-based approach that considers factors such as proximity to countries with cVDPV2 outbreaks, sub-optimal surveillance indicators, large populations, and significant immigrant or displaced populations. The review teams comprised of representatives from Ministry of Health and Social Services, WHO, US Centers for Disease Control and Prevention (CDC), Bill & Melinda Gates Foundation consultancy/ McKing.
Interviews were conducted using standardized forms on the Open Data Kit (ODK) platform. The review process included evaluating existing policies, guidelines, reports, and surveillance data, as well as examining key surveillance documents at the offices of surveillance focal persons and major health services The teams also visited specific health facilities, the national laboratory, and communities to observe surveillance activities.
Currently, Namibia is implementing surveillance for VPDs within the Integrated Disease Surveillance and Response (IDSR) framework. The findings of the review were used to develop a Surveillance Improvement Plan to address the gaps in surveillance.