The 13th Horn of Africa Technical Advisory Group meeting on polio has ended with a call for the affected countries to close gaps in surveillance sensitivity in high risk areas, improvement of routine immunization, population immunity and end to continued undetected low level polio transmission.

The TAG met in Nairobi August 17-20 to look at country situations, preparedness plans and standards in surveillance, Routine immunization and eradication of the Wild Polio Virus (WPV) and Circulating Vaccine Derived Polio Virus (cVDPV).

The meeting was attended by Ministry of Health teams and partners from nine countries namely, Sudan, South Sudan, Somalia, Uganda, Ethiopia, Tanzania, Yemen, Djibouti and Kenya.

The TAG underlined the concerns in the region including: over one million unreached under five years age children in inaccessible areas of South Sudan (400,000), Sudan (160,000), Yemen (250,000) and Somalia (320,000). It underlined concerns about continued transmission/ spread of cVDPV and new emergences in South Sudan; risk of importation/ continued undetected low level transmission in Somalia; persistent gaps in population immunity due to gap in SIA quality and weakness in RI and suboptimal surveillance sensitivity in some of high risk areas in Eritrea, South Sudan, Kenya and Ethiopia.

“TAG notes that South Sudan, Somalia, Sudan and Yemen have substantial unreached children due to ongoing the conflict situation. South Sudan has more inaccessible children than Somalia and will pose extreme challenge if any WPV importation takes place” TAG Chairman Dr Jean-Marc Olive’ said.

He also noted that though Africa had completed one year without the World Polio Virus1, there was great need for improved surveillance. The last WPV was in Somalia in August 2014.

“There is need to ensure high level of surveillance in all subnational areas in Horn of Africa countries, particularly in high risk areas.” he said.

The TAG noted the significant progress in closing the HOA WPV outbreak with last WPV case in August 2014 in Somalia adding:

TAG also endorsed the results of the assessment indicating that Kenya and Ethiopia had stopped the transmission and that it was highly likely that transmission in Somalia had also stopped. However, low level of undetected transmission in Somalia could not be ruled out, the TAG noted.

Dr Olive’ called for countries to take specific steps to improve surveillance in areas with identified gaps and for regional offices to monitor the progress on monthly basis.

He noted communication and social mobilization had continued to yield positive outcomes but emphasized that awareness gaps existed at subnational level. TAG called on all countries in the region to undertake detailed communication outbreak preparedness planning to include an assessment of communication gaps to be addressed.

Speaking at the meeting Dr Ephantus Maree on behalf of the Director of Medical Services Dr Nicholas Muraguri said Kenya had made great progress since the outbreak in 2013. He said Kenya had just completed a successful polio campaign amidst resistance from the Catholic Church. Over six million children were vaccinated in 32 counties, a noted more than 100 per cent achievement of the targeted children.

Addressing the meeting, the WHO Kenya Country Representative Dr Custodia Mandlhate said the governments of the polio-infected countries in HOA had in the last two years mounted an emergency response in collaboration with local and international partners with excellent achievement.

She commended the region for keeping the World Polio Virus (WPV) out of the continent for one year.

“Africa now stands on the brink of making history as a polio free continent with the good news coming out of Nigeria,” she said. Nigeria has not reported any case for a year.

She called for the strengthening of subnational surveillance sensitivity and for the detection of any transmission/new importations if they occurred. She also called the countries to increase population immunity through strong routine immunization services and good quality polio SIAs (Supplementary Immunization Activities) especially in high risk areas and populations.

“Countries should work in a timely manner to achieve the objectives of the Polio Eradication and Endgame Strategic plan including strengthening immunization systems, planning for IPV introduction and the switch from tOPV to bOPV scheduled for April 2016,” she said.

The TAG recommended that South Sudan and Somalia outbreak response assessment should be conducted before end October 2015. It also called on all countries in the region to undertake detailed communication outbreak preparedness planning that includes an assessment of communication gaps to be addressed. Somalia is expected to fully implement a 6-month action plan presented by country and report on progress in the next HOA TAG in February.