Antananarivo, 24 April 2024 – A high-level delegation of the Global Polio Elimination Initiative (GPEI) is in Madagascar to support the country in strengthening routine immunisation while combatting a polio outbreak in the country.

Over the next three days, the delegation will meet with President of Madagascar, the First Lady, the Minister of Public Health and the Minister of Foreign Affairs to strengthen collaboration between the government and the partners, while taking advantage of "The Big Catch-up" to fill immunisation gaps in Madagascar. The partners will also discuss how best to build on the government’s successes in strengthening routine immunisation and sustaining progress in the fight against polio in Madagascar.

The team is composed of the World Health Organization (WHO) Regional Director for Africa, Dr Matshidiso Moeti, the Polio Oversight Board Chair, Dr Chris Elias, the UNICEF Regional Director for Eastern and Southern Africa, Etleva Kadilli, Director of Health System Strengthening at Gavi, the Vaccine Alliance, Alex de Jonquieres, and the French Ambassador in Madagascar, M. Arnaud Guillois.

"We are here not only to discuss the way forward, but also to congratulate the national health authorities for their personal commitment as immunisation champions. Their contributions have paved the way to reach every child and it is therefore imperative that we continue to support and encourage Madagascar in its efforts to further improve immunisation coverage and end polio transmission," said Dr Matshidiso Moeti.

Madagascar was certified as a country free of indigenous wild poliovirus in June 2018, but it is now classified by the International Health Regulations (IHR) as a state infected with the circulating variant of poliovirus type 1 with a risk of international spread, and therefore put under temporary recommendations since January 2023.

Since September 2020, the country has been facing a resurgence of cases of poliomyelitis. A total of 287 cases had been confirmed (as of November 2023), including 45 paralytic cases and 198 detections in wastewater samples. Two paralytic cases have been reported in adults (aged 32 and 29 years) since 28 January 2023. Cases in adults thus place the country in a unique position that has required innovative responses. Four large-scale vaccination campaigns were carried out in 2023. The first round conducted from 16 to 19 May 2023 vaccinated more than 5,000,000 (99.8%) children under 5 years of age. As a result, no new polio cases have been reported in Madagascar in the last 6 months. In addition, simple hygiene practices such as good sanitation and hand washing can aid in reducing transmission.

"Too many children continue to be deprived of life-saving vaccines and the longer we wait to reach and vaccinate them, the more vulnerable they become and the greater the risk of deadly epidemics," said Alex de Jonquieres, Director of Health System Strengthening at Gavi, the Vaccine Alliance. "By strengthening routine immunisation and increasing vaccination coverage, we can ensure that the most marginalised communities are no longer left behind," he added.

In order to meet this challenge, and mobilize all social, economic, cultural and governmental sectors to strengthen routine immunisation, increase vaccination coverage, catch up with zero-doses and under-vaccinated children, the visit will be marked by a series of meetings with senior government officials, technical and financial partners, humanitarian actors and the media.

The delegation will join H. E. President Rajoelina at the inauguration of a new vaccine storage facility in the heart of Antananarivo, which was funded by Gavi. They will also launch "The Big Catch-up" under the patronage of H.E the First Lady while marking African Vaccination Week and the 50th anniversary of the Expanded Programme on Immunization.

“By putting routine immunisation at the centre of the country’s primary health care system, the Government of Madagascar will be able to stop transmission of the poliovirus and significantly improve the declining routine immunisation rates. We stand ready to support the Government with reaching every child with the vital immunisations they need to be protected from polio and other easily preventable diseases,” said UNICEF’s Etleva Kadilli.

These moments will be dedicated to the recognition of the continuous improvement of the quality of polio campaigns and the potential of its integration into activities to strengthen immunisation coverage.