Polio Transition – A Missed Opportunity on the path towards UHC?

This guest post was originally posted on the RESULTS website and was written by Laura Kerr, Senior Policy Advocacy Officer (Child Health), RESULTS UK, and a member of the Gavi CSO Constituency Steering Committee. RESULTS is a movement of passionate, committed, everyday people. Together we use our voices to influence political decisions that will bring an end to poverty.

How are we going to achieve Universal Health Coverage (UHC)? This is the focus of this year’s World Health Assembly (WHA) taking place in Geneva from May 21st-26th. Since taking office, the World Health Organization (WHO) Director-General, Dr. Tedros, has set out ambitious objectives as part of the WHO’s 13th General Program of Work.  Known as the Triple Billion Targets, he ambitiously wants to ensure 1 billion more people benefit from UHC, 1 billion more people are better protected from health emergencies, and 1 billion more people enjoy better health and well-being.

Photo: Tom Maguire/RESULTS UK

But can we, and will we, achieve these objectives when only 7% of children in the world’s poorest countries receive all 11 WHO recommended vaccines? Out of all health services, immunisation does have one of the highest global coverage rates but when 1 in 10 kids still receive no vaccines, it is clear we are still too far from universal coverage of this essential service. Routine immunisation drives an equitable approach to health services, but these need to be urgently strengthened if we are to reach the Sustainable Development Goals (SDGs) and the Triple Billion targets.

This year’s WHA could be a defining moment for immunisation. With an agenda item on polio transition up for review by Member States, leadership and ambition could turn a situation with great potential risk into one that leaves a positive legacy on child and global health; but this will only happen if the WHO and Member States act now.

The Global Polio Eradication Initiative (GPEI), of which WHO is one of five core partners, is a $1billion a year partnership which was set up to eradicate polio. As we near that end goal, the GPEI is winding down, completely ending when polio is eradicated. The WHO is presenting to Member States this week their plan for what comes next after the GPEI winds down, in some countries in 2019.

The draft WHO Strategic Action Plan on Polio Transition lays out what the WHO will do to ensure the world remains polio-free after the wind down of GPEI and that the objectives set out in the polio end-game strategy are reached. This plan is just one piece of the global process of polio transition, but as it stands, it lacks the details, ownership, and aspiration needed to drive transformative change for immunization and health systems.

There are three main ways in which the WHO Strategic Action Plan could be improved to take advantage of this unique situation:

1) Focus on essential immunization coverage:
  the WHO needs to set out more clearly how they will strengthen routine immunization systems

2) Confirm coordination mechanisms: There needs to be a clear coordination mechanism in place to guide the implementation of WHO’s strategic action plan at global, regional and national levels otherwise it just won’t happen. It is not enough to set out what needs to happen at this stage, we urge concrete plans be put in place before the plan is implemented.

3) Set out clear financial requirements: There are large assumptions in the plan around future financing but at this stage, it is very unclear where funds are guaranteed and where they will and can come from. We also don’t know the extent of Gavi, the Vaccine Alliance’s role in supporting various elements of polio transition.  Increased clarity of current fundraising expectations and gaps at a country, regional and global level, for the WHO Plan and the Post-Certification Strategy, is critical.

With funding from GPEI ending in all except polio-endemic countries in 2019, the window of opportunity is small. The current version of the plan leaves too many unanswered questions, especially how it will be operationalized. You can read our full recommendations for improving the plan here.

WHO leadership and ownership of essential elements of the transition process going forward is essential; without their guidance, the risks for polio transition being a missed opportunity are just too high.

If we are to reach UHC in all countries, we need ambition, innovation, and to proactively seek new ways of tackling barriers to healthcare. Polio transition provides us this opportunity. All we need to do is take it.