Transitioning Lessons Learned and Assets of the Global Polio Eradication Initiative to Global and Regional Measles and Rubella Elimination

Abstract

The Global Polio Eradication Initiative has built an extensive infrastructure with capabilities and resources that should be transitioned to measles and rubella elimination efforts. Measles continues to be a major cause of child mortality globally, and rubella continues to be the leading infectious cause of birth defects. Measles and rubella eradication is feasible and cost saving. The obvious similarities in strategies between polio elimination and measles and rubella elimination include the use of an extensive surveillance and laboratory network, outbreak preparedness and response, extensive communications and social mobilization networks, and the need for periodic supplementary immunization activities. Polio staff and resources are already connected with those of measles and rubella, and transitioning existing capabilities to measles and rubella elimination efforts allows for optimized use of resources and the best opportunity to incorporate important lessons learned from polio eradication, and polio resources are concentrated in the countries with the highest burden of measles and rubella. Measles and rubella elimination strategies rely heavily on achieving and maintaining high vaccination coverage through the routine immunization activity infrastructure, thus creating synergies with immunization systems approaches, in what is termed a “diagonal approach.”

Measles Vaccine

“…In industrialized countries, the current vaccine is usually given subcutaneously or intramuscularly in combination with live virus vaccines for mumps, rubella (MMR), and sometimes varicella (MMRV). In resource-poor countries, MeV vaccine is often given alone, but there is an effort for these countries to transition to delivery of combined measles and rubella (MR) vaccine (72).…”

Lessons learned from the 2009–2010 H1N1 outbreak for the management of the 2013 silent polio outbreak

“…For instance, several factors that were mentioned by the majority of our interviewees as being responsible for the change in the MoH response (e.g., transparency, regional leadership with national leadership support and prioritizing proactive communication) have been recently reported to be critical in achieving control of polio eradication [ 43 ]. Similarly, lessons learned from the polio elimination experience were also implanted into the recent efforts to contain measles and rubella spread [ 44 ]. Although the risk for outbreak in the Western world is smaller than ever, in an era of IPV- only vaccination schedule in these countries, small pockets of susceptible individuals create a challenge to prevent future polio transmissions [ 45 ].…”

Addressing the Challenges and Opportunities of the Polio Endgame: Lessons for the Future

“…The associated support, experience, and lessons learned have played a key role in the development of the global and regional networks for vaccine-preventable diseases [88,89]. The GPEI has contributed substantially to efforts to eliminate measles and rubella globally and nationally [90,91]. GPEI-initiated social mobilization networks and polio-funded global positioning system mapping activities to support microplanning have had their use extended to other health priorities [92,93].…”