- Interrupt wild poliovirus transmission in Asia and Africa.
- Enhance poliovirus surveillance and outbreak response.
- Minimize the risks of poliovirus re-introduction and the emergence of circulating vaccine-derived poliovirus (cVDPV).
What are the health needs and challenges?
Polio (poliomyelitis) is a highly infectious disease caused by a virus. It invades the nervous system and can cause irreversible paralysis in a matter of hours. The strategy to eradicate polio is therefore based on preventing infection by immunizing every child until transmission stops and the world is polio-free.
Though this disease has nearly disappeared from the collective consciousness, it continues to trigger epidemic outbreaks in certain countries of sub-Saharan Africa and central/south Asia. Although the number of cases has dropped by over 99% since 1988, polio remains a devastating disease for the people it strikes. Polio is still endemic in three countries (Nigeria, Afghanistan, Pakistan) and the infection has reappeared in several countries. That is how, since 2003, annual case numbers have fluctuated between 1000 and 2000, and between 12 and 23 countries every year have reported polio cases due to imported polioviruses. In light of the current situation, the challenge for Sanofi Pasteur is to continue to play a decisive role in eradicating the disease.
From 2017, if no cases of wild polio are detected for three years, the time the virus can survive outside the body, the world will be officially declared polio free.
Description of partnership activities and how they address needs and challenges
Since 1988, the Global Polio Eradication Initiative, spearheaded by WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF -- with additional support from the Bill & Melinda Gates Foundation -- has achieved a 99% reduction of the number of polio cases worldwide. Polio is caused by three strains of poliovirus, types 1, 2 and 3. Wild poliovirus type 2 has already been eliminated, and it is hoped that poliovirus type 1 and 3 will be eradicated within a few years, definitively wiping polio from the surface of the earth.
In 2013 Sanofi announced its commitment to provide 1.7 billion doses of oral polio vaccine (OPV) to support the Global Polio eradication Initiative’s (GPEI) strategy to eradicate polio this decade. The doses of OPV will be delivered through 2017 for GPEI polio vaccination program.
Sanofi Pasteur, as a leader in providing both OPV and IPV (inactivated poliovirus vaccine), has been a partner of the Global Polio Eradication Initiative for over 20 years. The company has provided more than five billion doses of OPV to UNICEF over last two decades.
When an epidemic broke out in Egypt and at the request of the WHO, the Group developed the first monovalent oral polio vaccine, which contributed to eliminating the disease in this country.
In 1982, Sanofi Pasteur registered the first enhanced-potency inactivated polio vaccine (IPV), which is now distributed globally as a stand-alone poliovirus vaccine as well as in combination with pediatric vaccines to immunize against many diseases in a single shot. Since then, Sanofi Pasteur has distributed more than 800 million doses of IPV and IPV-containing vaccines.
Sanofi Pasteur has made significant investments in modern technology to produce very large quantities of IPV -- up to 300 million doses a year. As well as this substantial investment in production capacity, Sanofi Pasteur support to IPV now includes development of a five-dose vial presentation (as well as the standard ten-dose vial presentation) to reduce wastage, a massive regulatory and licensing program in about 100 countries and expert contributions on scientific, program and technical questions.
In 2015, Sanofi Pasteur and the Bill and Melinda Gates Foundation began offering a new IPV pricing structure so that 120 new countries can be provided with large quantities of high-quality vaccines at low cost to ensure their rapid and widespread adoption.
The eradication of polio needs a global approach. First, it must include all endemic countries but also have an approach of countries with re-established transmission as well as those susceptible to import the disease. In addition of the vaccine supply, a strong political engagement is crucial but also the mobilization of the community and oversight community mobilization.
Summary of impact and forward looking information
Huge achievements have been made in the global fight against polio since 1988, when the World Health Assembly resolved to eradicate the disease. The number of polio cases worldwide has decreased by more than 99%, from 350 000 in 1988 to just 26 cases at the end of September 2016 – a 99.9% decrease in the number of cases worldwide between 1988 and 2016. Over 2.5 billion children have been vaccinated and an estimated 10 million people have been saved from polio-related paralysis.
When the initiative was first launched in in 1988, the virus was endemic in 125 countries. Today. This is only true of two countries: Afghanistan and Pakistan. The last case of polio in Africa was reported in Somalia in August 2014. Since then, no new cases have been recorded anywhere on the continent, representing a major advance in the eradication of the disease. In September 2015, the WHO announced that Nigeria had been removed from the list of endemic countries.
Sanofi Pasteur will continue to maintain its important historic role and commitment to vaccination. In the future, the Group is convinced that the use of injectable vaccines will increase. Sanofi Pasteur offers an industrial solution that enables mass production of IPV on a global scale. Following the eradication of smallpox, polio is expected to be the second infection to be eradicated worldwide.