Seventh meeting of the Regional Subcommittee for Polio Eradication and Outbreaks
28 February 2023

Noting the progress achieved globally in eradicating wild poliovirus transmission since 1988, with virus transmission at the start of 2022 restricted to just two countries – Pakistan and Afghanistan; 

Noting that detection of wild poliovirus cases in both countries is at the lowest levels in history, with five cases reported in Afghanistan and one in Pakistan since January 2021, which presents a unique epidemiological window of opportunity to eradicate wild poliovirus once and for all;

Underscoring that the recent isolation of wild poliovirus from environmental samples in Pakistan and children in Afghanistan confirms continued poliovirus circulation in this joint, cross-border epidemiological block; 

Highlighting that the current favourable epidemiological situation is thanks to sustained commitment by leaders at all levels, notably by political leaders, community and religious leaders, civil society (especially Rotary International and individual Rotarians) and health workers at the forefront; 

Underscoring the resumption of nationwide polio immunization campaigns in Afghanistan in late 2021 after a gap of  more than three years; 

Noting ongoing vaccination coverage gaps in key high-risk areas and among high-risk population groups in both countries, and concerned about the lack of house-to house-vaccination in key polio endemic areas of Afghanistan; 

Recalling that the spread of poliovirus constitutes a Public Health Emergency of International Concern under the International Health Regulations (2005); 

Noting with concern the increasing humanitarian needs, economic crisis, risk of disruption of primary health services through the Sehatmandi Programme and limited hospital care in Afghanistan, all of which can jeopardize the integrity of childhood immunization and polio eradication in the country; 

Noting that UNICEF and WHO have restored Sehatmandi programme and have received financing to sustain delivery of health services through June 2022; 

We, the Eastern Mediterranean Regional Subcommittee on Polio Eradication and Outbreaks:

DECLARE:

1. The ongoing circulation of wild poliovirus in Afghanistan and Pakistan to be a Regional Public Health Emergency; and, 

COMMIT TO: 

2. Enhancing engagement and support by all political, community and civil society leaders and sectors at all levels, needed to fully resolve the afore-declared Regional Public Health Emergency; 

3. Supporting the coordination of activities across borders to ensure synchronized and cross-border response activities, including in Pakistan and Afghanistan. 

REQUEST:  

4. The international donor and development community to provide the much-needed humanitarian relief and financing to sustain and expand health services to the people of Afghanistan; 

5. The sustained and strengthened commitment by all leaders at all levels in Afghanistan and Pakistan, to capitalise on the current epidemiological window of opportunity through intensified eradication efforts, including by continuing to increase access to all children in previously inaccessible areas, implementing area-specific emergency action plans in known under-performing areas and responding to the detection of any new viruses from any source (be it from an acute flaccid paralysis case or environmental sample) as an emergency; 

6. All authorities in Afghanistan to facilitate resumption of house-to-house vaccination in all areas to ensure delivery of vaccine to the youngest and most vulnerable children who are not being reached by mosque-to-mosque only vaccination and who must be vaccinated to capitalize on the current opportunity across both countries, and 

7. The Regional Director to continue his tremendous leadership and support to Afghanistan and Pakistan in their efforts to eradicate polio, including by advocating for all necessary financial and technical support, reviewing progress, plan corrective actions as necessary, and regularly informing Member States of the afore-mentioned and of any eventual further action required, through the World Health Organization Executive Board, World Health Assembly and Regional Committee mechanisms.  

Taizz | Sayoun, 22 November 2022 – Participants from WHO’s recent basic and advanced life support trainings in Yemen are taking matters into their own hands to rollout these lifesaving skills to their peers. Among the more than 1200 health workers trained, below are some success stories of health workers playing critical roles in improving delivery of lifesaving care for the Yemeni people. The training was conducted with the World Bank’s support via the Yemen COVID-19 Response Project (YCRP). 

Dr Raef is working in the Al-Jamohoury Hospital Cardiac Centre and is a teacher at Taizz Faculty of Medicine and Health Sciences. She successfully completed the 9-week national critical care training and recently got an opportunity to train in basic life support and advanced cardiac life support courses (for the first time), under the supervision of master trainers. 

When Dr Raef and her colleague Dr Zahra returned to their governorate, Taizz, they were thinking about how to promote knowledge and skills for a long-term future and sustainability for the next generations. They came up with 4 ways forward:

They convinced the management of Taizz Faculty of Medicine to embed basic life support and advanced cardiac life support into the main curriculum of the ICU and anesthesia module.

Dr Zhara started teaching the theoretical part of basic life support and advanced cardiac life support in Taiz Faculty of Medicine.

Dr Raef delivers the practical part in Al-Jamohoury Hospital Taizz halls and cardiac-ICU for fifth-grade medical students with minimum available tools.

They keep communicating with Taizz governorate health office towards procuring more resources for an effective educational process. 

Dr Nabil participated in the basic life support training of trainers in Aden. He passed the exam aligned with international standards to be a basic life support provider and instructor. Dr Nabil used his skills and knowledge to conduct a basic life support provider course at Sayoun University in Hadramaut Governorate targeting medical college students. In doing so, he complied with international standards as much as possible in a low-resource setting. Dr Nabil will have the chance to be a co-facilitator in WHO Yemen’s basic life support rollout plan.

WHO project team conducting the virtual briefing session. Credit: WHO/Islamic Republic of Iran

27 November 2022 – In line with the project’s progress towards results and achieving determined objectives, the World Health Organization (WHO) country office in the Islamic Republic of Iran, together with the State Welfare Organisation (SWO), organized and conducted several briefing and training sessions to inform and engage the stakeholders and enhance the capacity of staff in long-term care facilities. 

The project “Improving access to inclusive health care for elderly and people living with disabilities during the COVID-19 pandemic” is designed to reduce the risk and improve the response capacity in long-term care facilities. To maximize efficiency and ensure the achievement of results, the project team in WHO, in collaboration with the project steering committee, has planned a rigorous capacity-building component whereby public and private institutions (long-term care facilities, national and provincial SWO experts) would be trained to contribute to the implementation, monitoring, and evaluation of project. By 15 November 2022, 2 phases of the capacity- building had successfully been completed. 

In the first phase, the staff of the target facilities and national and provincial authorities from the SWO received online training on standards and preparation of isolation rooms, and the steps of the project implementation in October 2022. These online sessions were conducted in 2 groups on Monday 10 October and Wednesday 12 October 2022, for facilities in Alborz, Ardabil, East Azerbaijan, Fars, Guilan, Hamedan, Isfahan, Kerman, Kermanshah, Khorasan Razavi, Qom, South Khorasan, Tehran and Yazd.  

During the training, the requirements for establishing a standard isolation room, including room attributes and anteroom, bathroom, ventilation and air conditioning, necessary equipment, surfaces condition, and facilities outside of the room were presented. Also, the essential requirements for effective and sustainable quarantine of patients with respiratory infections were discussed thoroughly.  The process of preparing the designated room, verification modalities, repackaging and delivery of procured items to the 30 selected long-term care facilities in 14 provinces, and reporting and documentation requirements, and the timeline of activities and responsibilities were reviewed. 

In the second phase, a virtual workshop titled “introduction to project monitoring and evaluation at long-term care facilities” was held for representatives from the SWO provincial offices and coordination and reporting focal points of long-term care facilities on 8 and 9 November 2022. This workshop was designed to train facility staff on result-based management and the effective operation of isolation rooms to facilitate the early quarantine of older persons and people living with disabilities. 

Monitoring and evaluation online workshop for the target SWO representatives and facility focal points. Credit: WHO/Islamic Republic of Iran

The participants gathered in 2 virtual sessions on 2 consecutive days to learn about result-based management, logical framework, project monitoring and evaluation and documentation and reporting against indicators. Throughout this highly interactive training, more than 50 participants engaged in multiple roundtables and group activities to brainstorm, discuss and practice modeled monitoring and evaluation. 

The project capacity-building programme will continue to expand the practical knowledge and capacity of caregivers and service providers. The next phase is planned for December 2022, during which training courses will be provided on how to improve the quality of care and inclusive health care at the long-term care facility level via the tailored guidelines, standard operation procedures, and the monitoring tools.