The strategy for the eradication of polio rests on immunizing every at risk child until there is no one left for the disease to transmit to and the disease eventually dies out. The Initiative is spearheaded by the following Organizations in the form of multistakeholder governance:
WHO who are responsible for planning, technical direction, surveillance and eradication certification.
Rotary International whose responsibilities include fundraising, advocacy, and volunteer recruitment.
The CDC who are in charge of deploying scientists and public health experts to WHO and UNICEF.
UNICEF is in charge of the distribution of the vaccine and helping countries develop communication and awareness strategies.
Key tactics used by the GPEI include strengthening childhood immunization through oral vaccines, conducting surveillance through investigation of acute flaccid paralysis cases among children under 15 years old, and conducting "mop up" campaigns in areas where cases of polio have been identified.
Funding
By 2012 the GPEI had raised 9 billion dollars in funding and in alone 2011 the GPEI received a 1.1 billion dollars, for a budget of 0.98 billion dollars. 30% of their funding came from the Gates Foundation 30% from developed governments, 27% from countries at risk of polio, and the rest was made up of donations from non profits, private funders, and other foundations. It is likely that the GPEI will become almost entirely funded by private organizations in the future.
Evaluation
In 1995 a Global Certification Commission was created to oversee the certification of the eradication of wild-type poliovirus transmissions. Certification for the six WHO regions requires all of the countries in that region to be certified by the commission. By the year 2000 both the regions of the Western Pacific and the Americas met the criteria to be certified free of polio transmissions. By 2012 the initial number of estimated cases in 1988 of 350,000 across 125 endemic countries had dropped to 650 confirmed cases. In addition, three of the six WHO regions are now certified polio eradicated. India, which many thought would face the greatest challenge to eradication was removed from the list of endemic countries. According to the most recent study by the GPEI, in 2016, there are only three countries still listed as endemic, Nigeria, Afghanistan and Pakistan. It is owing to this dramatic reduction that the funding for the GPEI will likely soon come entirely from private donors and foundations such as the Gates Foundation instead of from individual countries. In fact Bill Gates has listed polio eradication as one of his "Top Personal Priorities". A 2011 study by Middlebury College indicated a list recommendations for how the GPEI should operate moving forward:
Include surveillance for other diseases in AFP surveillance systems
Use integrated campaigns to reach marginalized populations
Standardize and compile polio’s maps of marginalized populations to provide them with additional services
Build staff capacity in a variety of areas beyond polio
Share pertinent information gathered during polio campaigns with other health programs
Add questions on key health indicators of interest to post campaign monitoring
Communicate to workers why repeated campaigns are necessary in high intensity areas
Raise monetary incentives for campaign workers to a living wage or eliminate them entirely
Conduct cross planning sessions to determine how programs and services can be integrated to reduce workforce burden without compromising programmatic objectives
Conduct polio campaigns only where and when they are necessary
Mitigate the most serious effects of service interruption with strategic planning
The Bill and Melinda Gates Foundation has significantly helped fund and support the GPEI. Reports from a blog suspiciously named nsnbc international claimed that Bill and Melina's efforts with helping to eradicate polio in India had allegedly resulted in 47,500 cases of death or paralysis. However, rumor verification websites dispute the claims.
Endgame
The final steps of polio eradication for the GPEI, or what is known as the "endgame" are as follows:
