I thought some folks might be interested to know about the program I am involved with here in Uganda. This is some background info and hopefully inspiration for anyone out there keen to play an active role in the global eradication of polio and improvements to routine immunisation. Please hit me with any questions you may have!
*this is my own personal blog not a official thoughts of CDC or it’s employees
The Global Polio Eradication Initiative Stop Transmission of Polio (STOP) Program — 1999–2013
In 1988, the Global Polio Eradication Initiative (GPEI) was established through a partnership between the World Health Organization (WHO), Rotary International, CDC, and the United Nations Children’s Fund (UNICEF).
By 2012, the annual incidence of polio had decreased by >99%, compared with 1988, and the number of countries in which wild poliovirus (WPV) circulation has never been interrupted was reduced to three: Afghanistan, Nigeria, and Pakistan (1). However because of continued reinfection and transmission of polio it was declared a programmatic emergency by the World Health Assembly in 2012 (5).
A key component of GPEI is the Stop Transmission of Polio (STOP) program, which was developed and initiated by CDC with WHO in 1999 to mobilize additional human resources and technical assistance for countries affected by WPV transmission. STOP workers providing countries with critical technical support to strengthen polio eradication activities and routine immunisation systems.
During 1999–2013, 1,563 volunteers were identified, trained, and deployed for 2,221 assignments in 69 countries. The number of volunteers increased from 90–120 per year to 378 in 2013. The STOP program has aided GPEI by strengthening the capacity of country-level immunization programs and by allowing a large cohort of volunteers to gain valuable field experience that prepares them well for subsequent work as staff members of WHO, UNICEF, and other public health agencies.
Development and Implementation of the STOP Program
A key factor contributing to the success of the global smallpox eradication program in the 1970s was the deployment of international public health field staff to assist national programs with smallpox outbreak investigation, surveillance, and planning of vaccination activities in endemic countries (6). In 1999, STOP was developed to support GPEI in a similar fashion.
- STOP teams typically comprise a diverse mix of health professionals, including nurses, physicians, epidemiologists, veterinarians, and information systems and communication specialists
- STOP volunteers receive daily subsistence allowances, but no other financial remuneration. (Recently, only a small proportion of volunteers are otherwise supported by their employers)
- The STOP program recruits and deploys three types of volunteers: field staff and data managers who work with WHO country teams, and communications officers who work with UNICEF teams
- WHO and UNICEF are responsible for assigning volunteers to specific countries to provide technical assistance and training for immunization programs supervise volunteers during their assignment
- Field assignment objectives were expanded in 2002 to support accelerated progress toward measles mortality reduction and development of data management systems for disease surveillance.
- The objectives were further expanded in 2003 to support strengthening routine childhood immunization activities
- In 2006 an inclusion of communications specialists was added to the STOP program to support polio program communications and social mobilization at UNICEF country offices
- All volunteers undergo 10 days of intense technical, security, and cross-cultural training at CDC in Atlanta before being deployed on field assignments of 5 months duration
Scope of Volunteer Assignments
Among the assignments, 1,592 (72%) have been to English-speaking countries, 520 (23%) to French-speaking countries, and 109 (5%) to Portuguese-speaking countries. The GPEI partnership will continue the STOP program throughout the period of eradication, certification, and progressive withdrawal of oral poliovirus vaccines, as outlined in the Polio Eradication and Endgame Strategic Plan, 2013–2018 (7).
56% of the volunteers in 2013 had served in previous assignments. Roles generally include a mix of training and capacity building; monitoring health facilities – checking for good plans, systems, suspect cases of polio on records; and most importantly listening and learning from the communities and health workers so good information and decisions can be made from the ground up.
So far in the two weeks as a STOP communications worker in-country I am thrilled to feel and act as an important person in the middle of accessing grassroots health facilities and workers in the hardest to reach district and also engage with the Minister of Health and others to strengthen a system of people who are essentially trying to do what is best for the health of all their people.
I strongly encourage anyone with a background in health, communications, data analysis and aid and development to have a look at this unique and limited opportunity as aStop Transmission of Polio (STOP) worker, which I feel is making a strong contribution to see polio-free world for everyone, everywhere, forever!
Most of this article has come from: Polio Eradication Dept, World Health Organization; Global Immunization Program, UNICEF. Bill and Melinda Gates Foundation. Global Immunization Div, Center for Global Health, CDC.
Benjamin Nkowane, MD, World Health Organization. Tim Petersen, Bill and Melinda Gates Foundation. Rotary International. Geospatial Research, Analysis, and Services Program (GRASP); Kim Porter, PhD, Global Immunization Div, Center for Global Health, CDC.
- CDC. Progress toward eradication of polio—worldwide, January 2011–March 2013. MMWR 2013;62;335–8.
- CDC. Resurgence of wild poliovirus type 1 transmission and consequences of importation—21 countries, 2002–2005. MMWR 2006;55:145–50.
- CDC. Wild poliovirus type 1 and type 3 importations—15 countries, Africa, 2008–2009. MMWR 2009;58:357–62.
- CDC. Outbreaks following wild poliovirus importations—Europe, Africa, and Asia, January 2009–September 2010. MMWR 2010;59:1393–9.
- World Health Assembly. Poliomyelitis: intensification of the global eradication initiative. Resolution WHA65.5. Geneva, Switzerland: World Health Organization; 2012. Available at http://apps.who.int/gb/ebwha/pdf_files/wha65-rec1/a65_rec1-en.pdf#page=25 .
- CDC. Smallpox surveillance—worldwide. MMWR 1997:46;990–4.
- Global Polio Eradication Initiative. Polio eradication and endgame strategic plan 2013–2018. Geneva, Switzerland: World Health Organization; 2013. Available at http://www.polioeradication.org/portals/0/document/resources/strategywork/endgamestratplan_whaversion.pdf
* Additional information on the STOP program and countries to which volunteers have been assigned (including map) is available at http://www.cdc.gov/polio/stop.