2024-02-26-世界卫生组织-Polio_Transition_M_E_Trend_Analysis_2018_-_2022_25页_2mb

Polio Transition Monitoring & Evaluation (2018-2022)

The review of M&E indicators for the 20 polio transition priority countries (AFRO, EMRO, SEARO) shows overall limited progress towards the strategic action plan's objectives, with significant regional and country-level variations.

Key Findings by Objective:

1. Sustaining a polio-free world:

   • Progress: IPV1 and OPV3 coverage saw small increases (73% vs 63% for IPV1, ~72% stable for OPV3). AFP surveillance improved (rate increased to 11/100,000 children <15 years, better stool specimen collection). Non-endemic WPV cases temporarily dropped in 2021 before rising slightly to 27 cases in 2022. cVDPV cases peaked (833 in 2020), then declined slightly but remained high (772 in 2022). Environmental surveillance site numbers increased, but samples per site decreased (from 21x to 13x). AFR and EMRO cVDPV cases remained prevalent or peaked.
   • Challenges: cVDPV cases surged in 2020 and remain a major concern. WPV cases returned to 2019/2020 levels. Full coverage targets for inactivated/oral polio vaccines remain far off.

2. Strengthening immunization systems and surveillance:

   • Progress: Immunization systems saw some improvements, particularly in SEAR (high MCV and OPV coverage). Routine immunization spend increased overall. AFP surveillance rate improved, and stool sample collection for AFP cases significantly increased (from 87% to 91%).
   • Challenges: MCV coverage (1 dose ~70%, 2 doses ~57%) remains low across regions and years post-COVID dips. Government expenditure data is inconsistent and doesn't meet all countries' reporting requirements, hindering assessment.

3. Strengthening emergency, preparedness, detection and response capacity (IHR):

   • Progress: Self-assessment scores for laboratory (54% -> 61%), surveillance (73% -> 76%), and emergency management (49% -> 60% for 2018-20) showed improvement (data limited by self-reporting). Emergency capacity saw a boost coinciding with the COVID-19 pandemic.
   • Challenges: Much work remains, and reliance on self-assessment limits accuracy.

Other Key Aspects:

• Regional Focus: SEAR generally showed higher performance on vaccine coverages and surveillance targets than AFRO and EMRO. EMRO faced challenges achieving minimum coverage levels and lacked national plans in some countries.
• Process: Twelve countries endorsed National Transition Plans, but few developed Action Plans. The number of GPEI-supported polio positions decreased significantly from 2018 to 2022 (671 to 440).
• Data Limitations: Inconsistent government expenditure reporting and high reliance on self-assessment for IHR capacity indicators are noted drawbacks.