New Program Eyed to Tackle Polio

Posted by: Medical Observer

EXTANT world boxing champion Diosdado “Dodie Boy” Peñalosa—he now trains Nonito Donaire, a rising global ring icon– may have prolonged his reign in two weight divisions had he been spared the battle against a disease that has always threatened to bring a man to his knees. He has been suffering from polio since he was born in 1962—one among many children that slipped past the nationwide anti-polio immunization drive.

For decades, authorities in the Philippines have been waging a war against polio but the next-to-best feat mustered to eradicate the disease has been 73 to 91-percent nationwide inoculation coverage since 2002.

“Never in the history of Philippine immunization was a 95-percent coverage achieved. But we have to do this to increase the population immunity and reduce the risk arising from circulating emergent polio virus. Since the Philippines has been classified as high-risk for polio importation, we included oral polio vaccine—one dose in September—for infants less than five years of age, 13.6 million to be covered in the one-month campaign,” cites Dr. Maria Joyce U. Ducusin of the Department of Health’s family health office.

Dr. Ducusin says that the more challenging component of the current anti-polio strategy (adopted from the World Health Organization immunization practice) is the introduction of the inactivated poliovirus vaccine or IPV, currently the vaccine of choice in the United States.

“For the initial IPV start-up to begin by October 2015, we have dedicated around P100 million for the vaccination. But to cover about 2.5 million infants per year requires P250 million just for the IPV alone,” she notes, and adds that funds for this has to be provided by the Philippine government since local health authorities “don’t receive any support from other organizations for the vaccines.

“The program right now has focused its intervention in achieving high population immunity in the high-risk areas. It used to be (at barangay or village level) but now we (are setting sights) on the different purok or zones, or the different blocks, as designated here in the national capital region. There are criteria that have been set. Where are these high-risk areas? And we found out that in these identified high-risk areas, these are the usual areas where we have always missed children for immunization. (The program is keen on) strengthening local and national capacities for program management, micro-planning, social mobilization and monitoring of the program performance,” she explains.

Dr. Ducusin cites the need to develop “a logistics plan for supply distribution, storage and management and pullout of the remaining P-OPV stocks with secure collection and the proper documentation.”

Too, she mentions the urgency for health leaders “to develop a training and communication plan targeting both the health worker and the community, because in the previous years, the communication gap or cascading of knowledge about the shift from one antigen to another or from one schedule to another contributes to the low performance of the immunization drive in the country.”

In terms of the containment and certification, she notes that strategies and activities to be worked out here include “laboratory containment, to ensure that all polio virus stocks are safely contained.

“The third is to initiate the implementation of Phase 2, because we’re only in the Phase 1 of the containment and certification of the laboratory containment plan, according to the draft global action plan, for polio virus laboratory containment. And the last is to establish a good facility… and management with both primary and secondary safeguards if the laboratory needs to retain OPV materials and that of the cessation of the OPV in routine immunization,” she elaborates.

The new approach, in sync with WHO recommendations, was trotted out in 2013 and may see completion by 2018 and may entail the cost of about US $62.9 million.

- Dong Delos Reyes