18th meeting of the Regional Commission for Certification of Polio Eradication in the Region of the Americas (RCC)

PAHO/WHO

Credit

The RCC recalls that the increase in regional polio vaccination coverage in the Americas is insufficient in many countries to prevent disease outbreaks

The week of 15-19 July 2024, the city of Lima, Peru, hosted the 18th Meeting of the Regional Certification Commission for Polio Eradication of the Americas (RCC), with the objective of reviewing the polio situation in the Region, as well as discuss and validate the 2023 annual reports on the status of polio eradication, polio outbreak risk analysis, progress in poliovirus containment, and the formulation of recommendations.

For the meeting, 27 of the 29 planned annual reports were received from which it was concluded, after a thorough review, that there are eight countries with very high level of polio risk, nine with high level of risk, ten with medium risk, and 17 with low risk of polio outbreaks by 2024.

In addition, it was reported that the U.S. and Peru have provided sufficient evidence to conclude that no additional polio cases have occurred. Wastewater samples in the U.S. and Canada have been negative for circulating vaccine-derived poliovirus type 2 (cVDPV2) for more than 12 months.

As part of the findings, it has been recognized that, since the July 2023 meeting, there has been an improvement in regional polio vaccination coverage for IPV1 and polio3. IPV1 increased from 89% in 2022 to 90% in 2023 and polio3 increased from 83% to 87%. It is also noted that all but one country in the Americas has introduced the second dose of IPV as was recommended by PAHO’s Technical Advisory Group (TAG) on Vaccine-Preventable Diseases.
However, the RCC noted that some countries have not yet reached the recommended coverage targets of 95% nationally and 80% in all municipalities.

And with regard to surveillance, the RCC noted that there has been an improvement in surveillance performance at the regional level from 2022 to 2023, with an increase in the reporting rate of acute flaccid paralysis (AFP) cases from 1.35 to 1.41 per 100,000 children under 15 years of age. However, significant risks of not identifying polio cases due to surveillance gaps at the national and subnational levels remain. According to national data, six countries and the Caribbean subregion have not reached the reporting target of 1 AFP case per 100,000 children under 15 years of age.

In addition, during the closing session, the RCC paid tribute to Dr. Cuauhtémoc Ruiz, head of PAHO's immunization program for 15 years, and to Dr. Ken Berns, the first chair of a National Certification Commission (NCC) and a long-time member of the US NCC – two individuals who made notable contributions to the efforts to sustain polio elimination in the Region, both at the programmatic and NCC levels, and who passed away earlier this year:

About the Commission

The Commission consists of nine recognized experts in the Region in areas of public health, epidemiology, pediatrics, virology, infectious diseases, and immunology. Members of the RCC are appointed by the Director of PAHO/WHO for a 3-year term, and may be reappointed for additional terms, in accordance with the requirements of the Strategic Plan for Polio Eradication.

Responsibilities include:

Evaluate compliance with the certification requirements for polio eradication in the Region of the Americas, as defined by the Global Certification Commission (GCC), with special considerations for immunization coverage, surveillance, containment, risk assessment, risk mitigation, and outbreak preparedness;
Define and update, as necessary, the documentation required from each country in the Region to demonstrate their maintenance of polio-free status;
Annually review each country's updated polio eradication documentation and report the findings and required actions to the PAHO Director and NCC of each country;
Conduct country visits, as needed, to review or verify their polio-free status (including laboratory containment of wild polioviruses, VDPV, and Sabin);
Work closely with NCCs and provide recommendations to meet the requirements for global certification;
Review and validate national reports and documentation on containment of all polioviruses in laboratories to assess the progress to minimize the risks associated with the poliovirus facility and recommend actions needed to achieve laboratory containment goals within the Region.