Polio Legacy Planning discussion On behalf of Dr Salla Mbaye AFRO MR TAG meeting , June 2015

1. Polio Legacy PlanningdiscussionOn behalf of Dr Salla Mbaye AFRO MR TAG meeting , June 2015

2. Outline • Background • Objectives and activities • GPEI assets • Progress in AFR • Draft Global legacy framework • Next steps

3. Polio Eradication & Endgame Strategic Plan 2013-2018 • Poliovirus detection & interruption(by 2014) • Immunization systems strengthening & OPV withdrawal (OPV2 by 2016) • Containment & Certification(by 2018) • Legacy Planning

4. Polio Eradication & Endgame Strategic Plan 2013-2018

5. Polio Legacy Planning: Objectives & activities • Aim: • Develop a plan to ensure polio investments contribute to future health goals, through documentation and transition of lessons learnt, processes and assets of the GPEI • Major activities: • Mainstreaming polio functions • continued integration of polio immunization (utilizing IPV) and communications • polio surveillance and response activities into national and global disease alert and response mechanisms • appropriate containment of polioviruses according to agreed international and national standards, regulations and protocols • Leveraging the knowledge and lessons learnt • Share lessons of more than 20 years of polio eradication with other health initiatives • Transitioning the assets and infrastructure to support other health priorities

6. GPEI Assets • Human resources: Teams and individuals at global, regional, & country levels • Knowledge: experience and expertise on a wide range of issues of public health value, documentations • Systems: Networks, systems & processes, AFP surveillance, Polio laboratory network, partner coordination, governance, GIS/GPS • Physical: Vehicles, communication & information technology equipment, work locations, etc • Financial resources: Governments, local and GPEI partners funds

7. Immunisation Human Resources, 2014 CORE STAFF POLIO FUNDED STAFF, 93% (n=855) SURGE NON-POLIO FUNDED STAFF (n=66) *Kenya, Niger, Tanzania, Uganda

8. 2014 Polio Funding: $321,929,065 Partners Contribution By Activity By Country

9. Progress in AFR • RC 63 in Sep 2013 favoured scenario 2: • transition of the lessons, assets and resources to benefit other existing and relevant national, regional and/or global public health programmes • Regional inter-cluster working group established to: • Document best practices • Develop a regional framework • Elaborate regional legacy plan • Workshop held to develop protocol for documenting polio best practices in countries • Documentation conducted in 2014/2015 in 8 countries: Angola, Chad, Cote d’Ivoire, DRC, Ethiopia, Togo, Nigeria and Tanzania • Working group not functional for several months due to EVD outbreak response

10. Using Polio Infrastructure • Establishment of zones, hubs, sub-regions with appropriate staff and resources in priority countries • Surveillance of other diseases - Measles, Yellow Fever • Capacity building • Data management • Supplemental Immunisation Activities • Measles • Vitamin A and other pluses • Communication • Routine Immunisation • Micro-planning • Nigeria EOC helps response to Ebola • Emergency responses • Certification committees identified for tOPV/bOPV switch validation

11. EB January 2015- Legacy Planning • Reinforced conclusions of RCs in 2013 • should benefit existing health priorities • to be driven and led by countries • A draft global legacy planning framework and transition guidelines are being prepared to guide legacy planning at country level through a three-phase approach • planning and decision-making, • preparation, and • execution.

12. Proposed process, roles and responsibilities Three key stages for Legacy rollout in each country, ideally completed by 2018 Given asset base and current epidemiology, legacy planning may require more time for completion in certain geographies Should be a country-level and -led process, bringing together GPEI agency offices, government and key donors/other stakeholders Phase of Transition Planning & Decision Preparation Execution • Implementation of revised contracts • Transfer of assets / capabilities • Monitoring & Evaluation • Ongoing monitoring of transitioned assets / capabilities • Formation of project oversight team • MoUs with recipient institutions • Revision of contracts • Capacity building • Donor engagement • Definition of project oversight structure • Selection of transition opportunities, cost assessment • Creation of operation and communication strategies Activities Leadership Country government Transition Assistance Donor Consortium Project management Professional Project Management Team Roles and responsibilities Asset recipients Technical assistance Agencies and other stakeholders Recipients

13. Next steps • AFR has now nominated members to the Global Polio Legacy Management Group • Regional inter cluster working group to be reactivated • Legacy planning should be led at country level • Planning process should start now • With local and global partners support • Develop the Regional legacy plan

14. Anticipated effect to the measles elimination goal in AFR ? • The polio legacy plan intends to reduce resources • 93% of staff funded by Polio financing will have implications to the regional measles elimination targets unless • Resources are rationalised either by member states or identification of alternative source • Transition is well thought through in advance to sustain the support to countries with alternatives of preparing countries • Costed measles elimination strategic plans could be used for advocacy at country level • Other upcoming opportunities need to be immediately thought of • Background of reduced resources of traditional partners like MRI & other partners – already reduced resources observed • Cost of surveillance will increase as most countries move to elimination mode measles surveillance • WHO traditionally to assist with surveillance but with limited funding

15. Question for TAG • Between 2015 to 2018, what can be advocated for to the Region, and member states so that the assets from the Polio Eradication benefit the measles elimination as one of the beneficiaries ? This in background of reduced financial support that is currently faced

16. Thank you!