Background: Mathematical modeling continues to support the Global Polio Eradication Initiative (GPEI) as it works to achieve and maintain wild poliovirus (WPV) eradication, end the use of oral poliovirus vaccine (OPV), and integrate GPEI activities and assets into other health programs. The GPEI was off track prior to SARS-CoV-2 emergence and declaration of the COVID-19 pandemic in 2020. The GPEI faces multiple challenges: (i) completing WPV eradication, (2) ending the ongoing transmission of type 2 vaccine-derived polioviruses (VDPV2s) 7 years
after global cessation of type 2 OPV for non-emergency use, (3) limited financial and vaccine resources, and (4) the need to recover programmatic activities from the disruptions caused by COVID-19. Over the remaining 4 years, the GPEI still expects to eradicate WPV and coordinate phased OPV cessation. Novel OPV (nOPV) strains promise to reduce OPV risks, and the licensure of COVID-19 vaccines make it now a vaccine preventable disease (VPD). Integrated economic, risk, and dynamic disease modeling is needed to identify and support cost-effective strategies for their use.
Objectives: This work will extend a highly-successful collaboration that continues to support high-stakes GPEI decision making by providing the results of integrated disease modeling and economic analyses related to managing the polio endgame, manage US poliovirus importation risks, and could extend further to supporting other Global Immunization Division goals.
Approach: Building on previously-developed and actively updated integrated model, the proposed work will provide quantitative analyses to answer priority questions raised by GPEI partners during the polio endgame. Theproposed work may also apply and expand similar collaborative modeling efforts to support better global control, elimination, or eradication of other priority VPDs, including COVID-19.
Outcomes: Short-term outcomes of this work for polio will include characterizing the expected outcomes of updated GPEI strategic plans (anticipated to become available in 2021), modeling poliovirus transmission dynamics and epidemiology in Pakistan and Afghanistan and other prioritized high-risk areas, exploring different strategies to use nOPV to control VDPV2 outbreaks and complete OPV cessation, and synthesizing lessons learned. Short-term outcomes of this work for other VPDs may include the development of an integrated model for COVID-19.
Intermediate outcomes of this work will include analyses that support informed decisions by the GPEI and other stakeholders related to decisions and strategies for vaccines, surveillance, containment, and other risk management activities, and improved understanding among Ministries of Health and key stakeholders about lessons learned from polio eradication relevant to the global control, elimination, and eradication of other VPDs. Longterm outcomes will include key insights on issues identified as priorities after the first year, an updated health and economic analysis of the GPEI, and improved understanding and supportive policy development of cost-effective opportunities to better manage global VPDs with full consideration of the lessons learned from polio eradication efforts.
Anticipated impacts: This work will provide timely and critical analytical support for domestic and global health leaders as they manage polio and other prioritized VPDs by supporting the development of cost-effective programmatic strategies.
