The Emergency Committee reviewed the data on wild poliovirus (WPV1) and circulating vaccine derived polioviruses (cVDPV). The Secretariat presented a report of progress for affected IHR States Parties subject to Temporary Recommendations. The following IHR States Parties presented an update on the current situation and the implementation of the WHO Temporary Recommendations since the Committee last met on 24 April 2017: Afghanistan, Democratic Republic of Congo (DR Congo), Nigeria, Pakistan and Syria.

Overall the Committee was encouraged by continued steady progress in all three WPV1 infected countries, Pakistan, Afghanistan, and Nigeria, and the fall in the number of cases globally, with no international spread detected in the last three months. While falling transmission in these three countries decreased the risk of international spread, the consequences should spread occur would represent a significant set–back to eradication and a risk to public health.

The Committee commended the efforts of Pakistan that has seen the number of cases fall to just three so far in 2017. However, WPV1 continues to be widespread geographically as detected by environmental surveillance although the intensity of environmental surveillance in the country is now very high meaning the probability of detection is higher than previous years.

The Committee welcomed the reduction in the number of inaccessible children in Afghanistan. However, since the last committee meeting, new cases of wild poliovirus infection have occurred in Kandahar and Hilmand provinces, highlighting that the southern region of Afghanistan continues to have pockets of chronically missed children unreached by the polio program.

The main challenge is the shared poliovirus reservoirs between the two countries, within which there are high risk mobile populations such as nomadic groups, local populations that straddle the border, seasonal workers and their families, repatriating refugees, and guest children. This means coordination and cooperation is absolutely essential to achieve eradication, and the committee urged the two countries to continue and increase bilateral polio eradication activities.

The Committee noted that there were no new WPV1 cases detected in Nigeria since August 2016 but that there remains a substantial population in Borno state that is totally or partially inaccessible, including around 250,000 children. The committee concluded that there is a high risk that polioviruses are still circulating in these inaccessible areas.

There was ongoing concern about the Lake Chad basin region, and for all the countries that are affected by the insurgency, with the consequent lack of services and presence of IDPs and refugees. The risk of international spread from Nigeria to the Lake Chad basin countries or further afield in sub–Saharan Africa remains high. The committee was encouraged that the Lake Chad basin countries including Nigeria, Cameroon, Chad, Niger and the Central African Republic (CAR), continued to be committed to sub–regional coordination of immunization and surveillance activities. However, significant gaps in population immunity exist in some areas of these countries in border areas with Borno.

The committee was very concerned about the new outbreaks of type 2 cVDPV in DR Congo and Syria. Countries surrounding the outbreak zone are responding to the Syrian outbreak to prevent importation, particularly among Syrian refugees in Lebanon, Jordan, and Turkey. The committee urged any country receiving Syrian refugees, particularly from Deir Ez–Zor and Raqqa, to ensure polio vaccination with IPV where available. In DR Congo surveillance gaps need to be addressed with a comprehensive and sustained response.