The twelfth meeting of the Emergency Committee (EC) under the International Health Regulations (2005) (IHR) regarding the international spread of poliovirus was convened via teleconference by the Director General on 7 February 2017.

The Committee unanimously agreed that the international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC), and recommended the extension of the Temporary Recommendations for a further three months. The Committee considered the following factors in reaching this conclusion:

• The outbreak of WPV1 and cVDPV in Nigeria highlighting that there are high–risk areas where surveillance is compromised by inaccessibility, resulting in ongoing circulation of WPV for several years without detection. The risk of transmission in the Lake Chad sub–region appears high.
• The continued international spread of WPV1 between Pakistan and Afghanistan.
• The persistent, wide geographical distribution of positive WPV1 in environmental samples and AFP cases in Pakistan, while acknowledging the intensification of environmental surveillance inevitably increasing detection rates.
• The current special and extraordinary context of being closer to polio eradication than ever before in history, with the lowest number of WPV1 cases ever recorded occurring in 2016.
• The risk and consequent costs of failure to eradicate globally one of the world’s most serious vaccine preventable diseases. Even though global transmission has fallen dramatically and with it the likelihood of international spread, the consequences and impact of international spread should it occur would be grave.
• The possibility of global complacency developing as the numbers of polio cases continues to fall and eradication becomes a possibility.
• The serious consequences of further international spread for the increasing number of countries in which immunization systems have been weakened or disrupted by conflict and complex emergencies. Populations in these fragile states are vulnerable to outbreaks of polio. Outbreaks in fragile states are exceedingly difficult to control and threaten the completion of global polio eradication during its end stage.
• The continued necessity for a coordinated international response to improve immunization and surveillance for WPV1, to stop international spread and reduce the risk of new spread.
• The importance of a regional approach and strong cross­border cooperation, as much international spread of polio occurs over land borders, while also recognizing that the risk of distant international spread remains from zones with active poliovirus transmission.