NVAC

1. NVAC 2-5-03

2. The Global Certification Commission declares the world polio-free when: • No wild poliovirus has been found for at least 3 consecutive years • All laboratories have adopted appropriate measures of containment

3. Appropriate measures of containment assume that: • Global polio immunization recommendations remain in force. • Immunization rates will likely decrease in the absence of disease.

4. 2nd edition 2002 WHO Global Action Plan for Laboratory Containment GOAL: To minimise the risk of reintroduction of wild polioviruses from the laboratory to the community

5. Global Action Plan links biosafety measures to polio eradication progress

6. Laboratory inventory When Regions become polio-free. • Encourage Institutions/labs to dispose of unneeded wild poliovirus infectious and potential infectious materials. • Establish National Inventories of laboratories retaining such materials.

7. Update on US National Inventory • October 2002: Letters from ASH and inventory packages were mailed to >31,000 institutions with biomedical laboratories. • December 31, 2002: Target date for replies

8. National Laboratory Inventory response rate/category in database • 95% of 104 state/local government • 93% of 14 federal government • 78% of 684 industry/biotech • 77% of 865 academic institutions • 66% of 5,171 hospitals • 57% of 20,717 private laboratories • 53% of 4,800 other categories = 59% of 32,355 (01/31/03)

9. National Laboratory Inventory No. institutions with WPV among those reporting • 44 of 665 academic institutions • 19 of 3,419 hospitals • 18 of 535 industry/biotech • 13 of 2,561 other categories • 13 of 11,835 private laboratories • 13 of 99 state/local government • 05 of 13 federal government = 131 with WPV materials (01/31/03)

10. National Laboratory Inventory No.labs with WPV of no. surveyed • 82 of 53,626 academic institutions • 30 of 1,831 federal government • 25 of 7,837 industry/biotech • 17 of 8,289 hospitals • 15 of 254 state/local government • 14 of 7,314 private laboratories • 12 of 3,609 other categories = 195 of 82,760 (01/31/03)

11. Next Steps • Reminder letters to all non-responders (February and again March) • Validate and reconcile database information • Telephone follow up (April and May)

12. Global Certificationwhen one year has passed with no evidence of wild poliovirus transmission worldwide. • Labs on inventory have one further year to: -dispose of wild poliovirus materials or -implement biosafety measures

13. All activities, including storage BSL-3/polio Activities involving poliovirus permissive cells or animals BSL-3/polio Other activities (including bacteriology, etc laboratories) BSL-2/polio (within a class II Biosafety Cabinet) Certification phase biosafety measures Laboratory Activity Type of Material Biosafety Level WPV Infectious: • Clinical • Environmental • Laboratory Products Potential WPV infectious: • Clinical • Environmental • Laboratory Products

14. Global Certificationwhen two years have passed with no evidence of wild poliovirus transmission worldwide. Nations have one further year to: -ensure national containment is complete and -submit documentation to WHO.

15. Global Certification of Poliovirus Eradication

16. Post global certification: • At some time after certification, international bodies will consider future immunization policies. • Potential increased containment will be one of several factors influencing decisions to: continue IPV and OPV or discontinue OPV, with/without switching to IPV