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Reflections on Modeling Poliovirus Transmission and the Polio Eradication Endgame
Author(s) -
Thompson Kimberly M.,
Kalkowska Dominika A.
Publication year - 2021
Publication title -
risk analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.972
H-Index - 130
eISSN - 1539-6924
pISSN - 0272-4332
DOI - 10.1111/risa.13484
Subject(s) - poliomyelitis eradication , poliomyelitis , chess endgame , disease eradication , context (archaeology) , transmission (telecommunications) , political science , business , risk analysis (engineering) , computer science , medicine , poliovirus , geography , telecommunications , virology , disease , virus , archaeology , pathology , artificial intelligence
The Global Polio Eradication Initiative (GPEI) partners engaged modelers during the past nearly 20 years to support strategy and policy discussions and decisions, and to provide estimates of the risks, costs, and benefits of different options for managing the polio endgame. Limited efforts to date provided insights related to the validation of the models used for GPEI strategy and policy decisions. However, modeling results only influenced decisions in some cases, with other factors carrying more weight in many key decisions. In addition, the results from multiple modeling groups do not always agree, which supports selection of some strategies and/or policies counter to the recommendations from some modelers but not others. This analysis reflects on our modeling, and summarizes our premises and recommendations, the outcomes of these recommendations, and the implications of key limitations of models with respect to polio endgame strategy. We briefly review the current state of the GPEI given epidemiological experience as of early 2020, which includes failure of the GPEI to deliver on the objectives of its 2013–2018 strategic plan despite full financial support. Looking ahead, we provide context for why the GPEI strategy of global oral poliovirus vaccine (OPV) cessation to end all cases of poliomyelitis looks infeasible given the current state of the GPEI and the failure to successfully stop all transmission of serotype 2 live polioviruses within four years of the April–May 2016 coordinated cessation of serotype 2 OPV use in routine immunization.