The State of Global Citizen ‘The End of Polio’ Commonwealth Commitments April 2018 – Version 1.0 A Global Citizen Accountability Report
‘The end of polio’ impact summary Ending extreme poverty is advanced when everyone can access the healthcare they need to thrive, especially pregnant mothers, newborns, and children, for whom immunization is hugely successful and cost-effective. This includes the end of polio. Global Goal 3 Global Citizen's impact on polio eradication with Commonwealth leaders
Global Citizen ‘The End of Polio’ Commonwealth IMPACT since 2011
In 2015, Commonwealth leaders — in response to more than 250,000 actions by Global Citizens, and the efforts of our partners— promised to renew their financial support to polio. Since then, they’ve pledged more than $220 million, set to affect over 140 million children through immunizations over the next three years. In total, since 2011, thanks to the efforts of Global Citizens and our partners, Commonwealth leaders have pledged more than $1 billion, set to affect over 434 million lives. Global Citizen has calculated that from these commitments, $794 million has already been disbursed to the Global Polio Eradication Initiative, and that more than 323 million children have been immunized so far. This report reviews the progress and impact arising from these commitments, and where necessary, holds their makers accountable for their promises.
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1/4 million Global Citizen Actions
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8 Commitments
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$1.02 Billion Dollars
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434 million lives set to be affected by 2021
Contents
1. Global trends — future focus
p. 4
2. The role of the Commonwealth in polio eradication
p. 5
2 a. Report findings
p. 5
2 b. Progress over time — at a glance traffic lights
p. 6
2 c. Galvanizing and scaling impact from donor states
p. 8
2 d. Progress in polio endemic states
p. 9
2 e. The ongoing call to action
p. 10
3. Commitment progress — impact case studies and human stories
p. 11
4. Impact and accountability methodology
p. 25
Global trends — future focus Insights for future accountability Global Citizen is publishing this accountability report to demonstrate the progress and need for continued support for polio eradication, as Commonwealth leaders comes together in London for the 25th Commonwealth Heads of Government Meeting.
In compiling this update, we noted the continuation of several key trends outlined below, as well as some new developments to the polio landscape, including: The Last Mile is the Hardest From 350,000 cases in 1988 to just 22 in 2017, we have seen incredible progress in eliminating polio. While polio remains in only a few locations, these are some of the most difficult to access places in the world. If we miss just one community, the polio virus could spread again around the world reaching 200,000 cases a year within a decade. Since 2001, we have witnessed outbreaks of wild polio in 41 countries that were formerly polio-free. To reach the end, we must be persistent, which is why Global Citizen continues to call on world leaders to prioritize tackling this deadly disease. The Buck Should Stop Here The 2011 and 2015 Commonwealth Heads of Government Meetings were vital in rallying the international community’s support for polio eradication. However, we were disappointed to see the lack of political appetite for rallying behind polio once again at CHOGM 2018. It is great to continue to see exemplary commitments from donor governments through their pledges filling the US $1.5 billion, but while understanding the aspiration to focus on new priorities, consistency is important for success, and reaching the last mile will also take continued political will combined with adequate funding to accomplish such a legacy from past CHOGM summits. As Baroness Scotland remarked in 2015, polio eradication is “an exemplary example of what the Commonwealth can do”. We cannot afford to turns our backs now after all our hard work. If the Commonwealth continues to lead the way as it has in the past, by the time of the next Summit, we will have succeeded in finally wiped polio completely from the planet. Competing Priorities in a Crowded Landscape After 2017’s successful GPEI replenishment, Global Citizen has sensed that some governments are focusing their attention on other priorities. We note that robust support for immunization against preventable diseases within the Nigerian government, but hope this does not come at the expense of the polio program. Similarly, with upcoming 2018 and 2019 elections in Pakistan and Nigeria, respectively we hope to see polio eradication continue to remain a priority. We note that with several upcoming global health replenishments over the next few years, Global Citizens will need to keep taking action to ensure there remains a strong global commitment to achieving the eradication of polio, and we will look for ongoing leadership from the Commonwealth, and other donors.
The role of the Commonwealth in polio eradication Report findings Percentage lives impacted/ Total lives set to be affected
This report shows that are almost 61.55 percent toward impacting the 524,795,902 million lives set to be affected by 2030 achieved by all Commonwealth pledges to the Global Polio Eradication Initiative (GPEI), as a result of the significant effort of Global Citizens actions, our advocacy efforts, and the efforts of partners since 2011. Five years on since our first Commonwealth polio eradication commitment, we are currently tracking equivalent to reaching our goal of impacting 524.8 million lives by 2021 having already impacted 323 million lives, according to Global Citizen calculations. Our accountability tracking and reporting efforts reveal that as of the end of March 2018, these eight commitments have seen $794,808,803 disbursed to Global Polio Eradication Initiative, indicating that 323,005,436 lives have been impacted to date through GPEI child immunization programs. We have explained our methodology toward the end of this report. Out of these eight commitments: Seven are in progress and on track. One is completed on track. Three are reaching the end of their agreed commitments in financial terms. Of these three, all three have recommitted and are commencing their 2017 commitments, which currently are on track. Gaining support for polio eradication and vaccines as a global response to ending extreme poverty has never been more justifiable, especially with polio now 99.9 percent eradicated. Polio immunizations and interventions are demonstrably some of the most cost effective ways to respond to the Global Goals, especially as lessons learned may be applied to other vaccination efforts for preventable and neglected tropical diseases. For example, assets developed by GPEI for one purpose can be used to build overall capacity in health workers and disease surveillance systems.
61. 55%
323 million lives impacted at end March 2018 —61.55 percent of target 524.8 million lives set to be affected by 2021
Progress over time tracker At a glance traffic lights Pledged after CHOGM 2011 campaigning: Commitment
Previous Status
United Kingdom commits to GPEI (2013)
Current Status
Change
Comment Installments toward this commitment remain on track.
Status: In progress — on track
Isle of Man commits to GPEI (2013) Status: Complete — target met
Canada commits to GPEI (2013) Status: In progress — on track
Australia commits to GPEI (2013) Status: Revised commitment — on track
The Isle of Man commitment has been paid in full since 2016.
Installments toward this commitment remain on track
The revised commitment is on track.
Progress over time tracker At a glance traffic lights continued… Pledged after CHOGM 2015 campaigning: Commitment
Previous Status
Current Status
Change
Comment
Status: In progress — on track
The first installment has been paid. GPEI would welcome a formal agreement to support the remaining installments.
United Kingdom recommits to GPEI (2017)
Formal agreements are in place and the first installment is paid.
Malta commits to GPEI (2016)
Status: In progress — on track
Canada recommits to GPEI (2017) Status: In progress — on track
Australia recommits to GPEI (2017) Status: In progress — on track
Formal agreements are in place and the first installment is paid.
A formal agreement is in place to support future installments.
The role of the Commonwealth Galvanizing and scaling impact from donor states It is fitting that the Commonwealth, and Commonwealth nations, have taken a leadership role in the unfolding eradication of polio. Global Citizen has played a direct campaigning role in this story, alongside the efforts of sector partners including Rotary International, the Bill & Melinda Gates Foundation, UNICEF, the World Health Organization, and the U.S. Centers for Disease Control & Prevention. On October 28, 2011, Global Citizen held the End of Polio Concert in Perth Australia, raising $118 million from Commonwealth governments on the eve of the 2011 Commonwealth Heads of Government Meeting (CHOGM). This week, in April 2018, as the Commonwealth Heads of Government are again set to meet, this time in London, this report celebrates impact seen through the eight financial commitments made to the Global Polio Eradication Initiative, thanks to the quarter of a million actions taken by Global Citizens around the world to see the eradication of polio, together with our partners. Since our campaigning began in 2011, Global Citizens actions, our advocacy efforts, and those of our sector partners, have helped secure eight financial commitments from Commonwealth leaders, worth $1,020,272,792, which are together set to affect 524,795,902 lives. Through our accountability tracking and reporting, we are able to share that as of the end of March 2018, these commitments have seen $794,808,803 disbursed to the Global Polio Eradication Initiative, meaning that 323,005,436 lives have been impacted to date. Back when we first supported eradication efforts in 2011, polio was 99 percent eradicated. Today, we are more than 99.9 percent toward achieving the end game — zero polio. The impact is set out in this report, but our call to action is ongoing. At CHOGM 2018, Global Citizen calls on the Commonwealth Heads of Government to recommit to finishing the job on polio once and for all, and to apply these lessons to ending other deadly diseases, like malaria and neglected tropical diseases. Muscat underlined this message at Global Citizen Live London as the outgoing Chair of the Commonwealth saying from our stage, "At this year’s Commonwealth Summit, we will do our utmost to ensure we remain committed to finishing the job on polio in Pakistan and Nigeria."
Photo credit: CHOGM. Commonwealth Leaders and the UN Secretary-General come together on the end of polio at a sideevent co-hosted by Global Citizen and Rotary International in 2015.
Even with this story of ongoing progress — we must not become complacent. The latest statistics at March 2017 show that there were 22 cases of polio in 2017, and at the time of writing, eight cases in 2018, with two cases, one in Afghanistan, and Pakistan’s first case of 2018 being reported in the first week of April alone, making Global Citizen’s ongoing call to action all the more vital. Two of the three remaining polio-endemic countries are Commonwealth States, Pakistan and Nigeria, where progress toward the end of polio is evident.
The role of the Commonwealth Progress in polio endemic states Two of the three remaining polio-endemic countries are Commonwealth States, Pakistan and Nigeria, where progress toward the end of polio is evident. PM Nawaz Sharif spoke at CHOGM 2015 Prime Minister Nawaz Sharif spoke at CHOGM 2015 concerning the urgency of ending polio in Pakistan, saying: “Pakistan has made polio eradication a national cause. Our priority is to reach out to each and every child so no child remains unvaccinated. I am pleased to note that we have been able to significantly reduce the number of polio cases in Pakistan and we will not rest until polio is eradicated from our country.”— Prime Minister Nawaz Sharif of Pakistan.
Geoffrey Onyeama, Nigerian Foreign Minister at CHOGM 2015 Nigerian Foreign Minister Geoffrey Onyeama also spoke on the polio endemic in Nigeria at CHOGM 2015, saying, "No case of polio was reported since July 2014. This unprecedented feat informed the decision of the WHO to de-list Nigeria from polio endemic countries in October this year. The country is poised and committed to remaining vigilant to ensure that we completely eradicate polio from Nigeria.” — Nigerian Foreign Minister Geoffrey Onyeama.
In May 2017, we shared that Pakistan has never stopped the spread of wild polio virus and was one of three countries where the world’s only 37 cases occurred in 2016. However, the GPEI’s annual report states that 2015 saw “vast improvements” with 80 percent fewer cases than in 2014, thanks to the establishment of Emergency Operations Centers, operating under the National Emergency Action Plan and overseen by the Prime Minister’s office. Pakistan was an active contributor to the GPEI in 2015 through a loan agreement with the Islamic Development Bank until 2018. While Relief International recently reported that across Pakistan, immunization coverage rates increased from 85 percent in August 2016 to 92 percent in May 2017, with Pakistan’s first case of wild poliovirus announced in the last few days, it’s clear immunization efforts must remain a priority. We call on the Pakistan government to show continue giving the highest level of leadership toward polio eradication, including at CHOGM 2018 supported by a renewed financial commitment to fund the program beyond 2018.
Nigeria has never stopped the spread of wild polio virus. However, Nigeria's response is robust. Through a loan agreement with the World Bank, and other support, the Government of Nigeria disbursed $50 million through Nigeria’s Emergency Action Plan. We reported in May 2017 that it had been a challenging time for Nigeria, as four new cases of wild poliovirus were detected in Borno State in August 2016, suggesting the strain has been circulated since its last detection in the region in 2011. However, the government responded aggressively, declaring a national health emergency, and additional measures to prevent the disease crossing borders into neighboring Chad, northern Cameroon, southern Niger and parts of Central African Republic were taken immediately.
Sources: http://polioeradication.org/where-we-work/pakistan/ http://www.endpolio.com.pk/images/Stories/NEAP-2017-2018-LR.pdf
The role of the Commonwealth The ongoing call to action Progress in Nigeria continued… As of March 2018, no polio cases have been reported in Nigeria since 2016, when there were just four. Immunization days were scheduled to commence in Nigeria, with synchronized campaigns in countries across the Lake Chad Basin, following a previous immunization campaign in November 2017. The immunization days will target marketplaces which are considered high risk areas, with the aim of reaching the last two percent of children who had not been vaccinated in neighboring Chad. Nevertheless, children living in nomadic communities in the Lake Chad region remain at high risk.
In March 2018, Bill Gates and Aliko Dangote met with key Nigerian government officials resulting in the governors of Bauchi, Borno, Kebbi, Kaduna, Kano, and Sokoto States, signing extensions of their Memorandum of Understanding on routine immunization. We are glad to see this reaffirmed commitment to immunization by the governors, which is needed to protect every child against polio and other vaccine preventable diseases.
The Commonwealth Secretary-General At CHOGM 2015, Commonwealth Secretary-General designate Patricia Scotland expressed her hopes for the Commonwealth to collaborate to see the end of polio, saying, "I think this is an exemplary example of what the Commonwealth can do when it collaborates and works together with focus to bring something about, and I hope this is just the beginning." — Commonwealth Secretary-General Designate Patricia Scotland. Baroness Scotland also accepted our invitation to the 2016 Global Citizen Festival to call the member Commonwealth States to action. She announced from the stage, "At last year’s Commonwealth leaders meeting in Malta I promised to support all efforts to achieve a polio free world. A disease which is 99.9 percent eradicated, but we can't stop now. I encourage all Commonwealth countries to review their financial support in the polio program so that we can end [the] disease for good." Global Citizen looks forward to CHOGM 2018 as an opportunity to celebrate progress and continue the call for new political and financial commitments to ensure full funding of the Nigeria programme until the end.
Photo credit: GPEI. Health workers out immunizing in Nigeria. Sources: http://polioeradication.org/where-we-work/nigeria/ ; http://polioeradication.org/wp-content/uploads/2017/11/polio-vaccination-lakechad-situation-report-17102017-en.pdf
UK commits to GPEI (2013) The campaign At the 2011 Commonwealth Heads of Government Meeting (CHOGM), Britain's Prime Minister David Cameron indicated strong leadership toward the end of polio, saying, "We challenged others to match our extra funding with £5 for every extra pound, and that target has already been more than exceeded in the first year." So, working with our partners Rotary International and The Bill & Melinda Gates Foundation, in 2012 and 2013 we asked Global Citizens to push for a bold commitment from the UK government to help fill the GPEI's funding needs. In 2012, Global Citizens took more than 73,000 actions toward the end of polio and this rose to more than 152,000 actions the following year with almost 30,000 petition signatures alone, thanks to a huge push for awareness and support from Global Citizen's Global Poverty Ambassadors who took the message on ending polio to their communities across Britain as part of an enhanced delivery of our flagship 1.4 Billion Reasons presentation. These sustained efforts of Global Citizens, Rotary International, RESULTS UK and sector partners, alongside a detailed investment case developed by DfID, saw the United Kingdom announce their commitment of £300 million over six years in April 2013, making the United Kingdom the second largest public funder of the GPEI. In November 2016, Global Citizen reported that half way through the six-year period of this commitment, more than three quarters has been paid. Read on to see what’s happened since then…
Photo Credit: Global Citizen
UK commits to GPEI (2013) In progress — on track In November 2016, Global Citizen reported that half way through the six-year period of this commitment, more than three quarters has been paid. The UK's contributions on polio helped GPEI see progress in the three endemic countries, including Afghanistan, where there were just 20 cases in 2015 compared to 28 in 2014, Pakistan and Nigeria. In these countries, health workers are the key to success and can play an important role in community building and acceptance of immunization programs. This is achieved by working with UNICEF and carefully targeting polling research, health workers are trained and provided with videos and other materials that enable parents/guardians to understand the importance of immunization, and understand it as the social norm. This is because if a community is saying yes to polio vaccines, a caregiver is more likely to agree to immunization when they receive the knock at the door. For this reason, alongside vaccine distribution, on the ground communications is a critical part of how the GPEI spends its funds, allowing vital community engagement, building and maintaining trust, in order to reach every last child. In an update from GPEI in March 2018, Global Citizen learned that the funding they receive from the United Kingdom is unrestricted, and as one of few countries who don't tie their contributions, this is a huge asset to GPEI. We also learned from DfiD’s tracker, an online UK-aid accountability platform, that the commitment continues to be on track to pay their pledge from 2013, having paid GBP £283 million toward their GBP £300 million investment, standing at 94 percent and on track. This indicates to Global Citizen that so far this commitment has impacted around 274,680,000 lives through immunizations out of a projected 338.4 million lives set to be affected. Minister of State for the Foreign and Commonwealth Office, Hugo Swire, represented the UK at CHOGM 2015, saying, “I am proud of the role the United Kingdom has played, including our pledge of GBP £300 million pounds to support the GPEI. I urge Commonwealth countries to demonstrate their continued resolve in this fight. Together, I believe their leadership and commitment will help the world achieve one of its greatest ever public health success stories." The UK has lived up to their leadership promise by making a bold and additional replenishment pledge to GPEI in 2017, covered later in this report. Sources: https://devtracker.dfid.gov.uk/projects/GB-1-203826 https://devtracker.dfid.gov.uk/projects/GB-1-203826/transactions DFID Annual Report and Accounts for 2013-2014, 2014-2015 and 2015-2016; GPEI Annual Reports for 2013, 2014 and 2015; Vaccineswork.org;
Lives set to be affected: 338.4 million Lives impacted: 274.67 million ___________________________________________
81.17% of target met
How UK commitments are helping to end this devastating disease … For Pakistan’s polio programme, these High-Risk Mobile Populations, or HRMPs are critical. In a country that has seen a 98% reduction in polio cases since 2014, and with just five polio cases reported in Pakistan last year, these most vulnerable children, who often live outside the traditional health system, could be the key to stopping the virus from moving inside Pakistan or across the border to Afghanistan – and ultimately eradicating the disease all together. District Health Officer Dr Taouse Khan says it is the 5562 HRMP children the programme worries about the most: “HRMPs are not an afterthought, they’re our principal focus — on the first day of each campaign we cover these HRMPs. In this settlement there are 18 tents here and 27 children under the age of five, and each and every child of this camp has been identified and recorded.” Faryad Rehman can’t read or write, and lives on a dirt floor. Naina will likely never go to school — no one in the camp has ever been to school — she has never seen a doctor, or received an immunization against any disease. Except for one: in her two months of life she’s already been immunized twice by the visiting two-person polio vaccination teams.
Photo credit: GPEI
This is Faryad Rehman — pictured here with his two month old daughter Naina. The Rehman family are economic nomads. At the time of this photograph their tents were based on the side of the road on the route to Lakki Marwat in southern Khyber Pakhtunkhwa province in Pakistan. Yet they have probably already moved — with each new season they relocate to follow the harvest, work in a brick kiln, labor on a construction site, or attend a relative’s wedding or funeral. They also make bangles and work as beggars, “The women and infant children cloistering at red lights and intersections seeking small change,” according to the Global Polio Eradication Initiative (GPEI) frontline report.
Teams whose work has been partly funded by the £300 million commitment made by the UK government to the Global Polio Eradication Initiative described on the previous page. A commitment that would not have happened without the tireless work of our partners — Rotary International, The Bill & Melinda Gates Foundation and RESULTS UK — our high level advocacy and the actions of Global Citizens. The impact of this commitment will have been felt far beyond Pakistan as UK commitments are untied and can be directed anywhere as the need arises.
Sources: http://polioeradication.org/news-post/protecting-children-on-the-movepakistans-final-frontier/ (published January 22 2018).
Isle of Man commits GPEI Complete — on track One of our most unexpected commitments also came as result of just 73,000 actions. Global Citizens took toward the end of polio in 2012 and the 152,000 action in 2013 — of which 2,000 actions were taken by Isle of Man Global Citizens. As a direct result of Global Citizen’s Isle of Man Global Poverty Ambassador, the Isle of Man committed IMP/GBP £90,000 over three years. This came about as Global Poverty Ambassador Kristina Crawford took The End of Polio message around the island, collecting the 2,000 petition signatures — representing a notable 2.44 percent of the island’s population. She also noticed the opportunity to seek a commitment from the Isle of Man Government, and worked with our UK Policy and Advocacy team, to develop a proposal to the government, in partnership with Isle of Man Rotarian Kevin Kneen. The proposal recommended a contribution of MP/GBP £30,000 per year, to match the percentage of the ODA budget committed to GPEI by mainland Britain. The Isle of Man Government responded positively to Kristina's proposal, and GPEI and Rotary International together confirmed their commitment of MP/GBP £90,000 has since been paid in full through the local Rotary Club. As a result, this commitment has impacted the lives of more than 10,000 children through life saving polio immunizations. This story remains the biggest commitment arising from the leadership of a single Global Citizen.
Photo credit: Global Citizen. Global Poverty Ambassador Kristina Krawford with fellow Global Poverty Ambassadors, receiving an award for their campaigning efforts.
Over this funding period, GPEI implemented a strategic shift toward community health workers distributing vaccines, like Shagufta, a community mobilizer and vaccinator from Taxila in Pakistan. In a video on her work, Shagufta shared: “Most of the people in my area of duty are Pashtun. I am Pashtun and I talk to the community in their own language. My frequent visits and friendly behavior with the community have paid off — when I visit them, I never feel a stranger. They receive me like one of their own! We establish good relations to build trust, we share with them in moments of happiness and grief. The area where I work is now free of polio. Now mothers realize the risk of polio and how to protect their children.”
The Isle of Man is considered to have honorary affiliation with the Commonwealth States through its affiliation with the United Kingdom as a self-governing British Crown dependency.
Lives set to be affected: 10,300 Lives impacted: 10,300
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Sources: https://www.gov.im/news/2013/apr/19/isle-of-man-supports-global-efforts-to-eradicate-polio/; http://polioeradication.org/where-we-work/afghanistan / and Afghanistan's National Emergency Action Plan for Polio 2016-2017.
100% of target met
Canada commits to GPEI (2013) The campaign Global Citizen has actively campaigned for robust, ongoing, Canadian commitments to the Global Polio Eradication Initiative (GPEI) since 2012. Canada, and Canada's Rotarians have shown leadership on polio eradication since the onset, making the founding commitment before GPEI's creation in 1988. More recently, Canada showed ongoing leadership across CHOGM 2015, the G7 and at G20. In October 2012, D'Arcy Lunn, Global Citizen advocate and grassroots campaigner, reported back to us about his 15 minute conversation with Canada's then Minister for International Cooperation, Julian Fantino and his staffers, and Bruce Alyward, the Associate Director-General of the World Health Organization — a Canadian. During this conversation, Minister Fantino acknowledged how Global Citizens’ letters and emails to him had influenced the extent of his support for GPEI. This helped lay the foundations for the success of The End of Polio campaign in early 2013 because of its effectiveness at engaging the grassroots. Hot off the launch of Global Citizen Canada in February 2013, Global Citizen Canada organized a Pakistani diaspora event, hosted by Canadian Senator Salma Ataullalijan, garnering cross sector input from supporters like RESULTS Canada and Rotary International. This event was again attended by Minister Fantino, helping to build up pressure ahead of the Global Vaccines Summit in Abu Dhabi, held in April 2013.
The Global Vaccines Summit saw the re-launch of the revised Global Polio Eradication Endgame Strategy, which Canada and others praised for its innovative stance, using GPEI's lessons on accessing hard-to-reach children as a platform for reaching mothers and children with other critical healthcare support, like mosquito nets, hygiene education and rehydration fluids to treat diarrhea. Global Citizen also connected Canada with Afghanistan's health minister, with campaigner — and young Australian of the year — Akram Azimi facilitating discussions between the ministers and the Red Cross in Farsi. It was at the Global Vaccines Summit in April 2013 that Canada announced its commitment of CAN $250 million for 2013-18, and Global Citizen polio campaigner and advocate Akram Azimi personally thanked Minister Fantino for Canada's contribution. At CHOGM 2015, Minister of Foreign Affairs, Stéphane Dion of Canada affirmed polio continued as an aid priority, announcing, "Canada has changed its government, but our commitment remains. We were proud to commit CAN $250 million in Abu Dhabi at the 2013 Global Vaccines Summit. We are proud to be a donor of global polio eradication efforts and we will continue to do so until polio is gone.”
Read on to see how Canada’s commitment is progressing…
Canada commits to GPEI (2013) In progress — on track By World Polio Day in October 2016, Canada had signed and completed all the agreements that together form the CAN $250 million pledge, making this commitment fully operational. In May 2017 we reported Canada had paid USD $185.19 million, impacting more than 13 million lives. This was a very welcome development, and Canada deserves recognition for its continued leadership, particularly following the 2015 CHOGM and 2016 G7 meetings. Canada is particularly celebrated for their impact in Afghanistan, where polio aid workers work tirelessly to eradicate polio. Canada's supported efforts in Afghanistan at a time when peak immunization performance was reached, helping this polio endemic country establish a national and three provincial Emergency Operations Centers. By supporting community health workers, Canada helped to deploy much needed, low profile, permanent polio teams which helped reach inaccessible areas in the east of the country. 2016 also saw Afghanistan make their National Emergency Plan and Emergency Centers fully functional in high risk districts.
In 2017, Global Citizen launched a new campaign priority to see Prime Minister Justin Trudeau renew Canada's commitment to the GPEI. Prime Minister Trudeau responded in his video to the 2016 Global Citizen Festival, saying, "Canada has long supported effort polio eradication, which is now 99.9 percent eliminated, and we will be strong partners until the end." Canada has since made a new pledge to GPEI in 2017, covered elsewhere in this report. At March 2018, payments from Canada on the Vaccine Summit pledge are on track, with a total of USD $219,140,000 paid toward their original commitment of CAN $250 million. Canada has diligently followed the payment schedule indicated in their agreements, which earmark portions of the overall commitment to immunization efforts in particular countries. In 2017, they have continued their payments on the Nigeria agreements (still some payments to go), and Pakistan (finishing in 2018) as part of the CAN $250 million Vaccine Summit pledge. Global Citizen therefore estimates that to date, 15,641,091 lives have been impacted through GPEI immunization programs as a result of this commitment.
Australia commits to GPEI (2014) In progress — revised commitment on track In our May 2017 report, we found Australia's commitment to Global Polio Eradication Initiative (GPEI) to be at risk given that the peak 2014 commitment amounting to AUD $130 million had been previously reduced and/or reallocated so that just AUD $86million would be contributed to the GPEI as part of Australia’s pledge. Of this AUD $86 million commitment, AUD $6 million remained to be paid, and based on discussions to date we were reasonably confident this would be paid on schedule. In May 2017 it was projected that once paid, Australia’s ongoing contribution beyond mid-2019 toward polio eradication would reduce to zero. Furthermore, despite some encouraging conversations, Australia had shown no explicit inclination to the development sector that it might make an additional contribution toward GPEI’s ongoing funding needs.
In March 2018, GPEI informed us they have received the first of the final two AUD $3 million installments, and the final AUD $3 million is anticipated soon. This means the revised commitment is on track, with AUD $83 million (96.51 percent) of the revised pledge of AUD $86 million now paid, and Global Citizen calculates that of the revised 5.8 million lives set to be affected, 5,617,560 lives have been impacted to date. At CHOGM 2015, at a time of unprecedented aid cuts, we were reassured by Australian Prime Minister Malcolm Turnbull's statement,"We are very committed to this campaign and this issue. It is of vital importance to the people of every country. It's a great tribute to the generosity, the philanthropy, in the truest sense of the world, of the Commonwealth that polio eradication is deemed such a big priority in Malta.” The 2015 Malta CHOGM meeting further enabled Global Citizen to secure a commitment from Prime Minister Malcolm Turnbull to front-load the latest iteration of Australia’s commitment to the GPEI. This was a significant win, given that the planned cuts to Australia's GPEI commitment were enforced.
Photo credit: Global Citizen. The End of Polio Concert, our first music event, held on the eve of CHOGM 2011 in Perth Australia, where our polio campaigning began.
Lives set to be affected: 5.8 million* Lives impacted: 5.61 million ___________________________________________
96.72% of target met *Revised
The 2015 Malta CHOGM meeting further enabled Global Citizen to secure a commitment from the Turnbull Government to front-load the latest iteration of Australia’s commitment to the GPEI. That is, of the AUD $36M that remained to be paid to GPEI as of November 2015, AUD $30 million was disbursed by the end of 2016. This was a significant win, given that the previous planned cuts to Australia's GPEI commitment were enforced. The unrestricted nature of Australia’s commitment meant GPEI could allocate the resources to where they were most needed. Australia is honoring their revised commitment and, we welcome the additional commitment made to GPEI in 2017, and we track progress against this elsewhere in this report.
The leadership of Malta The campaign — announcements and calls to action at CHOGM 2015 At CHOGM 2015 the following announcements were made at a side event jointly hosted by Global Citizen and Rotary International, as well as in the official Communique issued jointly by all Heads of State and Government attending the Summit itself. These announcements demonstrated a common resolve to eradicate polio, by Commonwealth leaders and beyond. The announcements came about in significant part because more than 250,000 actions were taken towards polio eradication by Global Citizens in 2015 aimed at making polio an agenda item. In the lead up to the Global Citizen Festival, 66,268 emails were sent to leaders of Commonwealth countries asking them to eradicate polio for good, and more than 100,000 emails, tweets and phone calls were made asking Prime Minister Joseph Muscat of Malta (Current Chair-in-Office of the Commonwealth), to put polio on the agenda.
The campaign ran at a critical time, with the Global Polio Eradication Initiative (GPEI) needing to raise an additional $1.5 billion to fill a shortfall identified after the reviewed progress against their endgame strategy to eradicate polio by 2019. Malta prioritizes polio at CHOGM Global Citizens took more than 250,000 actions, including more than 66,000 emails to Commonwealth heads of state — asking them to end polio for good, and a further 10,000 emails, tweets and phone calls directly to Malta's Prime Minister Muscat, the Commonwealth's Chair-in-Office, asking him to put polio on the agenda of the CHOGM 2015. Prime Minister Muscat responded to the pressure. We invited him to 2015 Global Citizen Festival, where he met polio survivor and advocate Ramesh Ferris, who handed him a petition with more than 38,000 signatures urging him to make filling the GPEI funding gap a priority at CHOGM. And so, on the 2015 festival stage, Prime Minister Muscat promised he would "seek a renewal in global commitment to end polio once and for all." Later, for World Polio Day, he also published an article in The Guardian, entitled "Achieving a polio free world". Next, he wrote to Commonwealth Governments, inviting them to attend CHOGM ready to recommit to the global effort to eradicate polio. Muscat's leadership at CHOGM 2015 did not disappoint, as he secured statements of support for the end of polio from nine global leaders, including seven heads of government. The CHOGM 2015 Communiqué also reported The Commonwealth Heads of Government "reaffirmed their commitment towards making the complete eradication of polio a global priority".
Further leadership The campaign — announcements and calls to action at CHOGM 2015
UN Secretary-General Ban Ki-moon said, “Polio struck down many of my generation, and now we are on the verge of striking down polio. My thanks to the Commonwealth leaders for their support, and together, let us make the final push and wipe out polio from this earth”.
In 2015, Rotary International was the second largest private sector donor to GPEI, contributing more than $116 million in 2015 alone, often from the personal volunteering and gifts of the organization’s membership, but also through advocacy and fundraising efforts.
It’s clear that Commonwealth Nations remain critical investors in making the eradication of polio a reality, and that the Commonwealth has responded to this call through their replenishment commitments in 2017.
In 2017, at the Rotary International Convention, UNICEF’s Executive Director thanked GPEI for their thirty-year dedication to polio, saying, "Since 1985, Rotary has been the foundation on which the polio eradication programme is built,” with Margaret Chan, former WHO Director-General adding, "Thanks to your vision, humanity is on the verge of one of the greatest public health achievements in history. ... Thanks to you, we truly are "this close" to ending polio".
There are also positive indications that UN Secretary-General Guterres and the UN maintain the view that polio eradication is a priority following the recent change in leadership. Guterres mentioned progress on polio as one of a number of health challenges where key progress has been made at the Universal Health Coverage Forum in Tokyo, Japan, held on December 14, 2017, and before that, on October 24, 2017, the UN Health Agency published an article asserting that "Eradication of polio 'once and for all' is within reach, stating, "Despite progress towards global eradication of polio, sustained commitment is needed to overcome the final hurdle and stamp out the disease once and for all, the United Nations health agency said today, the World Polio Day.” Rotary International President, K.R. Ravindran on polio eradication “Until polio is gone everywhere, it is a threat everywhere,” said Ravi Ravindran, President of Rotary International. “In 1988, we committed Rotary to ending polio. We’re sticking with it, until we have delivered a polio-free world to all future generations.”— Rotary International President, K. R. Ravindran.
Current WHO Director-General Dr. Tedros Adhanom Ghebreyesus at the Rotary Convention in Atlanta on June 13, 2017 said, "It is humbling to see again the power of this incredible global partnership to generate funding to fight one of the world’s most horrible and debilitating diseases”, recognizing the GPEI as spearheaded by five partners, including Rotary International, which has since its formation in 1988 prevented 16 million cases of polio paralysis. Sources: https://www.un.org/sg/en/content/sg/statement/2017-12-14/secretary-generals-remarksuniversal-health-coverage-forum. https://news.un.org/en/story/2017/10/569192-eradication-polio-once-and-all-within-reachun-health-agency http://polioeradication.org/news-post/thank-you-rotary/ http://www.who.int/mediacentre/news/releases/2017/polio-funding/en/
Malta commits to GPEI (2016) In progress — on track At the 2016 Global Citizen Festival, Prime Minister Muscat was the first Commonwealth Leader since CHOGM 2015 to step up and make a new funding commitment to the Global Polio Eradication Initiative. Addressing Global Citizens by video message, saying, "Today I am pleased to announce another small contribution, and that Malta will contribute $10,000 dollars per year for the next three years, through to 2019, to the GPEI. As Chair of the Commonwealth, I urge other Commonwealth countries to follow through on their promise and announce additional funding to finish this job on polio once and for all." — Prime Minister Joseph Muscat, Malta. On September 27, 2017, the World Health Organization received the first installment of EUR €10,000 of the USD $30,000 over three years that Prime Minister Muscat pledged towards polio eradication on behalf of the Maltese Government through a recorded video message at the Global Citizen Live event in September 2016. GPEI is pleased to see that EUR €10,000 was paid in September 2017 as an unrestricted contribution. As USD $20,000 remain to be disbursed, GPEI would encourage a formal agreement to be signed with Malta, as a clear signal that the remaining annual installments for 2018 and 2019 will be honored. Global Citizen estimates that so far, 20,000 lives have been impacted as result of this commitment.
Lives set to be affected: 60,000 Lives impacted: 20,000
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33% of target met Sources: http://polioeradication.org/wp-content/uploads/2017/06/Copy-of-HistoricalContributions_31May2017.pdf
Photo credit: Global Citizen. Prime Minister Muscat announces his commitment by video link at the 2016 Global Citizen Festival.
Muscat’s pledge to use last six months as Commonwealth Chair for polio In September 2017 at Global Citizen Live, Prime Minister Joseph Muscat of Malta pledged to use his remaining six months as Chair of the Commonwealth to tackling preventable diseases like polio and malaria. — specifically by calling for Commonwealth leaders to renew their support for polio eradication at CHOGM 2018. In the lead up to the 2018 Commonwealth Summit, the Prime Minister has delivered on his pledge and sent letters to several Commonwealth heads of states, including Australia, New Zealand and Nigeria, emphasizing the Commonwealth's commitment to polio eradication in 2015 and calling on leaders to join him on stage at Global Citizen Live to be held on the sidelines of CHOGM. Additionally, Prime Minister Muscat has pledged to support the inclusion of strong language in support of polio eradication in the Commonwealth Leaders' Statement.
UK recommits to GPEI (2017) In progress — on track In August 2017, the UK’s former International Development Secretary Priti Patel committed GBP £100 million sterling to the Global Polio Eradication Initiative on behalf of the government of the United Kingdom’s DFID. According to DFID’s announcement this is set to affect 135 million lives, or 45 million lives each year to 2020. The commitment was reaffirmed on September 18, 2017 at Global Citizen Live by Britain’s Alistair Burt MP , Minister of State for the Middle East at the Foreign and Commonwealth Office and Minister of State at the Department for International Development, who said —
This commitment followed 481,000 Global Citizen actions including emails, tweets, phone calls, meetings with UK leaders, as well as the tireless efforts of RESULTS UK and One Last Push Campaign, and Rotary International, who campaigned in partnership alongside Global Citizen.
“The UK Secretary of State for International Development has just announced UK support to lead the last push needed to end polio through the Global Polio Eradication Initiative. This will immunize 45 million children against the disease each year until 2020. In our interconnected world, diseases don’t respect national borders. It is in all our interests to help build a healthier planet. The UK is stepping up – I’m also calling on the rest of the world to follow our lead and help us make polio history.”
The UK's commitment is on track and progressing strongly with a signed Memorandum of Understanding in place scheduling payment based on a review, with as before, the commitment funds being largely unrestricted enabling its flexible application to where it is needed most urgently. We also learned in March 2018 that the first tranche of funds has been received by GPEI, with GBP £34 million paid, indicating that the commitment has already impacted 45.9 million lives through immunization initiatives, out of the projected 45 million per year.
Lives set to be affected: 135 million Lives impacted: 45.9 million ___________________________________________
34% of target met Sources: https://devtracker.dfid.gov.uk/projects/GB-1-203826. https://devtracker.dfid.gov.uk/projects/GB-1-203826/transactions
Photo credit: GPEI.
Canada recommits to GPEI (2017) In progress — on track At the Rotary International Convention in 2017, Canada made a new commitment to GPEI of CAN $100 million. This news followed the advocacy efforts of Global Citizens and our partners, including 74,317 actions taken by Global Citizens to help see the GPEI fully replenished. This pledge to end polio for good was reaffirmed by Prime Minister Justin Trudeau at Global Citizen Festival Hamburg in July 2017. Standing alongside a Pakistani frontline female health-worker, he said, "Canada has committed $100 million toward polio and it will be women who are trained in their communities to make sure that every child is reached.” Updating Global Citizen in March 2018, the GPEI and partners were pleased to see Canada's continued commitment to polio eradication through a CAD $100 million pledge made by Minister Bibeau at the Rotary International Convention in June 2017. As announced by Minister Bibeau, out of the CAN $100 million pledged, CAN $70 million will be unrestricted and CAN $30 million will be earmarked for Afghanistan, one of the remaining three endemic countries. GPEI shared with us that the implementation process of the 2017 pledge was remarkably streamlined, providing increased flexibility and predictability of funding, and in turn helping the program plan the best use of its resources more efficiently.
At the end of March 2018, these two agreements, working with WHO and UNICEF were almost finalized: agreements covering the Afghanistan program were already signed, while for the unrestricted portion, finalization was ongoing. As a result of these agreements, CAN $26 million had been paid by Canada toward this pledge, of which CAN $8 million was directed toward Afghanistan and CAN $18 million for the unrestricted portion. Global Citizen therefore calculates that 1,136,400 lives are impacted by this commitment so far. Canada’s contributions to GPEI over three decades through to 2020 are set to protect 120 million lives from polio through immunization campaigns. Global Citizen and GPEI consider this commitment to be on track.
Lives impacted: 45.9 million ___________________________________________
34% of target met
Sources: http://polioeradication.org/wp-content/uploads/2017/06/Copy-of-Historical-Contributions_31May2017.pdf
How Canada’s latest funds might protect nomadic children in Pakistan… Vaccinating children who are born into high risk mobile populations, like children of brick kiln workers, is a core focus of healthcare workers seeking to eradicate polio With polio 99.9% eradicated, the core aim for health workers is to reach those children who due to their nomadic and low income status, often miss out on essential healthcare. In the district of Lakki Marwat, 742 polio vaccination teams go door to door to protect more than 173,000 children under the age of five against polio. It is teams like these whose work will be funded by Canada’s pledge of $11.4 million made on the Global Citizen stage in 2013. This is vital work that protects children like those pictured below from the paralyzing disease. These children at the time of the photograph were living on the road out of Lakki Marwat, near a brick kiln chimney alongside four other families with five children under five. These children are reached by social mobilizers like Kalim Ullah who visits all the brick kilns and nomadic settlements each month, investigating if there — are any new arrivals and asking if there are any pregnant women or newborn babies. “We go there and we gather their elders and we speak about the importance of the campaign. The settlements have a lot of issues — no water, no electricity. But I tell them that next week you might get water, you might get electricity, but if today your child gets paralyzed from polio, there’s nothing you can do for him next week.” Photo credit: GPEI
Photo credit: GPEI
And it is this tireless effort that is producing results in Pakistan. The total number of officially reported polio cases in Pakistan in 2017 remains at just 8. And so far, there have been no cases reported in 2018. The most recent case (by date of onset) was reported in Zhob district, Balochistan province, on 15 November 2017, just days after Global Polio Eradication Initiative went to the homes of these brick kiln workers. “Pakistan has a real opportunity to end transmission this year, but it must remain focused on reaching children in high-risk areas of the country, increase and enhance surveillance quality, and conduct high-quality campaigns to close immunity gaps.” The Global Polio Eradication Initiative reports. Sources: http://polioeradication.org/news-post/protecting-children-on-the-move-pakistans-final-frontier/ (published January 22 2018).
Australia recommits to GPEI (2017) In progress — on track Ahead of the Rotary International Convention’s ‘Global Drop to Zero’ polio pledging moment, June 2017 saw Australia’s Minister for Foreign Affairs Julie Bishop announce a new commitment of AUD $18 million over two years, from 2019, for the Global Polio Eradication Initiative (GPEI).
This new commitment is in line with history as it was an Australian Rotarian, Sir Clem Renouf, who led the charge in the campaign to end polio more than 30 years ago, making it Rotary’s priority campaign seeing more than $1.6 billion in donations worldwide. It is also fitting that this commitment was made ahead of Rotary International appointing the fourth Alongside the efforts of our partners, this new pledge arrived as the latest in our ever Australian, Ian Riseley from Victoria, as its International President six-year campaigning effort. The immediate six-month build up to this moment saw (2017-18). This acknowledges the important role Australian Rotarians have Global Citizen Australia lead behind the scenes advocacy meetings, secure major made in seeing an end to polio and the great story Australia has to tell media coverage, and more than 11,000 Global Citizen actions taken. about our role as a good global citizen. Critical to the success of this campaign was also Global Citizen and RESULTS The commitment was reaffirmed in July 2017 at Global Citizen Festival Australia’s outreach to every Member of Parliament (MP) twice, asking for support Hamburg, where world leaders stood on stage alongside Global Citizen as One Last Push polio champions, to securing motions and questions in youth advocate Sufi Mujghan. Australian Foreign Minister, the Hon. Julie Parliament, meeting with key officials in Canberra, having Australia push for polio Bishop said, “The Australian government is providing a further 18 to be included in the G20 Health Ministers communique, getting dozens of million dollars over two years to the Global Polio Eradication mentions of polio into the Australian media, and running three high-level events Initiative. This new commitment takes Australia’s total funding to with MPs. polio eradication since 2011 to 104 million dollars.” Since June 2017, a formal agreement between the Government of Australia and GPEI is now in place. Global Citizen calculates that the commitment is set to affect 769,335 lives.
Polio eradication Impact and accountability — methodology Impact methodology Global Citizen has adopted "lives set to be affected" as our main indicator of impact for commitments made through our platforms. We made this decision to focus on the outcomes in people's lives arising from the financial or policy commitments, rather than the inputs. We consider a Global Citizen commitment to have been made when the commitment is new, and announced on our stage, and to have been driven in a significant way by the actions of Global Citizens, as well as our own, and partner efforts to conduct high level advocacy. Since Global Citizen is an advocacy and campaigning organization, we rely on our partners, a combination of commitment makers, NGOs and multilateral organizations to provide data to calculate lives set to be affected, and later, lives impacted. In the case of our polio commitments, we work closely with the Global Polio Eradication Initiative. Our due diligence processes are all conducted in-house by our Impact team. Within the context of polio eradication, it is important to note that for each commitment, Global Citizen counts the number of children to benefit from immunizations as lives set to be affected. Thus, the number of people to be immunized against polio is not the same as the number of projected lives saved as a result of vaccination. This is because the number is more concrete, and because it has greater parity across all our issue areas. For example, we count the number of children who benefit from an education, not the number who achieve certain qualifications as a result of their education. For a detailed explanation of what counts as a life set to be affected, please visit https://www.globalcitizen.org/en/content/how-we-know-the-global-citizenfestival-is-set-to/
Polio eradication Impact and accountability — methodology continued… Accountability methodology Accountability is the term we use for ensuring intended impact transforms into actual lives impacted as promised. It is our core evidence based tool to celebrate successes, hold commitment makers to account through follow-on campaigning, and to learn lessons to drive new campaigning efforts. Global Citizen's accountability methodology is an ongoing iteration of our impact methodology. At the heart of the process is continuing open dialogue with the partners that originally made the commitment, alongside our original campaigning partners where appropriate, and the multilateral organizations and NGOs receiving those delivering on or receiving those commitments. For polio specifically, when we state the number of lives impacted, we mean the number children immunized to date (compared with the number of children set to be immunized) by a given commitment, calculated as an aggregate of the 400 million children GPEI aim to immunize each year. Thus it is worth noting that the immunization of these children is the target to reach herd immunity 650,000 cases of polio are prevented annually, compared with not conducting GPEI immunization programs. In discussion with GPEI, we have not multiplied the annual target to reflect the strategic period, in an effort to avoid double counting those children who may be immunized more than once through GPEI's immunization programs over the period. Increasingly, we hope to see Global Citizens in developing countries themselves contributing to our monitoring processes, starting in India with our partner TGELF. For each commitment Global Citizen reaches out to all appropriate sources for information and expert insight on the progress achieved to date, including from an independent source when possible. We also conduct significant independent desk research of our own. We also strive to collate evidence of on the ground impact to help visualize the nature of the impact in practice, as well as conduct desk research for additional supporting information. All commitments’ progress are graded using a standardized “traffic light system” designed by Global Citizen, working with our partners at PWC. However, since most commitments are not bi-lateral, most examples provided are windows into how similar funds have been utilized, rather than necessarily the specific funds of the donor, which will have been allocated centrally by the multilateral coordinating on the ground efforts.
Polio eradication Traffic lights— methodology continued… Accountability — color code explainer Exceeded — Completed and exceeded targets according to published materials.
Complete — Completed and targets met according to published materials.
On track — • Meeting interim milestones that have been publicly published and/or independently verified by an implementing partner, OR • On-track to meet or exceed total commitment targets based on linear projection of progress to completion date based on publicly published information, OR • On-track to meet or exceed total commitment targets based work-plan shared by commitment maker and verified by a third party.
Too soon to tell — • Commitment was made less than 6 months ago, OR • Update not yet due, based on agreed timeline for information to be shared publicly, OR • Update information has been provided, but implementation is still too preliminary to offer a meaningful assessment of progress.
Some risk — • On track to reach at leas 80% of overall target by agreed deadline according to any of the following; Published materials outlining current status and pathway to completion Interim milestones that have been published and/or independently verified by an implementing parter Linear projection of progress to date to completion date based on published information Work-plan and update shared by commitment maker and verified by a third-party. • Any on-track commitment that has recently had a shift in leadership, publicly stated priorities, delivery plans, partners or mechanisms. May also be marked as some risk if we have been unable to secure clarification that progress will stay on track. Off track — • Does not meet on-track or some risk criteria; OR • Failed to respond to requests for information. Targets not met — The commitment is no-longer on-going, and has failed to meet commitment targets.
The State of Global Citizen ‘The End of Polio’ Commonwealth Commitments April 2018 – Version 1.0 A Global Citizen Accountability Report For further information about Global Citizen's impact work and additional data and reports, go to www.globalcitizen.org/impact
