MEASLES and POLIO - AFRICA HEALTH INITIATIVE Appeal No

MEASLES AND POLIO - AFRICA HEALTH INITIATIVE Appeal no. MAA60001 This appeal seeks a total of CHF 3,011,0001 to fund programmes and activities to be implemented in 2006 and 2007. These programmes are aligned with the International Federation's Global Agenda, which sets out four broad goals to meet the Federation's mission to "improve the lives of vulnerable people by mobilizing the power of humanity".

Global Agenda Goals: · Reduce the numbers of deaths, injuries and impact from disasters. · Reduce the number of deaths, illnesses and impact from diseases and public health emergencies. · Increase local community, civil society and Red Cross Red Crescent capacity to address the most urgent situations of vulnerability. · Reduce intolerance, discrimination and social exclusion and promote respect for diversity and human dignity. This initiative forms part of a comprehensive Federation health and care strategy (click here to link directly to this appeal), and specifically aims to support an increased participation of national societies in community mobilization for immunization services, and a gradual transition from accelerated disease control initiatives in selected countries (measles mortality reduction and polio eradication) towards supporting sustainable routine immunization programmes. Funding from this appeal will also serve to strengthen national society and Federation participation in the “last mile” effort of polio eradication and to achieve even greater progress in measles reduction as part of the Measles Initiative Partnerships.

For further information please contact: · Dr. Bruce Eshaya-Chauvin, Head, Health and Care Department; phone: +41 22 730 4862; email: [email protected] · Jean Roy, Public Health Advisor; email: [email protected]; phone: +41 22 730 4419. · Elizabeth Mbizvo, Senior Health Officer; email: [email protected]; phone + 41 22 730 4487

The International Federation's mission is to improve the lives of vulnerable people. The Federation is the world's largest humanitarian organization, and its millions of volunteers are active in over 181 countries. All international assistance to support vulnerable communities seeks to adhere to the Code of Conduct and the Humanitarian Charter and Minimum Standards in Disaster Response, according to the SPHERE Project.

Click here to access the appeal budget summary.

2006-2007 (in CHF) Africa Health Initiative: 2006 1,506,000 Measles and Polio 2007 1,505,000 Total 3,011,000

1 USD 2.3 million or EUR 1.9 million

Measles and Polio - Africa Health Initiative 2006-2007 Appeal no. MAA60001 2

Context

Polio Eradication Globally, the number of polio endemic countries decreased dramatically between 1988-2003, from 125 countries to 6 (Nigeria, Niger, Egypt, India, Pakistan, Afghanistan) – a more than 99% reduction. However a major set back occurred in Africa when supplementary immunization activities (SIA’s) were suspended for some time in 2003- 2004 in the northern states of Nigeria. As a result, Nigeria experienced increased cases of wild poliovirus (WPV) transmission which then spread to other countries. Hence, 18 countries previously polio-free reported “importations”. Three of these countries were outside Africa (Indonesia, Yemen and Saudi Arabia). As of September 2005, 1,163 WPV cases were reported in 14 countries, with the highest rates in Yemen (440), Nigeria (389), Indonesia (231), while other countries reported fewer cases. These included India (27), Sudan (26), Pakistan (15), Ethiopia (15), Angola (7), Mali (3), Niger (3), Chad (1), Cameroon (1), and Eritrea (1).

In 2006 the highest and most urgent priority for the Global Polio Eradication Initiative and for the Federation is the rapid interruption of the WPV transmission in the six remaining endemic countries and in the newly infected countries. At ministerial meetings convened by WHO on polio eradication in Geneva in January and February 2005, Ministers of Health from the most polio-affected countries in Africa and Asia signed the Geneva Declaration for Polio Eradication, agreeing to an unprecedented intensification of supplementary immunization activities to reach every child under five years of age with multiple doses of OPV, to stop polio transmission, and to ensure that polio transmission is interrupted. The declaration includes a strategic plan of action until 2008, with indicators and milestones for interrupting transmission and for eventual achievement of global certification of polio eradication.

Success in interrupting the transmission of the WPV depends on: · The number of SIA’s conducted in each country reaching children with multiple doses of oral polio vaccine. · The quality of SIA’s conducted (i.e. the percentage of target population reached).

In September 2005, in recognition of the serious threat of re-establishment of polio in East Africa, confirmed by new cases in East African countries, the Global Polio Initiative announced a large scale plan for coordinated polio campaigns in East Africa to reach 34 million children. The campaigns covered the following countries Djibouti, Eritrea, Ethiopia, Somalia, Sudan, Yemen, and parts of Kenya and the Democratic Republic of the Congo. This is in addition to the West and Central African countries where synchronized polio campaigns have been conducted since 2004.

The Red Cross and Red Crescent national societies, as the organizations with the largest presence in the community, have a critical role in community mobilizations and raising awareness to polio.

Accomplishments in polio eradication: Mass synchronized polio immunization campaigns in 2005, aimed to reach 100 million children in 22 countries. The focus was on countries in West and Central Africa and other neighbouring countries at risk. Funding from the annual appeal supported 13 selected African national societies plus Yemen to participate in polio National Immunization Days (NIDs). The first of the 5 phases started in February, with more rounds in April, May, November and December.

National societies continued to demonstrate their comparative advantage in community mobilization by reaching the most vulnerable in the hardest to reach areas. The participation of Red Cross Red Crescent volunteers greatly enhanced the quality of the campaigns. · Angola Red Cross provided valuable assistance in the July-August NIDs aiming to control the spread of new cases imported from India. The national society was especially recognized by its partners WHO, UNICEF, Rotary, USAID, CDC, and CORE. · Red Cross Society of Côte d'Ivoire volunteers worked in both the spring and the summer (August) NIDs. For more info go to: Final onslaught against polio 11 March 2005, http://www.ifrc.org/docs/news/05/05031101/ · Red Cross of the Democratic Republic of the Congo received funds to participate in the October 2005 NIDs. · Ethiopian Red Cross Society engaged volunteers to target 14.7 million children less than 5 years with 1,063 volunteers with door to door community social mobilizing and administration of polio vaccine. · Red Cross Society of Guinea helped the Ministry of Health achieve very high coverage during both the 2ndand 3rd rounds of their NIDs. · Nigerian Red Cross Society continues to play a critical role in a country that has harboured the polio virus. Measles and Polio - Africa Health Initiative 2006-2007 Appeal no. MAA60001 3

More than 1,000 volunteers have been trained to work with local leaders and to conduct community mobilization targeting 2,078,266 children in difficult areas. · Yemen Red Crescent Society volunteers assisted in epidemic control with the introduction of polio virus in 2005 for the first time in 10 years. For more info go to: http://www.ifrc.org/cgi/pdf_appeals.pl?annual05/05AA08002.pdf · Red Cross Society of Niger is participating in a unique nationwide campaign in December 2005 to integrate polio NIDs with the distribution of free long-lasting insecticidal nets for households with children under five years of age. More than 1,800 volunteers will assist in the distribution of 2 million LLINs during a one week period. This effort is spearheaded by the Federation with funding from GFATM and the Canadian Red Cross. · Mali Red Cross received funds to participate in the December NIDs. · Burkinabe Red Cross Society will be participating in the December 2005 NIDs with 360 volunteers for community social mobilization. · Red Cross of Chad received funds to participate in the September NIDs.

Proposed operations for polio eradication: To contribute to the last phase of eradicating polio, this appeal will support national society participation in community mobilization for supplemental immunization activities, to contribute to the achievement of the highest possible coverage and to reach the most vulnerable and hard-to-reach children. Funding from this appeal will be used to support the mobilization of volunteer networks including training, materials, coaching, incentives and transport. Similar to previous operations, the International Federation will provide support to those few countries where wild poliovirus still exists or where resurgence occurs.

Expected results: · Children in hard-to-reach areas are vaccinated. · Interruption of wild poliovirus transmission by the end of 2008. · National societies are actively participating in the Inter-agency Coordination Committees. · Enhanced national society capacity in volunteer management and as a partner for other health initiatives.

Polio eradication activities: Financial and technical support to be provided to 15 national societies to enable: · Mobilization of volunteer networks, including coaching, training, incentives and transport and other logistic support. · Community social mobilization and education to increase the knowledge of poliomyelitis, its consequences and the benefits of immunizations. · Institutional capacity building of the national societies participating in the campaigns. · Participation of national societies in micro-planning for the campaigns with partners that include the Ministry of Health, Rotary, UNICEF, WHO, and others. · Volunteer participation in surveillance to report suspected cases to relevant authorities. · Media coverage, reporting, monitoring and evaluation of the activities.

Measles Mortality Reduction Measles remains an important leading cause of death among young children, despite the availability of a safe and effective vaccine for the past 40 years. Estimated measles deaths on the African continent approximated 250,000 in 2004. Most these measles deaths occur in disadvantaged populations where regular health services are not available for various reasons, such as cultural and geographical barriers. Morbidity from measles is higher and the complications are worse among the most vulnerable groups whose children are malnourished and those with other underlying conditions such as HIV infection and vitamin A deficiency. The high coverage requirement for measles elimination, and the need to achieve high routine immunization coverage for every birth cohort, are challenging. Addressing that challenge, and providing regular immunization services for the disadvantaged populations can provide the foundation for other life-saving public health interventions. Measles elimination will be of greatest benefit to disadvantaged and vulnerable populations who have the greatest disease burden. Measles elimination is not only a health issue but also an issue of justice and fairness.

Unprecedented reduction in measles mortality The good news is that, globally, consolidated efforts by the Measles Initiative Partnership and governments have resulted in a 39% reduction in measles deaths, from 873,000 in 1999 to an estimated 530,000 in 2003. The largest Measles and Polio - Africa Health Initiative 2006-2007 Appeal no. MAA60001 4 reduction occurred in Africa, the region with the highest burden of the disease, where measles deaths decreased by 46%. With more than 200 million vaccinations in more than 40 countries since 2000, high coverage is achieving population immunity with reduced measles transmission. Elimination of measles in Africa and Asia is possible. Elimination does not mean zero cases, but it does imply: · that the measles virus is no longer circulating and that following occurrences of “importation” any further spread is very limited. · Once elimination is achieved, it must be maintained by keeping practically every person immune to measles.

The measles elimination strategy includes ensuring that 95% of children get two doses of measles vaccine, that surveillance detects all suspected cases of measles, and that laboratory support is available to confirm diagnosis. Achieving measles elimination requires sustained political and financial commitment, technical capacity and high quality SIAs.

Achievements in measles reduction: During 2005, Red Cross volunteers from 7 National Societies, Bangladesh, Botswana, Cote d’Ivoire, Equatorial Guinea, Mozambique, Tanzania, and Tunisia, participated in SIAs, focusing their efforts on community mobilization. Their participation was well appreciated by their governments and the communities in which they served and helped achieve high immunization coverage in the target areas. · Botswana Red Cross volunteers supported the October 2005 measles campaign and take part in a Measles Initiative Partnership event for the first time. · Bangladesh Red Crescent prepared a proposal to participate in the September 2005 measles campaign making community volunteers available to assist with social mobilisation and at vaccination clinics. · Central African Republic Red Cross national society has funds to support the Ministry of Health’s nationwide measles campaign in October 2005. Red Cross volunteers will target 545,000 of the approximately 1.8 million children slated to be vaccinated. · Côte d’Ivoire Red Cross also participated in measles immunization campaigns conducted in July and August respectively on the request from the Ministry of Health and managed to increase the coverage in the difficult to reach areas. · Equatorial Guinea Red Cross has worked closely with measles/malaria partners for many months in planning the nationwide integrated measles and LLIN campaign in late September 2005. In addition to supporting social mobilization activities with measles/polio appeal funds, the malaria programme initiative funds assisted the Ministry of Health with the purchase of 20,000 LLINs through UNICEF. · Mozambique Red Cross worked with partners in planning measles and polio immunization campaigns. Over a period of 3 months, a nation-wide social mobilisation campaign involving the media was carried out to inform all parents, other caregivers, teachers and social workers, the private sector, community, political, and religious leaders about the need to have their children vaccinated against measles and polio, and provide them with Vitamin A. The immunization campaigns took place in 3 phases covering the Northern Region, Central Region and Southern regions. The Sofala and Manica Regions integrated 405,000 long lasting insecticidal nets (LLIN). A total of 2,876 volunteers were mobilized and trained to work on the campaigns. · Tunisia Red Crescent worked with the Ministry of Health, UNICEF and other partners to implement a combined measles-rubella vaccination campaign that included teenagers 13-18 year. 75,000 out of school teenagers were identified for vaccination. · Tanzanian Red Cross worked with American Red Cross, Ministry of Health and other partners on an integrated measles, mebendazole, Vitamin A and ITN campaign. Red Cross volunteers distributed ITNs in two districts. ITN coverage was over 100% and measles coverage was 99% on the mainland and 84% in Zanzibar.

Objectives (measles): · To work towards the achievement of the Millennium Development Goal of reducing child mortality. · To assist in the reduction of measles deaths among vulnerable children. · To work towards the interruption of indigenous measles transmission in targeted countries.

Expected results (measles): · Increased community awareness of the importance immunization. · National Societies increasingly participating in country ICC. · Community involvement and communities helping themselves. · Improved volunteer management and other NS capacity trickling-down to other programs. Measles and Polio - Africa Health Initiative 2006-2007 Appeal no. MAA60001 5

· Selected districts with RC capacity, emphasizing quality over quantity.

Activities: · Measles community control efforts coordinated and integrated with national immunization efforts to “reach the un-reached”. · Participation of selected national societies in measles campaigns. · Follow-up activities to maintain a high level of immunization coverage and use of ITN where this is the case. · Strengthening of partnerships for planning activities and implementation at national, regional and global levels · National society participation in ICC, and henceforth preparation of planned activities that are in line with the national programme. · Institutional capacity building of the national societies participating in the campaigns. · Participation of national societies in micro-planning for the campaigns with partners including the Ministry of Health, Rotary, UNICEF, WHO and others. · Volunteer participation in surveillance to report suspect cases to relevant authorities. · Logistic support plus media coverage, reporting, monitoring and evaluation of activities.

Please refer to the appeal budget below; click here to return to the title page and contact details BUDGET 2006 PROGRAMME BUDGETS SUMMARY Appeal no.: MAA60001 Name: Africa Health Initiative Measles & Polio

Health & Care Disaster Humanitarian Organisational Coordination & Emergency PROGRAMME: Management Values Development Implementation Total CHF CHF CHF CHF CHF CHF CHF

Shelter 0 0 0 0 0 0 0

Construction 0 0 0 0 0 0 0

Clothing & Textiles 0 0 0 0 0 0 0

Food 0 0 0 0 0 0 0

Seeds & Plants 0 0 0 0 0 0 0

Water & Sanitation 0 0 0 0 0 0 0

Medical & First Aid 0 0 0 0 0 0 0

Teaching Materials 0 0 0 0 0 0 0

Utensils & tools 0 0 0 0 0 0 0

Other Supplies & Services 0 0 0 0 0 0 0 SUPPLIES 0 0 0 0 0 0 0

Land & Buildings 0 0 0 0 0 0 0

Vehicles 0 0 0 0 0 0 0

Computers & Telecom 0 0 0 0 0 0 0

Medical equipment 0 0 0 0 0 0 0

Other Equipment 0 0 0 0 0 0 0 LAND, VEHICLES & EQUIPMEN 0 0 0 0 0 0 0

Storage 0 0 0 0 0 0 0

Distribution & Monitoring 0 0 0 0 0 0 0

Transport & Vehicles cost 250,000 0 0 0 0 0 250,000 TRANSPORT & STORAGE 250,000 0 0 0 0 0 250,000

International Staff 506,003 0 0 0 0 0 506,003

Regionally Deployed Staff 150,000 0 0 0 0 0 150,000

National staff 0 0 0 0 0 0 0

National Society Staff 0 0 0 0 0 0 0

Consultants 75,000 0 0 0 0 0 75,000 PERSONNEL 731,003 0 0 0 0 0 731,003

Workshops & Training 150,000 0 0 0 0 0 150,000 WORKSHOPS & TRAINING 150,000 0 0 0 0 0 150,000

Travel & related expenses 100,000 0 0 0 0 0 100,000

Information & Public Rela 50,000 0 0 0 0 0 50,000

Office Running Costs 50,000 0 0 0 0 0 50,000

Communication Costs 50,000 0 0 0 0 0 50,000

Professional Fees 0 0 0 0 0 0 0

Other General Expenses 27,000 0 0 0 0 0 27,000 GENERAL EXPENDITURE 277,000 0 0 0 0 0 277,000

Asset Depreciation 0 0 0 0 0 0 0 DEPRECIATION 0 0 0 0 0 0 0

Contributions & Transfers 0 0 0 0 0 0 0 CONTRIBUTIONS & TRANSFERS 0 0 0 0 0 0 0

Programme Support 97,882 0 0 0 0 0 97,882 PROGRAMME SUPPORT 97,882 0 0 0 0 0 97,882 TOTAL BUDGET: 1,505,885 0 0 0 0 0 1,505,885

REPORTS\BUDGET15.FRX BUDGET 2007 PROGRAMME BUDGETS SUMMARY Appeal no.: MAA60001 Name: Africa Health Initiative Measles & Polio