The Certification of the WHO European Region as Poliomyelitis Free: June 2002

"Certification" is the independent verification of wild poliovirus eradication. In June 2002 the European Regional Commission for the Certification of Poliomyelitis Eradication, meeting in Copenhagen, issued a certificate (see below) stating that the transmission of wild poliovirus had been interrupted in all the 51 member states, and that the European Region is formally declared poliomyelitis free.

In addition, the Committee:

1. Acknowledged the global efforts made to eradicate polio since the adoption of the World health assembly of resolution WHA41.28 in May 1988
2. Stated that the goal of elimination of polio from all countries of the region has been achieved
3. Congratulated all member states, all partner organisations concerned, the WHO Secretariat and all the other organisations and individuals that contributed to this historical achievement
4. Recognised that thorough virological surveillance is the key to ensuring that wild poliovirus is not lying undetected in pockets from which it could re-emerge
5. Requested Member States to continue their efforts to maintain polio-free status until global certification, particularly with regard to sustaining a high level of routine immunisation coverage, implementing supplementary immunisation activities where necessary, maintaining AFP surveillance, and making progress in the laboratory containment of wild polioviruses.
6. Requested the Regional Director to support Member States in continuing to implement the above-mentioned activities at country level, in order to sustain polio-free status within the European Region
7. Encouraged the partners of the Polio Eradication Initiative to continue to give strong support to and co-operate with the Regional Office for Europe in keeping the European Region 'polio-free' and to help mobilise the necessary resources for global activities until the global certification of poliomyelitis eradication.

Personal Certificates of Appreciation and brass pins will be issued to those people who have been directly involved in the core process of the polio eradication effort in Member states (immunisation, surveillance, certification and/or containment activities). In addition, a number of enamel pins will be provided for distribution to all other persons associated with the polio eradication programme in the past, as well as at the present time.

The next step: Certification of global polio eradication

The Global Polio Eradication Initiative aims to certify the entire world polio-free by the end of 2005. Certification of global polio eradication will be possible only when all regions have been certified polio-free and all pre- and post-eradication wild poliovirus containment tasks have been completed. Global certification will be an important milestone in the development of post-eradication immunization policy for polio.

The process

The Global Certification Commission (GCC), established by the Director-General of WHO in1995, is responsible for setting the process and criteria for certification and ultimately deciding whether to certify global polio eradication. This requires at least three years of zero polio cases due to wild poliovirus in the presence of certification-standard surveillance in all six regions. The GCC also requires all six regions to provide data demonstrating full implementation of the pre- and post-eradication containment activities outlined in the WHO global action plan for the containment of wild polioviruses prior to global certification.

In contrast to individual countries being certified free of smallpox, an entire WHO region must be certified polio-free. For this to happen, every country and area in a region must provide evidence consistent with there being no indigenous wild poliovirus cases for at least three years, under conditions of certification-standard surveillance for the virus. Surveillance for acute flaccid paralysis (AFP) is the gold standard for certification, though other surveillance strategies have been accepted for some countries that have long been polio-free and have high levels of sanitation and strong health systems. The capacity of a country to detect and investigate sufficient AFP cases in the absence of polio demonstrates that the poliovirus would be found if it were present.

This certification documentation is collected and verified by national certification committees (NCCs) and provided to a regional certification commission (RCC), which then decides on the basis of the data whether the region can be certified.
The RCCs are independent panels of 8 - 10 internationally recognized experts in public health, epidemiology, virology and/or clinical medicine. The finalisation of documentation is a multi-year, iterative process involving dialogue between the NCCs and the RCC. The documentation must also illustrate the capacity to detect, report and respond to "imported" polio cases.

Once a region is certified polio-free, and before global certification can be considered, all countries within the region must maintain certification-standard surveillance and implement post-eradication containment measures.

The post-eradication phase

The post-eradication phase begins one year after detection of the last wild poliovirus anywhere in the world. It requires all laboratories possessing wild poliovirus infectious or potentially infectious materials to implement recommended containment procedures (currently enhanced biosafety level-3 or BSL 3/polio) OR transfer such materials to WHO-designated repositories OR render such materials non-infectious, or destroy them, under appropriate conditions.

Last reviewed: 14 October 2008