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Reflections on Modeling Poliovirus Transmission and the Polio Eradication Endgame

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  • Kimberly M. Thompson
  • Dominika A. Kalkowska

Abstract

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.

Suggested Citation

  • Kimberly M. Thompson & Dominika A. Kalkowska, 2021. "Reflections on Modeling Poliovirus Transmission and the Polio Eradication Endgame," Risk Analysis, John Wiley & Sons, vol. 41(2), pages 229-247, February.
    • Handle: RePEc:wly:riskan:v:41:y:2021:i:2:p:229-247
    DOI: 10.1111/risa.13484
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    References listed on IDEAS

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    1. Radboud J. Duintjer Tebbens & Kimberly M. Thompson, 2019. "Evaluation of Proactive and Reactive Strategies for Polio Eradication Activities in Pakistan and Afghanistan," Risk Analysis, John Wiley & Sons, vol. 39(2), pages 389-401, February.
    2. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Dominika A. Kalkowska & Steven G. F. Wassilak & Stephen L. Cochi & Kimberly M. Thompson, 2013. "Characterizing Poliovirus Transmission and Evolution: Insights from Modeling Experiences with Wild and Vaccine‐Related Polioviruses," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 703-749, April.
    3. Kimberly M. Thompson & Radboud J. Duintjer Tebbens & Mark A. Pallansch & Steven G.F. Wassilak & Stephen L. Cochi, 2015. "Polio Eradicators Use Integrated Analytical Models to Make Better Decisions," Interfaces, INFORMS, vol. 45(1), pages 5-25, February.
    4. Thompson, K.M. & Duintjer Tebbens, R.J. & Pallansch, M.A. & Kew, O.M. & Sutter, R.W. & Aylward, R.B. & Watkins, M. & Gary Jr., H.E. & Alexander, J. & Jafari, H. & Cochi, S.L., 2008. "The risks, costs, and benefits of possible future global policies for managing polioviruses," American Journal of Public Health, American Public Health Association, vol. 98(7), pages 1322-1330.
    5. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Jong‐Hoon Kim & Cara C. Burns & Olen M. Kew & M. Steven Oberste & Ousmane M. Diop & Steven G.F. Wassilak & Stephen L. Cochi & Kimberly M. Thompson, 2013. "Oral Poliovirus Vaccine Evolution and Insights Relevant to Modeling the Risks of Circulating Vaccine‐Derived Polioviruses (cVDPVs)," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 680-702, April.
    6. Kimberly M. Thompson & Maria Segui‐Gomez & John D. Graham, 2002. "Validating Benefit and Cost Estimates: The Case of Airbag Regulation," Risk Analysis, John Wiley & Sons, vol. 22(4), pages 803-811, August.
    7. Kimberly M. Thompson & Mark A. Pallansch & Radboud J. Duintjer Tebbens & Steve G. Wassilak & Stephen L. Cochi, 2013. "Modeling Population Immunity to Support Efforts to End the Transmission of Live Polioviruses," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 647-663, April.
    8. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Olen M. Kew & Roland W. Sutter & R. Bruce Aylward & Margaret Watkins & Howard Gary & James Alexander & Hamid Jafari & Stephen L. Cochi & Kimberly M. T, 2008. "Uncertainty and Sensitivity Analyses of a Decision Analytic Model for Posteradication Polio Risk Management," Risk Analysis, John Wiley & Sons, vol. 28(4), pages 855-876, August.
    9. Dominika A. Kalkowska & Radboud J. Duintjer Tebbens & Kimberly M. Thompson, 2019. "Environmental Surveillance System Characteristics and Impacts on Confidence About No Undetected Serotype 1 Wild Poliovirus Circulation," Risk Analysis, John Wiley & Sons, vol. 39(2), pages 414-425, February.
    10. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Olen M. Kew & Victor M. Cáceres & Hamid Jafari & Stephen L. Cochi & Roland W. Sutter & R. Bruce Aylward & Kimberly M. Thompson, 2006. "Risks of Paralytic Disease Due to Wild or Vaccine‐Derived Poliovirus After Eradication," Risk Analysis, John Wiley & Sons, vol. 26(6), pages 1471-1505, December.
    11. Kimberly M. Thompson, 2013. "Modeling Poliovirus Risks and the Legacy of Polio Eradication," Risk Analysis, John Wiley & Sons, vol. 33(4), pages 505-515, April.
    12. Esther De Gourville & Radboud J. Duintjer Tebbens & Nalinee Sangrujee & Mark A. Pallansch & Kimberly M. Thompson, 2006. "Global Surveillance and the Value of Information: The Case of the Global Polio Laboratory Network," Risk Analysis, John Wiley & Sons, vol. 26(6), pages 1557-1569, December.
    13. Robert W. Hahn & Paul C. Tetlock, 2008. "Has Economic Analysis Improved Regulatory Decisions?," Journal of Economic Perspectives, American Economic Association, vol. 22(1), pages 67-84, Winter.
    14. Dominika A. Kalkowska & Radboud J. Duintjer Tebbens & Mark A. Pallansch & Kimberly M. Thompson, 2019. "Modeling Undetected Live Poliovirus Circulation After Apparent Interruption of Transmission: Pakistan and Afghanistan," Risk Analysis, John Wiley & Sons, vol. 39(2), pages 402-413, February.
    15. Radboud J. Duintjer Tebbens & Kimberly M. Thompson, 2009. "Priority Shifting and the Dynamics of Managing Eradicable Infectious Diseases," Management Science, INFORMS, vol. 55(4), pages 650-663, April.
    16. Kimberly M. Thompson & Radboud J. Duintjer Tebbens & Mark A. Pallansch, 2006. "Evaluation of Response Scenarios to Potential Polio Outbreaks Using Mathematical Models," Risk Analysis, John Wiley & Sons, vol. 26(6), pages 1541-1556, December.
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    1. Kamran Badizadegan & Dominika A. Kalkowska & Kimberly M. Thompson, 2023. "Health Economic Analysis of Antiviral Drugs in the Global Polio Eradication Endgame," Medical Decision Making, , vol. 43(7-8), pages 850-862, October.

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