The Global Polio Eradication Initiative (GPEI) launched the Polio Eradication Strategy 2022–2026 a revision of its earlier strategy to address emerging challenges. The strategy sets two goals: (1) In endemic countries, interrupt wild poliovirus transmission in endemic countries and (2) In non-endemic countries, stop circulating vaccine-derived poliovirus (cVDPV) transmission and prevent outbreaks. As with the pervious strategy, under these two goals, integration remains a priority in service delivery with immunization programs and other public health programs to increase immunity against polio and other vaccine preventable diseases (VPDs), to respond to outbreaks, and to accelerate transition of polio-essential functions for the benefit of the national health systems.

In the Eastern Mediterranean Region (EMR), levels of integration exist across polio endemic and non-endemic countries. In Afghanistan and Pakistan, integration supports achieving and maintaining polio eradication and stopping and preventing the ongoing circulating vaccine-derived poliovirus (cVDPV) outbreaks. In other countries, polio is working with immunization programs: some with support from GPEI, some without. To serve the specific needs of the EMR, integration can be strengthened specifically in two areas: (1) outbreak preparedness and response planning to mitigate the impact of vaccine derived polio outbreaks and (2) transition of polio experience to other priority public health programs.

To initiate the development of action plans that facilitate implementation of the integration in the region, GHD|EMPHNET in collaboration with GPEI partners held a workshop that brought together several EMR countries. Expanded Program on Immunization (EPI) managers, polio/VPDs surveillance officers, and Primary Healthcare directors from Afghanistan, Egypt, Iraq, Jordan, Somalia, Sudan, and Yemen participated in the workshop.  In attendance from the GPEI were the World Health Organization (WHO) HQ and Regional Office for the Eastern Mediterranean (EMRO), United Nations Children’s Fund (UNICEF), and the Centers for Disease Control and Prevention (CDC). The workshop was held in Amman, Jordan, between June 27 and 29, 2021.

Each country presented its experience with integration, focusing on successes, challenges, and lessons learned:

1. Challenges and successes in reaching hard-to-reach areas in Afghanistan
2. Transference of polio program assets to support measles/rubella elimination and strengthening routine immunization in Egypt
3. Community-based initiatives to enhance demand to vaccination in Iraq
4. Support of Field epidemiology to enhancing EPI functions in Jordan
5. Surveillance systems in emergencies in Somalia
6. Community-based Surveillance in Sudan
7. Integrated health campaigns and outreach services in Yemen

In group discussions, countries spoke in further detail on where integration is needed: vaccination campaigns, routine immunization, community-based initiatives, reaching hard to reach and mobile populations, surveillance, and outbreak preparedness and response. Presentations from the CDC, the WHO, and UNICEF presented on the polio situation globally and regionally, the integration immunization agenda 2030, regional progress in implementation of polio transitions, the new polio eradication strategy 2022-2026, and integrated social mobilization and health promotion initiatives.

As part of the workshop’s program and with guidance from facilitators, each country drafted an action plan for specific activities to facilitate integration, focusing on activities that are achievable with existing resources. Following this workshop, a focal point from each country will be leading and following up on the implementation of their respective plan, with the GPEI and GHD|EMPHNET will be providing technical support when needed.