Welcome to the first issue of the Polio Pipeline! The purpose of this newsletter is to keep partners and the scientific community informed about what is happening in the increasingly complex research pipeline for the Global Polio Eradication Initiative (GPEI). This newsletter is being coordinated by the Research and Product Development team of the Polio Eradication Department at the World Health Organization (WHO).

2007 was a successful year for polio eradication with poliovirus type 1 transmission at the lowest levels ever. While this progress is continuing in 2008 in Asia, this year is seeing a resurgence of type 1 in parts of Africa. There also remain continuing challenges, particularly in northern Nigeria and in India (Uttar Pradesh and Bihar states), which warrant enhanced efforts of those in the field as well as those engaged in research.

While our urgent mission remains the completion of eradication, we must also address the various policy issues associated with the post-eradication era. Research encompasses both supporting the completion of eradication, as well as addressing the

post-eradication era.

The expanded research agenda includes dozens of projects from a wide range of core scientific disciplines. Consequently, it has become challenging for people interested in polio eradication to track all of the research work being done and keep apprised of changes in the strategy.

Because publication and diffusion of research in peer-reviewed literature can take time to unfold, the Advisory Committee on Poliomyelitis Eradication (ACPE) – the global body providing strategic guidance to the GPEI – recommended:

“WHO should develop a GPEI research newsletter for regular dissemination to the scientific community, with interim updates on the GPEI website.”

This newsletter is envisioned as an effective means of keeping all of our partners up- to-date on the goals, strategies and status of ongoing and pending research.

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Polio Research Committee Meeting

1. Review polio eradication-related re- search conducted over the 5 years since the September 2003 WHO meeting on potential post-eradica- tion risks (esp. VDPVs).
2. Identify the remaining gaps in knowledge for interrupting wild poliovirus transmission and assess- ing and managing risks in the post- eradication era.
3. Determine a list of study questions to address those gaps and risks; then, rank study questions in order of priority for policy development and programme ac- tivities.
4. Propose appropriate studies to be initi- ated, commissioned or funded by GPEI and/or interested stakeholders to ad- dress priority knowledge gaps.
5. Review external research proposals in terms of conception, design and scien- tific merit, and determine their respec- tive priorities and funding levels.
6. Monitor, evaluate and direct the dissem- ination of progress and findings from all relevant research.
7. Further engage solution-oriented inter- ested parties, stakeholders and potential new collaborators.

The following proposals were discussed and endorsed by the committee for priority follow-up and funding:

1. Evaluation of antivirals in polio eradica- tion: This proposal focused on a system- atic evaluation of promising antiviral compounds against a panel of poliovi- rus strains. CDC has offered to screen potential candidate compounds.
2. Assessment plan for Sabin IPV alternate seed strains: This proposal initiated the process of evaluating potential alter- nate seed strains for the production of inactivated poliovirus vaccine (IPV). The aim of this project is to develop seed

strains that do not grow in humans, which could greatly facilitate the safe production of IPV in developing coun- tries in the longterm. A matrix is being compiled to assess promising candidate strains.
3. Sabin IPV alternative inactivation agents: The recovery of antigenic materials from Sabin type-2 poliovirus following inacti- vation with formalin is particularly low.
   A proposal to test alternative inactiva- tion methods, using β-propiolactone, will be investigated. The committee endorsed a proposal submitted by the Netherlands Vaccine Institute.
4. Assessment for the use of adjuvants in IPV: As part of the strategy to lower the production costs of IPV, a system- atic evaluation of adjuvants was pro- posed. Adjuvants offer the potential to decrease antigenic content at least 3 to 5-fold compared to non-adjuvanted vaccine. A systematic evaluation pro- posal of adjuvants submitted by IVR was endorsed by the committee.
5. Programme communication approach- es: Communication is an integral part of the eradication initiative. The commit- tee endorsed a proposal submitted by UNICEF to conduct an in-depth evalua- tion of communication in Nigeria.
6. Mathematical modelling: Additional mathematical modelling to guide the programme, especially in the areas of vaccine efficacy, population immunity and assessment of risks for paralytic disease due to poliomyelitis in the post- eradication era, is being evaluated. A proposal submitted by the Imperial Col- lege was endorsed by the committee.

The PRC is also committed to identifying remaining gaps in knowledge pertain- ing to the interruption of wild poliovirus transmission and preparation for the post- eradication era. This preparation revolves around proposing appropriate studies, de- termining their priority and funding levels, reviewing external research activities and engaging interested parties, stakeholders and potential new collaborators - all chal- lenging undertakings for the PRC during the coming year. To this effect, the PRC is currently soliciting research proposals, ahead of its next meeting in November 2008.