U.S. Centers for Disease Control and Prevention (CDC) Eradicating Polio World-Wide with Analytics

healthcare success story

The U.S. Centers for Disease Control and Prevention (CDC) is the world’s largest national public health government organization, with an annual budget of over $11 billion. The CDC works 24/7 to save lives and protect people from health threats. As a spearheading partner of the Global Polio Eradication Initiative (GPEI), the CDC annually contributes over $100 million of its budget and significant human resources to polio eradication activities for which it maintains high standards for developing evidence-based policies and expectations of cost-effective use of its resources.

In 2001, the CDC launched a collaboration with Kid Risk, Inc. to use a range of operations research and management science tools combined with the best available scientific evidence and field knowledge to develop integrated analytical models for the evaluation of the global risks, benefits, and costs of polio eradication policy choices. For example, as world leaders began to consider the end game that would follow the successful eradication of wild polioviruses (WPVs), questions emerged that demanded rigorous answers, such as: ”what vaccine (if any) should countries use after WPV eradication?” and ”what risks will need to be managed to achieve and maintain a world free of polio?” Based on this work, they won the 2014 Edelman Award with their work, "Polio Eradicators Use Integrated Analytical Models to Make Better Decisions."

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The team systematically developed each of the components required to support integrated analytic models, including clarifying the policy options using a decision analytic approach, developing a dynamic disease model for polioviruses using a system dynamics approach, and characterizing the risks and costs of the options with sensitivity analyses. By providing both analytical structure and a synthesis of the existing evidence, the team effectively engaged a wide range of stakeholders with diverse perspectives and values. The ability of the team to help decision makers visualize and quantify the expected impacts of their options encouraged effective dialogue and shared understanding of critical issues and uncertainties.

Analytical results from the collaboration significantly impacted polio eradication in many ways, including more rapid response to outbreaks and reaffirmation that pursuing eradication instead of control is the “best buy” to prevent cases of paralysis and to save lives and money. The results also supported global policies to coordinate global cessation of the use of oral poliovirus vaccine after successful WPV eradication and awareness of the challenging dynamics associated with ending the use of a live virus vaccine.

At a time of increased skepticism about the potential for achieving polio eradication in India, the collaboration demonstrated through modeling that success depended on the degree to which India intensified its immunization efforts to increase population immunity and the problems associated with a wavering commitment. Remarkably, the Government of India successfully stopped endemic WPV transmission in early 2011, and recently celebrated three years of polio-free status. Finally, the collaboration estimated $40-50 billion of net benefits by 2035 associated with the GPEI. Recognition of polio eradication as a major program in need of stable financing helped support a fundraising effort in 2013 that raised $4 billion from donors to finish the job. Increased integration of operations research and management science tools could also potentially be used to perform simultaneous probabilistic and dynamic modeling for other complex global health challenges, including other vaccine-preventable diseases like measles and rubella.

Video of CDC & KidRisk 2014 Edelman Finalist Presentation