title: Adapting Nepal's polio eradication programme.
abstract: OBJECTIVE
  Many countries have weak disease surveillance and immunization systems. The elimination of polio creates an opportunity to use staff and assets from the polio eradication programme to control other vaccine-preventable diseases and improve disease surveillance and immunization systems.
  
  
  METHODS
  In 2003, the active surveillance system of Nepal's polio eradication programme began to report on measles and neonatal tetanus cases. Japanese encephalitis and rubella cases were added to the surveillance system in 2004. Staff from the programme aided the development and implementation of government immunization policies, helped launch vaccination campaigns, and trained government staff in reporting practices and vaccine management.
  
  
  METHODS
  Nepal eliminated indigenous polio in 2000, and controlled outbreaks caused by polio importations between 2005 and 2010.
  
  
  RESULTS
  In 2014, the surveillance activities had expanded to 299 sites, with active surveillance for measles, rubella and neonatal tetanus, including weekly visits from 15 surveillance medical officers. Sentinel surveillance for Japanese encephalitis consisted of 132 sites. Since 2002, staff from the eradication programme have helped to introduce six new vaccines and helped to secure funding from Gavi, the Vaccine Alliance. Staff have also assisted in responding to other health events in the country.
  
  
  CONCLUSIONS
  By expanding the activities of its polio eradication programme, Nepal has improved its surveillance and immunization systems and increased vaccination coverage of other vaccine-preventable diseases. Continued donor support, a close collaboration with the Expanded Programme on Immunization, and the retention of the polio eradication programme's skilled workforce were important for this expansion.
authors.affiliation: Government of Nepal Ministry of Health and Population, Kathmandu, Nepal .
authors.forename: Krishna P
authors.initials: KP
authors.lastname: Paudel
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, United States of America (USA).
authors.forename: Lee M
authors.initials: LM
authors.lastname: Hampton
authors.affiliation: World Health Organization Expanded Programme on Immunization, Regional Office of the Western Pacific, PO Box 2932, 1000 Manila, Philippines .
authors.forename: Santosh
authors.initials: S
authors.lastname: Gurung
authors.affiliation: World Health Organization Expanded Programme on Immunization, Regional Office of the Western Pacific, PO Box 2932, 1000 Manila, Philippines .
authors.forename: Rajendra
authors.initials: R
authors.lastname: Bohara
authors.affiliation: World Health Organization Expanded Programme on Immunization, Regional Office of the Western Pacific, PO Box 2932, 1000 Manila, Philippines .
authors.forename: Indra K
authors.initials: IK
authors.lastname: Rai
authors.affiliation: The Boston Consulting Group, Boston, USA .
authors.forename: Sameer
authors.initials: S
authors.lastname: Anaokar
authors.affiliation: The Boston Consulting Group, Boston, USA .
authors.forename: Rachel D
authors.initials: RD
authors.lastname: Swift
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, United States of America (USA).
authors.forename: Stephen
authors.initials: S
authors.lastname: Cochi
mesh_terms: D057191:Capacity Building / Q000458:organization & administration; D003695:Delivery of Health Care / Q000458:organization & administration*; D060740:Disease Eradication / Q000458:organization & administration*; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration; D008457:Measles / Q000453:epidemiology; D009390:Nepal; D011051:Poliomyelitis / Q000453:epidemiology*; D062486:Public Health Surveillance / Q000379:methods*; D012409:Rubella / Q000453:epidemiology