appropriate approach to proving efficacy and safety and—most importantly—raising awareness of the importance of the task and mobilizing the necessary funds. Therefore, the committee recommends that a multidisciplinary steering team be assembled to guide the effort.

RECOMMENDATIONS

1. Public Health Considerations

The committee recommends that:

  1. The development of one or more polio antiviral drugs should be included as a goal of the global polio eradication effort. Under the assumption that administration of OPV will eventually be halted, the availability of an effective polio antiviral will be extremely useful for outbreak control in the context of declining levels of population immunity.

  2. The primary use of the antiviral/s should be to assist, possibly with IPV, in control of a cVDPV outbreak in the post-OPV era by preventing virus spread through prophylaxis of susceptible contacts and reduced virus shedding of infected persons. Treatment of patients chronically infected with poliovirus would be a secondary use of the antiviral drugs, but careful attention should be paid to the risk that resistant strains could emerge during long-term use.

  3. Careful consideration should be given to plans including criteria for employment of the drug, a distribution strategy, and innovative ways of enhancing compliance.

  4. Deployment of the antiviral or antiviral drugs should be under the control of public health authorities.

2. Biological Considerations

The committee recommends that:

  1. Capsid-binding molecules and 3C protease inhibitors initially be given priority for consideration: the availability of promising lead compounds, the critical replication functions interrupted by these classes of compounds and the likelihood that these compounds may



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