Polio is a highly infectious disease that kills and cripples children. Polio had been endemic for thousands of years until the mid-twentieth century when the development of vaccines against polio by Drs. Jonas Salk and Albert Sabin offered the first hope for prevention and control. At the birth of the Global Polio Eradication Initiative (GPEI) in 1988, polio was endemic in more than 125 countries on five continents, and attacked 350,000 children each year. The GPEI is a public-private partnership led by the World Health Organization (WHO), the Department of Health and Human Services’ Centers for Disease Control and Prevention, UNICEF, and Rotary International, and represents a coordinated, global effort to eradicate polio everywhere.
Since 1988, the world has made remarkable progress toward polio eradication. The Americas, Europe, and the Western Pacific have been certified as polio-free. Now only four countries -Afghanistan, India, Nigeria, and Pakistan- still have endemic polio transmission. In addition, global polio cases dropped 34% from 2006 (1,997 reported cases) to 2007 (1,315 reported cases), and 24 of the 27 re-infected countries have stopped polio outbreaks. Asia in particular has seen improvements particularly in the significant reduction of the most virulent form of polio. We have never been closer to the goal of eradicating polio.
A number of obstacles stand in the way of achieving polio eradication. Eliminating a global funding gap of $355 million for vaccination campaigns, surveillance, and emergency operations are critical for future eradication efforts. Additionally, in 2008 Nigeria reported 90% of the most virulent polio cases in the world, and outbreaks continue to occur in previously polio-free countries. The populations still affected by polio in the remaining endemic countries are among the poorest and most difficult to reach with tools of public health, such as vaccines, communication campaigns, or trained health workers. In many cases, conflict, grim poverty, and religious-social tension trouble the affected areas. Setbacks in these areas have resulted in the exportation of the disease, creating new challenges for countries and for the global program.
Eliminating polio will require commitment, cooperation, and diplomatic efforts that extend to the highest levels of government. The political will of the governments of Afghanistan, India, Nigeria, and Pakistan to follow through on commitments to polio eradication must be maintained or increased. Furthermore, eradication of polio requires amplified coordination between governments and other key players in global health initiatives, including the international community, nongovernmental organizations, civil society, and the private sector. At each stage of planning and implementation, there must be increased transparency and accountability to ensure that programs are executed efficiently and effectively. Polio-free countries need to rapidly increase their routine immunization in order to fully protect their populations against importations thus protecting the achievements gained to date.
The U.S. International Strategy
The strategies and tools used to facilitate polio eradication are well developed and effective:
U.S. Assistance for Global Polio Eradication
The U.S. Government has contributed over $1.4 billion to the GPEI since 1988, representing nearly thirty percent of global contributions. The U.S. commitment remains constant at $133 million for Fiscal Year (FY) 2008 and is anticipated to be similar for FY2009.
· The U.S. Government funds help to improve health systems: purchase vaccine; detect and investigate suspected cases of polio; map communities and plan vaccination campaigns; train and supervise surveillance officers, vaccinators, and laboratory personnel; develop evidence-based communication strategies to sustain community participation in immunization; provide and maintain equipment to transport and store vaccine; and develop and maintain critical accredited laboratories.