In 1988, when the World Health Assembly resolved to eradicate polio, 350,000 children were being crippled by the virus in 125 countries. Since then, the incidence of polio has been slashed by 99 per cent, thanks to mass immunization campaigns that have brought the oral polio vaccine to more than 2 billion children. In 2004, only 1,255 cases were reported worldwide (8). The Americas were certified polio-free in 1994, the Western Pacific in 2000 and Europe in 2002.
Six countries have yet to stop the transmission of the indigenous wild poliovirus: Afghanistan, Egypt, India, Niger, Nigeria and Pakistan. Strong progress is being made, but challenges remain. In a setback in 2004, a polio outbreak originating in West Africa spread to several countries that were polio-free; its advance was fuelled by low immunity levels and a breakdown of services caused by civil conflict in some countries of the region. Countries as far afield as Indonesia and Yemen have reported cases linked to the outbreak.
Achieving polio eradication will depend upon countries' capacity to launch focused immunization campaigns, including massive, targeted social mobilization activities, to stop any cases from spreading, especially in the poorest areas where immunity gaps persist. Vital in that regard is the support of public- and private-sector partners in the Global Polio Eradication Initiative: the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention, and UNICEF.
The polio goal will be reviewed in October 2005 by partners in the Global Polio Eradication Initiative. Once polio transmission has been stopped in every region, a strong, ongoing surveillance system must confirm three polio-free years have passed before global eradication can be certified.