Copenhagen 21 June 2002 - The historic decision to certify the WHO European Region polio-free was announced today at a meeting of the European Regional Commission for Certification of Poliomyelitis Eradication (RCC) in Copenhagen. For some 870 million people living in the region's 51 Member States, this landmark decision is the most important public health milestone of the new millennium.
"This is a tremendous achievement in the global effort to eradicate polio. To get where we are today required the full commitment and cooperation of each of our 51 Member States, the hard work of public health workers in the field and the firm support of international partners in coordination with WHO," declared Dr Marc Danzon, WHO Regional Director for Europe.
The European Region has been free of indigenous polio for over three years. Europe's last case of indigenous wild poliomyelitis occurred in eastern Turkey in 1998, when a two-year-old unvaccinated boy was paralysed by the virus. Poliovirus imported from polio-endemic countries remains a threat. In 2001 alone, there were three polio cases among Roma children in Bulgaria and one non-paralytic polio case in Georgia - all caused by poliovirus of Asian subcontinent origin. A decade ago, an imported poliovirus paralysed 71 people and caused two deaths in a community which refused vaccination in the Netherlands.
Of the recent importations, Sir Joseph Smith, Chairman of the RCC noted, "We are satisfied that all measures were taken to ensure that wild poliovirus imported into the Region did not lead to ongoing circulation. All evidence confirms that. However," he cautioned, "Our work does not stop here. Throughout the European Region, ongoing vaccination and surveillance is vital. The risk of poliovirus being imported into Europe will continue until we eradicate polio globally."
The path to a polio-free Europe began in 1988, following the call of the World Health Assembly to eradicate polio. A partnership was set up, spearheaded by WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF, to free the world of the disease. Success in Europe was achieved through unprecedented coordinated national immunization campaigns, known as Operation MECACAR, which involved 18 polio-endemic countries and areas in the WHO European and Eastern Mediterranean Regions . Sixty million children under five years old received two extra doses of poliovaccine every year from 1995-98. Since 1997, MECACAR included special door-to-door mass vaccination in the high-risk areas of these countries. Supplementary vaccination campaigns have continued in the highest risk countries through 2002. This synchronization of immunization days between neighboring countries has become a model for eradicating polio globally.
An independent panel of international public health experts who make up the RCC has been engaged in the formal polio-free certification process in Europe since 1996. Before certification could be declared, the RCC had to scrutinize surveillance data and the evidence of national certification committees. In addition, it received firm commitments from all ministries of health on maintaining immunization and surveillance. "Excellent surveillance for acute flaccid paralysis is an essential tool in regional certification, and in the global initiative to eradicate polio. It provides the exact location and ages of every child stricken with polio, guiding immediate immunization responses," said Dr David Fleming, Acting Director of the CDC. "Sustaining surveillance will be vital in guarding against the ongoing threat of importations."
In addition to maintaining immunization, surveillance and the ability to respond to importations, European countries are now cataloguing all laboratory stocks of the poliovirus, as part of a global plan to ensure effective containment in a polio-free world. In contrast to smallpox where absolute containment was the goal, this plan aims for effective containment, to minimise the risk of an accidental or intentional reintroduction of wild poliovirus by handling retained materials under the appropriate biosafety conditions.
Since the Global Polio Eradication Initiative was launched in 1988, two regions have been certified polio-free: the Americas in 1994, and the Western Pacific in 2000. Polio cases have dropped from an estimated 350,000 cases in 125 countries in 1988 to 480 reported cases in only 10 polio-endemic countries in 2001.
"In Europe and elsewhere we have worked to reach children living in some of the most difficult conditions imaginable, including conflict-affected areas," said Philip D. O'Brien, UNICEF Regional Director for Central and Eastern Europe. "This unprecedented effort, which has been rewarded today with European certification, must be continued until we reach all children, everywhere, with polio vaccine."
A US$ 275 million funding gap for global eradication activities through 2005 is now the single biggest threat to achieving polio's eradication globally, required to minimise the risk to the children of Europe. "This is truly an historic achievement," said Rudolf Hörndler, Chairman of the European PolioPlus Committee for Rotary International. "Yet as we get closer to reaching our goal of a polio-free world, we must not grow complacent. Our toughest challenges are ahead of us - a US$ 275 million funding gap remains." As the volunteer arm and lead private sector partner in the global effort to eradicate polio, Rotary has contributed over US$ 14 million to end polio in Europe, and US$ 462 million worldwide to date. In addition, Rotary members volunteer their time to help immunise children during national immunisation days. To help the global effort to close the funding gap, Rotary will launch its second major fundraising campaign to raise US$ 80 million through 2003 this July.