Polio nears eradication from the Earth

Humanity is on the verge of one of the greatest public health achievements in history — eradicating polio. The Global Polio Eradication Initiative (GPEI) has reduced polio cases by 99.9 percent since 1988, bringing the world closer than ever before to ending polio for good. This means a world in which every child would be safe from the paralysis caused by the virus, and no family would have to bear the emotional and financial costs of polio again. With sustained political and financial commitment to protect every last child, we can seize this chance to end the virus forever.

The GPEI is a public-private partnership led by national governments with five major partners — the World Health Organization, Rotary International, the US Centers for Disease Control and Prevention, UNICEF, and the Bill and Melinda Gates Foundation. This coalition unites frontline health workers, governments, donors, and global leaders behind the vision of a world where children are forever safe from the threat of polio.

Today, polio exists in the smallest geographic area in history. The world has not experienced any outbreaks of wild polio virus outside the three polio-endemic countries-Afghanistan, Pakistan, and Nigeria-since August 2014. In 1988, there were 350,000 annual cases of wild polio virus from 125 countries. In 2017, there were 22 wild polio virus cases reported in only two countries-Pakistan and Afghanistan. Nigeria has not seen a case since 2016. Only one of the three wild polio virus strains appears to survive. Wild Poliovirus Type 2 was certified eradicated in 2015, and there has not been a case of Wild Poliovirus Type 3 detected since 2012.

India, once described as the most challenging place in the world to end polio, has not seen a polio case since 2011. This incredible achievement paved the way for the World Health Organization to certify the South-East Asia Region, home to 108 billion people, as polio-free in March 2014.

The tools, infrastructure and knowledge developed to eradicate polio have been used to fight every vaccine-preventable childhood disease, tackle Ebola, deliver malaria prevention tools and improve disease surveillance worldwide. Through the delivery of vitamin A supplements alone, the program has helped to prevent more than 1.5 million deaths.

We desperately need to protect our gains. If we don’t end polio now, we could see a resurgence of up to 200,000 cases annually within a decade. The world could also risk losing the $50 billion in estimated savings that eradication would generate over the next 20 years.

To protect global progress, the program vaccinates more than 400 million children across 60 countries every year, and conducts disease surveillance in more than 70 countries. Since 2001, there have been wild polio outbreaks in 41 countries that were previously polio-free. While each outbreak has been stopped, each one is a reminder that as long as polio exists, every country and every child is at risk.

Through its surveillance, the program investigates more than 100,000 suspected cases of polio each year using a community reporting network. It has also expanded environmental sewage testing to help vaccination campaigns target areas where the virus is circulating even before any child shows symptoms of polio.

Pakistan and Afghanistan have made impressive gains toward ending polio in a region challenged by insecurity and population movement across the countries’ shared border. Vaccinators are reaching more children at border and transit points, and the program has increased the use of locally recruited-mostly female-social mobilisers to vaccinate children in the highest risk areas.

Since 2014, Pakistan has reduced polio cases by more than 97 percent and greatly expanded its surveillance network. While the country saw a record-low eight cases in 2017, there still are four cases so far this year, indicating that the wild virus continues to circulate in the environment.

Afghanistan has seen an 80 percent drop in wild poliovirus cases since 2011, but these gains remain fragile. The program has used a range of interventions-including vaccinating during brief windows of opportunity in conflict areas and collaborating with religious and community leaders and implementing strategies in coordination with Pakistan to reach mobile populations. To rid the region of polio, these countries must increase access in hard-to-reach areas and among mobile populations.

The detection of the wild poliovirus in Nigeria in July 2016 after two years without detecting a case was a sobering reminder of the complex challenge of eradicating polio, especially in areas with ongoing humanitarian crises and faltering health systems.

We have to stay the course to finally rid the world of polio.