Unique Opportunity For Eradication Success Now Rests With Key Governments

Data presented from Afghanistan, Egypt, India, Niger, Nigeria and Pakistan, show poliovirus beaten back to only a few remaining reservoirs. These data, and the introduction of aggressive new programmes, present an unprecedented opportunity to eradicate a disease that once paralyzed hundreds of thousands of children each year.

After an international investment of US$ three billion over 15 years, and the successful engagement of over 200 countries and 20 million volunteers, polio could be the first disease of the 21st century to be eradicated. Health ministers in Geneva noted that the success or failure of the world’s largest public health initiative, spearheaded by national governments, the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF, now rests with the governments of the six endemic countries. Polio transmission levels are now at their lowest ever in the key countries of India, Pakistan and Egypt, providing these governments with a rare opportunity to halting spread of the virus. The first milestone in 2004 toward global polio eradication may well come from Egypt, according to epidemiologists, followed closely by India. Nigeria is currently the greatest risk to global eradication. In late 2003, immunization activities against polio were brought to a halt in the state of Kano, the last major polio reservoir in Africa, because of unfounded rumours which suggested that the polio vaccine was not safe. With immunization activities stalled in Kano and polio campaigns of a sub-optimal quality in other northern states, polio was able to creep back across Nigeria and spread into the previously polio-free countries Cameroon, Chad, and through Niger, into Benin, Burkina Faso, Ghana and Togo, putting 15 million children at risk and necessitating a massive immunization campaign across west and central Africa. The Nigerian Minister of Health, Professor Eyitayo Lambo, outlined the steps his country will take to “dramatically” improve polio campaigns in the first half of 2004, particularly in the northern states where the virus continues to circulate widely. He said: “We will work together as one – federal, state and local governments, religious and traditional leaders, Christians and Muslims – to reach every child with the polio vaccine. It is the responsibility of every Nigerian to ensure polio is eliminated from every area, north and south, of our great country. Nigeria is determined to break the chains of polio transmission for the sake of our children, our neighbours’ children, and the children of the world.”

Speaking from Delhi, Ms Sushma Swaraj, India’s Minister of Health, said: “Polio eradication is a tremendous challenge in a vast, densely populated country like India. But in 2003, we have shown the world we have the capacity, resources, and most importantly, the will, to vanquish this devastating disease.” The Minister referred to preliminary data from 2003, showing a 84 per cent reduction in polio cases there compared with 2002.

She continued: “We have a unique window of opportunity in which to end polio forever. We will seize this opportunity by reaching each and every child with vaccine, particularly in western Uttar Pradesh and any other corner of India where transmission has not been stopped. There is no room in India’s future for polio.”

The year 2003 also demonstrated the serious risks at play in the world’s final push to eradicate polio. In 2003, funding shortfalls required most polio-free countries to stop their polio immunization campaigns, thereby leaving millions of children more vulnerable to poliovirus infections from endemic countries, underscoring the urgency of interrupting poliovirus transmission in the six remaining endemic countries.

The Ministers concurred on an all-out effort to reach every child with the polio vaccine from early in 2004, particularly in Nigeria, India and Pakistan, which together account for more than 95 per cent of all polio cases worldwide. Within these three countries, transmission of poliovirus is further confined to “polio hotspots,” especially in five states and provinces (Kano in Nigeria, Uttar Pradesh and Bihar in India and North West Frontier Province and Sindh in Pakistan) that together are linked to more than 75 per cent of all new cases worldwide in 2003.

To fully implement the bold eradication plans outlined by the Ministers of Health requires the continued generous support of public and private donors. An additional US$150 million is urgently needed to fill the remaining funding gap for activities during 2004 and 2005.

The Global Polio Eradication Initiative is spearheaded by WHO, Rotary International, the US Centers for Disease Control and Prevention and UNICEF. The polio eradication coalition includes governments of countries affected by polio; private foundations (e.g. United Nations Foundation, Bill & Melinda Gates Foundation); development banks (e.g. the World Bank); donor governments (e.g. Australia, Austria, Belgium, Canada, Denmark, Finland, Germany, Ireland, Italy, Japan, Luxembourg, the Netherlands, New Zealand, Norway, the United Kingdom and the United States of America); the European Commission; humanitarian and nongovernmental organizations (e.g. the International Red Cross and Red Crescent societies) and corporate partners (e.g. Aventis Pasteur, De Beers).