By Dan Nixon
Rotary International News -- 25 August 2011

Among the key goals of the Global Polio Eradication Initiative (GPEI) is interrupting transmission of the wild poliovirus by the end of 2012. Although the GPEI Independent Monitoring Board (IMB) reported in July that this goal may be in jeopardy, it also noted signs of progress and provided several recommendations that could help get the program back on track.

The GPEI has made significant steps forward since the launch last year of its new strategic plan and the bivalent oral polio vaccine. Among the four polio-endemic countries, India has reported only one case of polio so far this year. The country “is on track to interrupt transmission this year,” the report states.

“The northern part of India, where most of the problem had been, hasn’t had one case in 15 months,” adds Robert S. Scott, chair of Rotary’s International PolioPlus Committee.

The other polio-endemic countries are Afghanistan, Nigeria, and Pakistan. The IMB report cites good progress in Afghanistan while spotlighting the challenge of immunizing children in conflict areas. Nigeria also has been making good headway but, following elections in April, needs to sustain the political commitment required to ensure eradication of the disease.

In Pakistan, cases doubled in the first six months of 2011, compared with the same period in 2010. The report commended the country’s high-level commitment to polio eradication through its national emergency action plan, launched in January, but added that the plan needs to make a stronger impact at the local level.

The report also expressed concern about controlling polio in countries with reestablished transmission, including Angola, Chad, and Democratic Republic of the Congo.

Despite these challenges, polio cases worldwide decreased almost 50 percent during the first six months of 2011, compared with the same period in 2010.

“Type 3 polio numbers have dropped to 15 this year,” says Scott, referring to one of only two strains of the wild poliovirus that remain. “It appears type 3 will soon be eradicated completely.”

Health experts believe that eradicating polio, rather than trying to control the disease, is both feasible and essential.

“There are approximately a dozen countries where polio gets reported sporadically, and those cases can all be traced back to the four countries where transmission has continued,” says Robert Murphy, director of the Center for Global Health at Northwestern University in Illinois, USA. “If we focus on those four countries, the cases in the other countries are going to evaporate.

“It’s very important to finish the job soon, because we’re so close. If we back off now, the problem is going to get bigger and even more expensive.”

Finishing polio once and for all, the IMB report states, will require enhanced political commitment, secure funding, and strengthened technical capacity.

“The eradication of polio is the responsibility of every government,” says Scott, noting the unanimous decision in 1988 at the World Health Assembly to pursue that goal. “Rotarians in every country must continuously talk it up with their fellow Rotarians and, at every opportunity, with their political leaders, to ensure support, both financial and moral.”

During a TED conversation in July, Bruce Aylward, the World Health Organization’s assistant director-general for polio eradication and related areas, called Rotarians’ efforts at the international and grassroots levels “incredibly powerful for a global health initiative like polio eradication.”

Everyone can help end the disease, Aylward said, by providing funding and reminding their communities and government leaders that polio still exists and causes tremendous suffering.

“We have the chance to ensure that no child ever suffers from polio again, and each of us plays a role in that,” he said.