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Although the Global Polio Eradication Initiative (GPEI) has faced sobering challenges in the past year, officials say it is moving forward in key political, technical, financial, and operational areas.

Stepped-up efforts to end the disease in the four endemic countries -- Afghanistan, India, Nigeria, and Pakistan -- are paying off, they say.

 

"Rotary International has played an extraordinarily special role [in the GPEI], not just as one of the initiators but in bringing financial resources, political advocacy, and volunteerism on the ground to getting the job done," said Dr. Bruce Aylward, director of the GPEI at the World Health Organization, speaking to the National Press Club in Washington, D.C., in June.

Aylward said that all levels of government in the four countries are committing unprecedented support for the polio eradication effort by monitoring the performance of immunization activities and holding local authorities accountable for the results.

According to WHO, the incidence of polio in India in 2009 has dropped by 28 percent to 284 cases as of 8 September, compared with 397 cases over the same period a year ago. Monthly immunization campaigns in the highest-risk areas have reduced wild poliovirus type 1 -- the more dangerous of the two remaining strains -- to record lows. Type 1 causes paralysis in about 1 out of every 200 children infected, versus 1 out of every 1,000 children with type 3.

In Nigeria, the incidence of polio has decreased by 41 percent to 379 cases, from 646 cases a year ago. By early 2009, the proportion of unimmunized children in the highest-risk states had fallen below 10 percent for the first time.

Unrest along the Afghanistan-Pakistan border has resulted in a slight increase in the number of cases in both countries in the past year. Between large-scale immunization campaigns, however, teams have exploited lulls in the conflict to enter normally inaccessible areas and give children an additional dose of vaccine. In Afghanistan, the wild poliovirus is endemic only in the south, and about 80 percent of children live in polio-free areas.

Rotarians in Pakistan have encouraged the national government to give strong support to ending polio. In early 2009, Pakistan launched the Prime Minister's Action Plan for Polio Eradication. On behalf of Rotary International in August, International PolioPlus Committee Chair Robert S. Scott recognized Pakistan's president, Asif Ali Zardari, with a Polio Eradication Champion Award for his outstanding support for a polio-free world. Read more

A new vaccine will be introduced in India as early as November to help stop the transmission of the type 1 and type 3 wild polioviruses. (Type 2 has been eradicated globally except in Nigeria.) This bivalent vaccine, health officials believe, will multiply the gains made during the past year toward eradicating polio. Intended to complement, not replace, monovalent and trivalent vaccines already in use, the bivalent vaccine will also be considered for Afghanistan, Nigeria, and Pakistan.

Worldwide, the number of polio cases has dropped from more than 350,000 in 1988, when the GPEI began, to 1,651 in 2008.

"This is a great improvement from the worst days of polio epidemics," said Rotary Foundation Trustee Chair Glenn E. Estess Sr. "But it is not good enough, and it will not be good enough until the number is zero. We cannot pause or slacken our efforts."

Global health experts are calling the push to end polio "the final inch," in light of the remaining 1 percent of cases that are the most difficult and expensive to prevent. Rotary's US$200 Million Challenge, which ends 30 June 2012, is seen as crucial to the initiative's success.

"This is an absolutely devastating disease that affects the poorest, most marginalized communities in the world," Aylward said. "We have the tools to eliminate it forever."