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Back To Vidyya Polio Eradication: Final 1% Poses Greatest Challenge

The Eradication Of Crippling Poliomyelitis Is 99% Complete

The eradication of crippling poliomyelitis is 99% complete according to figures released today by the Global Polio Eradication Initiative.

In 2000, there were no more than 3500 cases of polio reported worldwide*, a 99% decrease from the 350 000 annual cases estimated in 1988 when the Initiative was launched. In just 12 months the number of polio cases has been more than halved, from 7141 in 1999. This reduction is a result of the World Health Assembly’s call in 1999 to accelerate eradication activities, including increased rounds of National Immunization Days (NIDs) and use of a house-to-house vaccine delivery strategy enabling vaccination teams to find and immunize more children.

Last year a record 550 million children under five years were immunized during intensified NIDs in 82 countries. This included India, where 152 million children were vaccinated in three days, and a synchronized effort across West and Central Africa, which immunized 76 million children in 17 countries.

The partners behind the Initiative hailed the major progress, which keeps the campaign on track for a world certified polio-free by 2005. But they warned that the biggest challenges of the programme lie ahead: accessing all children, closing a US$ 400 million funding gap, and maintaining political commitment in the face of a disappearing disease.

"Victory over the poliovirus is within sight," said Dr Gro Harlem Brundtland, Director-General of the World Health Organization. "We must now close in on the remaining strongholds of the disease and use all possible resources to extinguish polio. We ask that everyone involved maintain the focus on achieving this historical milestone in international public health."

The Global Polio Eradication Initiative is spearheaded by WHO, Rotary International, the U.S. Centers for Disease Control and Prevention (CDC), and the United Nations Children’s Fund (UNICEF).

The poliovirus now circulates in no more than 20 countries, down from 30 in 1999 and 125 in 1988. These are mainly in South Asia and sub-Saharan Africa. They are: Afghanistan, Angola, Bangladesh, Benin, the Central African Republic, Chad, Congo, Côte D’Ivoire, the Democratic Republic of the Congo, Egypt, Ethiopia, Ghana, India, Nepal, Niger, Nigeria, Pakistan, Sierra Leone, Somalia, and Sudan. Poliovirus transmission is at very low levels in 11 of these countries.

Access Crucial

"The key now is urgently accessing and vaccinating the children we haven’t been able to reach because of war, isolation and lack of infrastructure," said Carol Bellamy, Executive Director of UNICEF. "It’s essential that warring parties and international mediators give priority to cease-fires that allow us to get polio vaccine to these children. Children should be seen as zones of peace." Added Bellamy: "By reaching into conflict zones we are not only stopping polio, we are putting these children on the map for other essential services."

Some of the most intense poliovirus transmission is in Angola and the Democratic Republic of the Congo. This summer, these countries will join the Republic of Congo-Brazzaville to synchronize their National Immunization Days for the first time. The effort will emphasize immunization of children in conflict-affected and cross-border regions. The Initiative relies on warring factions laying down their weapons – "Days of Tranquillity" – to allow polio vaccination teams to safely do their work.

Funding Needed

In order to stop transmission of the poliovirus in all countries, additional funding is urgently needed. A total of US$ 1 billion is required to ensure delivery of more than six billion doses of oral polio vaccine (OPV) to 600 million children around the world by 2005. Of this there is a US$ 400 million funding gap. To help meet this funding challenge, The Rotary Foundation of Rotary International and the United Nations Foundation are collaborating to secure funds from the private sector, philanthropists and foundations.

"This money must be found – there is no option here," said Frank Devlyn, President, Rotary International. "We have worked extremely hard to come this far. Polio eradication will benefit all children, for all time. We owe it to this and future generations to raise these funds and finish the job. I call on all potential donors to invest in the eradication of this crippling disease."

Rotary International, the volunteer arm of the global partnership, has members in 163 countries and is the leading private sector partner in the Initiative. So far the service club has contributed US$ 407 million to the effort since 1985, and will commit a total of US$ 500 million by 2005.

Commitment

Given the magnitude of the polio eradication effort, political commitment to achieving the 2005 certification target is required from the highest levels in polio-endemic and polio-free countries. In addition to remaining vigilant against the disease, polio-free countries must begin the process of containing all laboratory stocks of the virus. In total, tens of thousands of laboratories worldwide will be searched for the virus.

Until global eradication, no child is safe from polio. For example, in August 2000 an imported poliovirus from Angola caused a major outbreak on the small West African island nation of Cape Verde, which had been polio-free for years. This outbreak paralysed 44 people and killed 17.

"The sad outcome of this importation reaffirms that until all children everywhere are protected, every child is at risk," said Dr Jeffrey Koplan, the Director of the US Centers for Disease Control and Prevention. "This experience highlights the need to maintain recommended levels of routine immunization, and ensure certification-standard surveillance for polio cases in every country."

About Polio

Poliomyelitis (polio) is a highly infectious disease caused by a virus that mainly affects children under three years of age. It invades the nervous system and can cause total paralysis in a matter of hours. The virus enters the body through the mouth and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis (usually in the legs). Between five and ten per cent of people infected with polio die when their breathing muscles are paralysed.

As there is no cure for polio, the best treatment is preventive. A few drops of a powerful vaccine protects a child for life.


* Note: Laboratory results for the year 2000 are still being finalized. Please see www.polioeradication.org for weekly updates.

Today the Global Polio Eradication Initiative is also launching a series of three 30-second public service announcements (PSAs). These television spots, in English, French and Spanish, feature polio eradication supporters such as Nelson Mandela, Bill Gates and Claudia Schiffer. A specially produced PSA includes Olympic gold medalist and world running champions Noah Ngeny and Daniel Komen of Kenya.


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Editor: Susan K. Boyer, RN
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