Polio Eradication Goal Still Elusive

Abstract

AS WORLD POLIO DAY IS REMEMbered on October 24, public health workers find themselves tantalizingly close to eradicating the disease, yet frustratingly stymied in their efforts to do so. The Global Polio Eradication Initiative was launched in 1988 with a deadline to vaccinate all children around the world by 2000 and to make poliomyelitis the second disease (after smallpox) that has been eradicated worldwide. Setbacks pushed that deadline back to 2005, but initiative officials were confident the goal would be reached. Indeed, by late 2003, polio had been eliminated from all but 6 countries (Nigeria, India, Pakistan, Niger, Afghanistan, and Egypt) and fewer than 1000 children worldwide developed the disease. According to estimates by the Global Polio Eradication Initiative, 5 million children have been spared the disease and 250000 childhood deaths have been averted since the eradication effort began. Since then, however, problems in Nigeria have threatened the goal of polio eradication by the end of 2005. Politics and religious and cultural issues in the west central African nation of 137 million people—notably, a rejection of vaccination efforts in 8 northern states after some Muslim clerics said it would lead to sterilization of girls or infection of children with HIV/AIDS—led to a suspension of polio vaccination efforts in Nigeria from September 2003 until August 2004. With this suspension came new outbreaks of polio and projections that 1000 Nigerian children will be paralyzed by the disease this year. Nigeria’s problems are not limited to its borders. With a large reservoir of susceptible children, polio has spread to neighboring countries. In late August, confirmed cases were found in Guinea, Mali, and in the Darfur region of Sudan. Previously, polio cases were last reported in Guinea and Mali in 1999; and the Sudan in 2001. Altogether, there are 10 countries that reported polio importation in 2004.