The Eradication of Poliomyelitis in Spain: Projects, Obstacles, Achievements, Realities

Abstract

he main aim of our paper is to provide a historical approach to the complex process undertaken in Spain to achieve the official WHO certificate of polio eradication in 2002, within the framework of the initiatives launched in the WHO European Region. At the time of the first meeting of the European Regional Commission for the Certification of Poliomyelitis Eradication in 1996, the epidemiological situation and levels of vaccination cover (over 90%) enabled Spain, like other countries, to ensure compliance with the conditions set by the World Health Organization. This showed that the country, at the end of the twentieth century, had achieved high public health standards, which is remarkable if one considers that the country had suffered forty years of dictatorship and that the previous health care system had important failings. The changes that allowed Spain to join those European countries that obtained eradication certification are to be found within the framework of the deep social, political, economic and cultural transformation behind this process. In order to make a more complete assessment, we seek to analyse the set of projects designed, the obstacles encountered in their practical implementation and the final outcomes. Our main sources are the official WHO publications – technical reports, the Bulletin of the WHO and other documents– as well as Proceedings of the International Poliomyelitis Conferences (1948–1960) and the European Association against Poliomyelitis Symposia (1953–1969). In addition we have used printed sources and other kinds of grey literature (reports and other unpublished