Will global polio eradication miss yet another deadline?

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The Hindu

The target of year 2000 was not met, nor the two deadlines set after that, 2004 and then 2012. Photo: Nagara Gopal

When the world embarked on polio eradication 26 years back, the goal was to complete that task by the year 2000. That target was not met, nor the two deadlines set after that, 2004 and then 2012.

The ‘Polio Eradication & Endgame Strategic Plan 2013-2018’ formulated by the World Health Organisation and its partner agencies then set the goal of ending transmission of all naturally-occurring ‘wild’ polio viruses by the end of this year.

In 2012, although the deadline had been missed, things did indeed look hopeful. India had succeeded in remaining polio-free for a whole year and was taken off the list of endemic countries. Polio cases recorded worldwide that year shrank to an all-time low. But all that changed last year when the virus came roaring back and spread out of Nigeria and Pakistan to countries that had been polio-free. Over 80 per cent more polio cases were reported globally in 2013 than during the previous year. There have been 89 cases so far this year, almost twice as many as during the same period last year.

“The latest strategic plan goal of interrupting transmission by the end of 2014 stands at extreme risk,” warned the Independent Monitoring Board (IMB) of the Global Polio Eradication Initiative in its latest report issued recently. The Board was established four years back to provide periodic external assessments of the global effort.

Stopping global polio transmission had been serially missed. “Every additional polio year costs lives and money, saps morale, puts future donations at risk and holds the public health world back from making further health gains,” the IMB pointed out. Nigeria and more so Pakistan, both polio-endemic countries, were at risk of failing to stop transmission in time, it said.

“Currently Pakistan is firmly on track to be the last polio-endemic country in the world,” the IMB observed. “It is an indictment of this country’s programme that even in the easier eradication context of the low-season, it has had almost as many cases in the first four months of 2014 as in the whole of 2012 — and nine times as many as in the same period last year.”

The Board recommended that an Emergency Operations Centre be established in Pakistan, building on the country’s recent experience in responding to natural disasters and other countries’ experiences in emergency polio response.

Nigeria had on two previous occasions — in 2007 and 2010 — come very close to stopping polio transmission but then lost momentum.. There had been strong improvements in performance during the last 18 months, which had reduced viral circulation to a new historic low.

However, “the country is in danger of failing to capitalise on this unprecedented opportunity to stop polio transmission once and for all,” the IMB cautioned.

The strain of forthcoming elections was already showing. The kidnapping of children in Borno state had heightened tension and danger in a key polio-affected area.

Moreover, one or more of the current outbreaks in non-endemic countries could become prolonged. In addition, there was serious risk of failure to anticipate and prevent outbreaks elsewhere, the Board noted.