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Time to ramp up the fight against polio
By Dan Nixon

The Global Polio Eradication Initiative (GPEI) has made significant progress since the launch of its new strategic plan and the bivalent oral polio vaccine last year. In India and Nigeria, the sources of all recent wild poliovirus importations into previously polio-free countries, the disease declined by 95 percent between 2009 and 2010.

The World Health Organization calls the progress encouraging, “but the job is not yet finished, and we must see this through to the end,” said its director-general, Margaret Chan, at the World Health Assembly in May.

In addition to the gains made by India and Nigeria, 15 countries in Africa have stopped outbreaks of the disease that started in 2009, reported the GPEI Independent Monitoring Board (IMB) in April.

The GPEI’s leading partner agencies -- the World Health Organization, Rotary International, the U.S. Centers for Disease Control and Prevention, and UNICEF -- and the Bill & Melinda Gates Foundation welcomed the report. They particularly noted the IMB’s assessment that polio eradication is “entirely feasible” and “desperately needed,” and that countries that are off track in meeting GPEI milestones can be brought back on track with support from national governments, donors, and the spearheading partners.

Among those countries is Pakistan, which launched the National Emergency Action Plan for Polio Eradication 2011 with the goal of halting transmission of the disease by the end of the year. Rotarians there are working “to cover every nook and corner of the country,” said Aziz Memon, chair of the Pakistan PolioPlus Committee. “We are committed to a polio-free Pakistan.”

The report also referred to an estimated US$665 million funding gap through 2012 as the “single greatest threat to the GPEI’s success.” To help address the gap, the Gates Foundation has awarded two grants totaling $355 million to Rotary in support of its work. Rotary has responded with Rotary's US$200 Million Challenge, which will be completed on 30 June 2012; to date, Rotarians have raised $173.2 million.

“The IMB clearly stated that all member states have decided together to eradicate polio, and that funding the effort should be a shared responsibility,” said Rotary Foundation Trustee Chair Carl-Wilhelm Stenhammar at a May meeting with Margaret Chan, Bill Gates, health ministers from polio-infected countries, and international development agency representatives. “We therefore invite donor governments from around the world to join the Bill & Melinda Gates Foundation and the ongoing commitment by Rotary's 1.2 million members worldwide, and rapidly make available flexible funding critically needed to implement all activities of the strategic plan.”

The IMB’s report concludes that polio eradication is feasible in the near future, but warns that the goal will only be achieved with “heightened attention” at all levels.

“If we fail, the disease will not stay at its current low level,” said Bill Gates, speaking at the RI Convention in May. “It will spread back into countries where it has been eliminated, and it will kill and paralyze hundreds of thousands of children who used to be safe.”

“We are at a crossroads right now,” said Bruce Aylward, assistant director-general of WHO for polio eradication and related areas, said in March. “We have a new vaccine, we have new resolve, we have new tactics. We have the chance to write an entirely new polio-free chapter in human history. But if we blink now, we will lose forever the chance to eradicate an ancient disease. End polio now.”