Bulletin of the World Health Organization

Photo special

The last days of polio

In 2002, world-renowned Brazilian photographer, Sebastião Salgado, joined the global effort to eradicate polio. These photographs, which are also published in his latest book, The End of Polio: A Global Effort to End a Disease (1), provide a visual account of the final stages of the fifteen-year campaign which aims to stop transmission by 2004.

“As Sebastião Salgado’s luminous photographs attest, there are few more heartbreaking illustrations of the world’s negligence towards children than polio,” writes United Nations Secretary-General, Kofi Annan, in his foreword to the book which was launched in September 2003. Salgado’s photographs depict the tragic toll taken by this preventable disease and also moments in the campaign against it.

“The scale of it caught my attention,” says Salgado. “Though I had frequently visited most of the countries where polio is still a problem, I had not noticed what a terrible impact this disease still has. I was also not aware of the gigantic effort being made to eradicate it: millions of people delivering drops of polio vaccine to tens of millions of children. It is an amazing story that I wanted to help tell.”

In 1988, when the World Health Assembly resolved to eradicate polio and the Global Polio Eradication Initiative was launched, there were 125 polio-endemic countries. Now that figure has dropped to just six: Afghanistan, Egypt, India, Niger, Nigeria, and Pakistan. Somalia, after being polio-free year for one year, was taken off the list at the end of December 2003.

Since the inception of the Global Polio Eradication Initiative — a global partnership spearheaded by the World Health Organization, Rotary International, US Centers for Disease Control and Prevention (CDC) and the United Nations Children’s Fund (UNICEF) — the number of polio cases has fallen from more than 350 000 in 1988 to 556 reported cases in 2003 (as of 26 November 2003) — a reduction of more than 99%.

However, ongoing transmission in the remaining polioendemic countries threatens the 2004 target. As long as transmission continues in these countries, there is a risk that wild poliovirus could cross borders and become re-established in countries and areas which have previously been polio-free. In West Africa, for example, an outbreak in northern Nigeria infected the neighbouring polio-free countries of Burkina Faso, Chad, Ghana and Togo in 2003. Responding to these importations cost over US$ 20 million in emergency mop-up campaigns.

Whilst significant progress has been made since 1988, stopping transmission by the end of 2004 is crucial if the disease is to be eradicated. “The immense efforts to eradicate polio have renewed my hope, my faith in solutions. The world cannot afford to miss this chance to finish with a disease,” says Salgado.

Photograph by Sebastião Salgado/Amazonas Images

INDIA, 2001. The Amar Jyoti Rehabilitation and Research Center in New Delhi accommodates 540 children.

1 The End of Polio: A Global Effort to End a Disease was published in English by Bulfinch Press (AOL TimeWarner Book Group) and produced by PixelPress, New York.