Press Release WHO/52 13 July 1998   POLIO ERADICATION – HOME STRETCH IS AROUND THE CORNER "The countdown for the year 2000 goal of poliomyelitis eradication has begun in earnest," said Dr Bjorn Melgaard, Chief of the WHO Expanded Programme on Immunization, at the end of a week-long session at the headquarters of the World Health Organization (WHO) in Geneva. "We have the road map, we know we are on the right track but the last leg of the race includes some of the toughest terrain. Failure in one country is global failure. We must focus our efforts on the remaining polio-endemic countries". Members of the Global Technical Consultative Group on Polio Eradication (TCG), gathered in Geneva for their annual assessment meeting, voiced their concern that a deadly combination of a shortfall in funds and an overdose of complacency can jeopardise efforts to eradicate polio in the final stages of the global campaign. "We are virtually on the home stretch", explains Dr Bruce Aylward, in charge of the WHO Global Polio Eradication Initiative, "and we badly need the second wind to finish on time. Only a handful of polio-endemic countries is left in the world. The programme is already fully functioning even in Afghanistan and Somalia. But unless all countries of the world without a single exception are certified polio-free we can not stop routine polio immunization nor can we start enjoying the benefits of polio eradication to the tune of US$ 1.5 billion which will be saved each year". The polio virus is still circulating widely in three specific areas which include large, densely populated countries: Bangladesh, India, Nepal, Pakistan in South Asia; the Democratic Republic of Congo and Nigeria in West and Central Africa; and Ethiopia, Somalia and Sudan in the Horn of Africa. Members of the TCG group pointed out that "in the decade since the initiative was launched there has been a 90% decline in reported cases worldwide. This achievement is especially remarkable given a chronic shortfall in human and financial resources needed for this task". However, unless sufficient resources are mobilized on a timely basis, the eradication goal will not be met, warned the experts. While the vast majority of the costs of polio eradication are borne by the polio endemic countries themselves, for 1999 alone, nearly US$150 million in additional external support is still to be found. It is particularly critical that additional resources are mobilized for the poorest countries where the shortfall is greatest. The funds are needed not only for the purchase and delivery of polio vaccine. Since the start of the global effort to eradicate polio in 1988, over 110 countries have conducted mass immunization campaigns and virtually all polio-endemic countries have started or enhanced their national epidemiological surveillance programs. The latter is critical as the global effort to eradicate polio gets closer to the finishing line. Unless governments can demonstrate that polio has been eradicated in their country, the independent Global Commission for the Certification of Polio Eradication can not complete its work. WHO and its partners are helping the remaining polio-endemic countries to build reliable epidemiological surveillance systems. It is difficult to overestimate the importance of this particular phase of the global polio eradication campaign. In order to be able to pronounce their country polio-free, epidemiologists should investigate all cases of acute flaccid paralysis. This is impossible to do without properly equipped laboratories and properly trained personnel. Establishing the necessary surveillance and laboratory infrastructure obviously costs money. But this is money well spent. Once polio has gone, the former polio-endemic countries will retain fully functional epidemiological surveillance systems which are already being used to track other communicable diseases. At the end of their deliberations, the TCG group made the following recommendation: Because of the time sensitive needs of the polio eradication effort, this programme must be made a top priority of WHO, UNICEF, other United Nations agencies, national governments, partners, bilateral and multilateral agencies, and the global community. Commitment of the leadership at the highest level in all these organizations is essential to eradicate polio. The legacy of polio eradication will not only be the prevention of millions of cases of paralysis and permanent disability, but also a victory for global public health, with the demonstration that diverse groups throughout the world can work together towards a common goal. The successful conclusion of this initiative will have substantial implications for other public health initiatives, the strengthening of national health services and the credibility of national and international organizations.

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