A child is marked to show she received the polio vaccine orally (in Nigeria) Photo: ACTION / Tom Maguire
Following successful pledging at the Rotary International Convention in June and ever diminishing cases of the disease worldwide, World Polio Day 2017, October 24, marked the remarkable progress the world has made since the establishment of the Global Polio Eradication Initiative (GPEI) in 1988, when more than 350,000 people suffered from the disease. It also served as reminder, that despite the successes, the work is not yet done and our attention, energy, and resources must continue to be directed toward this vaccine preventable disease until the world is truly polio free.
Full funding and political will are the two most important elements to ensure that this paralyzing disease does not return to previously polio-free countries and put children everywhere at risk. The re-emergence of polio in Nigeria’s conflict-affected north in 2016 showed how possible it is for the disease to show up in parts of the world thought to be free of it. Weak health systems, conditions of conflict and displacement among populations are conditions that could give rise to the spread of the disease.
Today, polio cases are endemic in only three countries—Pakistan, Afghanistan, and Nigeria—which means these countries have never stopped transmission of the disease. Last year (2016) saw the fewest cases ever reported worldwide—only 37 in the entire year. According to projections, failure to eradicate polio from these last remaining strongholds could result in as many as 200,000 new cases around the world every year within 10 years. In most countries, the global effort has resulted in greater capacity to address other infectious diseases through better surveillance and effective immunization systems. Ending polio would mean only the second deadly childhood disease to be eradicated; smallpox is the only one so far.
So far this year, Afghanistan has reported five new cases, Pakistan three, and Nigeria, none—more reasons for advocates to celebrate, while remaining cognizant of the goal to fully eradicate the disease, and that even one infected child anywhere in the world represents potential spread of the disease. Geographic isolation, poor public infrastructure, armed conflict, and cultural barriers are among the factors contributing to complete eradication of the disease where it continues to show up.
One of the deadliest childhood diseases, one in 200 infections leads to irreversible paralysis. Among those paralyzed, 5 to 10 percent die when their breathing muscles become immobilized. Because of the global effort to eradicate the disease, more than 16 million people have been saved from paralysis, one of the most lethal effect of the infection which mostly affects children under age five.
To completely eradicate polio from the globe, GPEI has sought funding from donors every three to five years to fund the next phase of its work during a replenishment. At the 2013 replenishment, GPEI secured commitment of US $5.5 billion, most which was specified for the 2013–2017 period. At the Rotary International Convention in Atlanta, Georgia, June 12, 2017, GPEI raised $1.2 billion to fund its operations through the eradication of polio and the critical three-year certification period following the world’s last polio case. ACTION applauds the continued support from policymakers around the globe who have demonstrated a strong, continuing commitment to end polio, without which eradication would certainly not be reached.
The goal of completely eradicating polio is consistent with ACTION’s effort to ensure that diseases of poverty, undernutrition and other barriers to health will less systematically prevent the world’s poorest people from achieving their potential. This means strong and consistent advocacy to ensure “increased investments and better policies, developed and sustained through the leadership of governments around the world in partnership with civil society, global institutions, and the private sector, and sustained by broad political will.”
The immense success of polio programs and eradication of polio will depend on continued immunization and surveillance systems currently funded by GPEI. ACTION’s new report on transition, Progress in Peril? The Changing Landscape of Global Health Financing, calls for greater coordination, planning, and analysis of the country-level impacts of transition during GPEI’s sunset, planned in the next three years as eradication is at hand. Launched on the sidelines of the United Nations General Assembly in September, ACTION’s report examines some of the risks posed by GPEI transition and provides a way forward to ensure that critical successes in global health are not reversed.