Accountability Tools

Polio Accountability Tool

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The Polio Epidemic—Overview and History

Polio, once a global scourge, affected over 600,000 people a year before the development of an effective vaccine in 1955.1 Polio (poliomyelitis) is a highly contagious viral infection that spreads from person to person and affects the brain and spinal cord after infection. Polio is known worldwide for causing paralysis and sometimes death in its victims, who are most frequently children.

Building on early successes using the polio vaccine, the Global Polio Eradication Initiative (GPEI) was launched in 1988 to eradicate polio in all countries. At that time, over 350,000 cases still occurred annually in 125 countries.2  A public-private partnership consisting of five core partners, the World Health Organization (WHO), the US Centers for Disease Control and Prevention (CDC), Rotary International, the United Nations Children’s Fund (UNICEF), and the Bill and Melinda Gates Foundation, housed at WHO and working with partners globally, GPEI has worked tirelessly to ensure that no child suffer the paralysis or death for which polio is known – and the ultimate goal of eradication is now in sight.


Though there have been challenges, the tremendous efforts of GPEI with national governments, donors, civil society, and many other partners have paid off: in 2016 only 37 cases of wild polio virus were recorded globally.3 Without this effort, over 16 million people alive today would have been paralyzed.4 Since GPEI’s establishment, four regions have been certified by WHO as entirely polio-free: the Americas (certified in 1994), the Western Pacific (certified in 2000), Europe (in 2002), and South-East Asia (in 2014).5

Only three countries today remain polio endemic: Pakistan, Afghanistan, and Nigeria.  In order for these countries to be certified as being free, there must be no wild poliovirus transmission for at least three consecutive years. With fewer cases in 2016 than in any other year, the goal of polio eradication is increasingly in reach.

Needed: A Sustained Commitment from Donors

A sustained commitment to ending polio remains critical well after the elimination of transmission of wild poliovirus.  As the recent cases of wild poliovirus in Nigeria attest, the threat from polio remains.  Nigeria believed it had seen its last case of polio in 2014, but several new cases were discovered in Northern Nigeria in 2016, in an area of the country heavily impacted by fighting and attacks from Boko Haram. It should come as no great surprise that the world’s last remaining cases of wild polio occur in areas frequently beset by instability and violence. However, the numbers are dropping nonetheless. To finally eradicate polio, programs must continue in the three remaining endemic countries as well as in 60 countries considered to be at risk for outbreaks. Eradicating polio for good will require a strong and sustained commitment from donors in the face of setbacks and through the three-year waiting period between elimination of transmission and certified eradication.

Global Health Security

The money invested in GPEI has not only funded progress towards the eradication of polio, it has simultaneously helped build resilient health systems that can respond to other threats. As global health security takes center stage in an ever more closely connected world, polio eradication partners have demonstrated how investments in frontline health workers, community engagement, disease surveillance, and emergency/outbreak response infrastructure can prevent the next global epidemic.

The success of using polio assets, including trained polio vaccinators, to support other global health priority areas was perhaps best showcased during the 2014 Ebola outbreak in Lagos, Nigeria.  Polio vaccinators, trained in contact tracing and other epidemiological methods, rapidly traced people in Lagos who had come into contact with Ebola victims in that city — Africa’s most populous — and ensured that they were isolated to prevent the outbreak from spreading.  Through their rapid and effective efforts, Nigeria rapidly contained its Ebola outbreak.

The former director of the U.S Centers for Disease Control and Prevention, Dr. Tom Frieden, described the efforts of those in Nigeria who worked to contain Ebola as “an example for all the world.” Their success highlights the impact that polio programs have had in saving lives across a spectrum of diseases far wider than polio alone.

About the Polio Accountability Tool

The fight to eradicate polio is led by the Global Polio Eradication Initiative, and is supported by generous public and private donors. To fund this life-saving work, in 2013 GPEI hosted a replenishment in Abu Dhabi raising over $4 billion. In the Scorecard, ACTION analyzes donor performance in delivering on these pledges, and provides additional recommendations for pledges to GPEI in the June 2017 replenishment.

This scorecard lists a subset of GPEI donors. Contributions and funding captured here are those from national governments only. Additional funding from multilateral agencies, philanthropies, NGOs and private sector donors to GPEI, though not reflected on this tracker, are critical to reaching the end of polio.

ACTION's contribution recommendation was based on four factors: an analysis of the scale of the pledges made in 2013, in addition to three other criteria: a past history of pledging to GPEI, the past pledge as a percentage of total Official Development Assistance (ODA) levels, and an analysis of political feasibility of continued giving to polio eradication. To read about our methodology in full, please click here to access the full methodology and data table.