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One Thousand Days Until the Target Date for Global Poliomyelitis Eradication

On April 6, only 1000 days will remain until the end of 2000, the target date established by the World Health Assembly in 1988 for the eradication of poliomyelitis (1) and included as a year 2000 goal by the World Summit for Children in 1990. Progress toward this goal has included elimination of endemic polio from the Western Hemisphere in 1991 (2) and apparent elimination of endemic transmission in 1997 from both the Western Pacific and European (except Turkey and Tajikistan) regions of the World Health Organization (WHO). In addition, globally, reported polio cases have decreased greater than 90% since 1988. These accomplishments underscore the feasibility of global eradication (3). All countries with endemic polio, except for Democratic Republic of Congo, Liberia, Sierra Leone, and Somalia, have conducted National Immunization Days *, one of the key strategies advocated by WHO to achieve polio eradication (4).

Despite this progress, many challenges remain. To accomplish the goal of eradication by the target date, polio eradication strategies ** must be accelerated in all countries with endemic polio, especially in areas experiencing civil unrest or war. In particular, adequate surveillance must be established, and funding for eradication activities must be increased by external partner organizations, especially for the poorest countries. Support will need to be sustained through 2005, when global certification is anticipated.

The global partnership working to achieve polio eradication includes governments of countries with current or recent endemic polio, WHO, United Nations Children's Fund (UNICEF), Rotary International, and the governments of Australia, Canada, Denmark, Japan, United Kingdom, and the United States. Enhanced efforts are needed by this partnership to achieve a polio-free world by the beginning of the 21st century.

Reported by: Global Program for Vaccines and Immunization, World Health Organization, Geneva, Switzerland. United Nations Children's Fund, New York. Respiratory and Enteric Viruses Br, National Center for Infectious Diseases; Vaccine-Preventable Disease Eradication Div, National Immunization Program, CDC.

References

  1. World Health Assembly. Global eradication of poliomyelitis by the year 2000. Geneva, Switzerland: World Health Organization, 1988; resolution no. 41.28.

  2. CDC. Certification of poliomyelitis eradication -- the Americas, 1994. MMWR 1994; 43:720-2.

  3. CDC. Progress toward global poliomyelitis eradication, 1996. MMWR 1997; 46:579-84.

  4. Hull HF, Ward NA, Hull BP, de Quadros C. Paralytic poliomyelitis: seasoned strategies, disappearing disease. Lancet 1994;343:1331-7.

* Mass campaigns over a short period (days to weeks) during which two doses of oral poliovirus vaccine are administered to all children in the target age group (usually 0-4 years) regardless of previous vaccination history, with an interval of 4-6 weeks between doses. 

** WHO recommends the following four strategies: 1) achieving and maintaining high routine vaccination coverage, 2) providing supplemental vaccination during National Immunization Days to interrupt widespread circulation of poliovirus, 3) establishing sensitive systems for epidemiologic and virologic surveillance, and 4) conducting mopping-up operations to eliminate the last remaining foci of poliovirus transmission.


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