Polio: Challenge and Opportunity

The Challenge

In most of the world, polio is only mentioned in the context of an important vaccine; it has been eliminated from Europe, the United States and most of the Northern Hemisphere for a long time. Yet, many children still get this disease and suffer from the debilitating effects of polio.

Polio, poliomyelitis, is a highly infectious disease caused by a virus that enters the blood stream and invades the central nervous system. Infections can lead to irreversible paralysis, generally in the legs. Children who survive polio can often spend the rest of their lives dealing with severe disability.

The poliovirus lives only in humans and is spread through the feces of someone who is infected. It can be transmitted through water, food, or through contact with someone carrying the virus.

In areas with poor sanitation and limited immunization programs, vulnerable populations are particularly susceptible to the virus. Pregnant women, young children, and those with weakened immune systems are at the greatest risk of contracting poliovirus. All ages are vulnerable, but young children are particularly disadvantaged; over 50% of all cases are among children under three.

Despite progress in controlling polio in most countries around the world, re-infection is still a constant threat until global eradication has been achieved. There are currently four countries that remain polio endemic: Afghanistan, India, Nigeria, and Pakistan. However, Chad and countries in Western Africa have recently experienced a resurgence of polio cases in long-uninfected areas, representing a setback in polio eradication. The WHO noted that the number of countries with polio outbreaks following wild poliovirus importations has increased from 13 to 19 in 2009. The last mile to eradicating polio is doing so in the four endemic countries and preventing its spread to other countries; this is proving difficult, but it can be done.

The Opportunity

The elimination of polio could be the next big success in global health, following the eradication of smallpox in 1977, and the significant global reductions in Guinea worm, hepatitis B, measles, and neonatal tetanus. In 1988, there were 125 polio-endemic countries, now there are just three.

While there is no cure for polio, the polio vaccine, given multiple times, is highly effective and can protect a child for life. Innovative techniques are helping to get children vaccinated, like sending text messages to Zambian parents, encouraging them to bring their children to the nearest clinic for free polio vaccinations.

Polio used to cripple thousands of children in industrialized countries, but the introduction of effective vaccines in the late 1950s and early 1960s brought polio under control, and it was virtually eliminated as a public health threat in industrialized countries. In the 1970s, polio was found to be a significant problem in developing countries and national immunization programs were introduced around the world.

The Global Polio Eradication Initiative, led by the World Health Organization, Rotary International, the U.S. Centers for Disease Control and Prevention, and UNICEF, was launched in 1988 to end the disease. Due to global eradication efforts, polio cases have decreased by over 99 percent since its launch, from 350,000 cases in 1988 to fewer than 650 cases in 2011. In the same timeframe, 2.5 billion children around the world have been immunized against polio.

Nigeria, one of the last endemic countries, has recently conducted nationwide polio supplementary immunization activities in response to a large polio outbreak in its northern states. The Nigerian government has also approved funding for the next three fiscal years for a project intended to achieve the goal of zero polio transmission and WHO polio free certification.

A concentrated global effort is needed to wipe out the last vestiges of this disease, in every country.