sharon sanders
Editor-in-Chief & President
The Lancet 2006; 368:732
DOI:10.1016/S0140-6736(06)69282-9
Polio eradication: what do we do now?
Chandrakant Lahariya
a, Jyoti Khandekar a and SK Pradhan a
The polio eradication programme has reached a critical juncture. Success was remarkable up to the year 2000, reducing the number of cases from hundreds of thousands to just a few hundred. However, for the past 5 years, the situation has not changed much.1 Number of cases have ranged from 483 to 1951 with no trend towards decline. In the first half of 2006, more cases were reported than in the same period the previous year.1 This year, nine countries have reported new cases, some of which have not had a case of polio since 2000. Most were imported.1
The Global Polio Eradication Initiative newsletter2 reports that it will take at least another year before polio is eradicated from Nigeria, which is currently thought to contain the last pocket of infection. All the eradication deadlines to date have been missed. This year, an average of 30 cases have been reported every week, and the rainy season in endemic countries, which is a high transmission period for the virus, is yet to arrive.1
It is 18 years since the WHO resolution on eradication,3 and after more than a decade of polio eradication campaigns in endemic countries, programme fatigue is a forgone conclusion. But we cannot afford to stop now. We need to make some important decisions to achieve eradication immediately, and the role of international experts is more significant now than ever before.
Experts in the affected countries need to meet more frequently, maybe on a weekly basis. Conventional strategies should be changed for a more area-specific approach, whereby the spread of the virus is contained locally. The world has seen the effectiveness of a rapid response in containing avian influenza. Every case of polio should be treated as an emergency. There is little justification for the large number of cases seen in a single locality such as Moradabad, India, or some pockets of Nigeria.
The threat from importation should spur debate among public-health experts about the feasibility of implementing compulsory polio vaccination in the affected areas and also for international travel, whereby a child younger than 5 years, coming from an affected country, is required to carry certification of at least four doses of polio vaccination.
Implementation of such strategies will be difficult, but that doesn't mean we shouldn't make the effort. After all, who doesn't want polio to disappear soon?
We declare that we have no conflict of interest.
<!--start simple-tail=-->References
1. WHO. Polio cases count 2006. Global polio eradication Initiative
http://www.polioeradication.org/content/general/casecou...
(accessed July 17, 2006).
2. Global Polio Eradication Initiative. Monthly situation report July 2006
http://www.polioeradication.org/content/general/PolioSi...
(accessed July 17, 2006).
3. WHO. Global eradication of polio by year 2000. Resolution WHA 41.28. Geneva: World Health Organization, 1988:.
Back to top
<!--end simple-tail-->Affiliations
a. Department of Community Medicine, Lady Hardinge Medical College, New Delhi 110001, India
DOI:10.1016/S0140-6736(06)69282-9
Polio eradication: what do we do now?
Chandrakant Lahariya
a, Jyoti Khandekar a and SK Pradhan aThe polio eradication programme has reached a critical juncture. Success was remarkable up to the year 2000, reducing the number of cases from hundreds of thousands to just a few hundred. However, for the past 5 years, the situation has not changed much.1 Number of cases have ranged from 483 to 1951 with no trend towards decline. In the first half of 2006, more cases were reported than in the same period the previous year.1 This year, nine countries have reported new cases, some of which have not had a case of polio since 2000. Most were imported.1
The Global Polio Eradication Initiative newsletter2 reports that it will take at least another year before polio is eradicated from Nigeria, which is currently thought to contain the last pocket of infection. All the eradication deadlines to date have been missed. This year, an average of 30 cases have been reported every week, and the rainy season in endemic countries, which is a high transmission period for the virus, is yet to arrive.1
It is 18 years since the WHO resolution on eradication,3 and after more than a decade of polio eradication campaigns in endemic countries, programme fatigue is a forgone conclusion. But we cannot afford to stop now. We need to make some important decisions to achieve eradication immediately, and the role of international experts is more significant now than ever before.
Experts in the affected countries need to meet more frequently, maybe on a weekly basis. Conventional strategies should be changed for a more area-specific approach, whereby the spread of the virus is contained locally. The world has seen the effectiveness of a rapid response in containing avian influenza. Every case of polio should be treated as an emergency. There is little justification for the large number of cases seen in a single locality such as Moradabad, India, or some pockets of Nigeria.
The threat from importation should spur debate among public-health experts about the feasibility of implementing compulsory polio vaccination in the affected areas and also for international travel, whereby a child younger than 5 years, coming from an affected country, is required to carry certification of at least four doses of polio vaccination.
Implementation of such strategies will be difficult, but that doesn't mean we shouldn't make the effort. After all, who doesn't want polio to disappear soon?
We declare that we have no conflict of interest.
<!--start simple-tail=-->References
1. WHO. Polio cases count 2006. Global polio eradication Initiative
http://www.polioeradication.org/content/general/casecou...
(accessed July 17, 2006).
2. Global Polio Eradication Initiative. Monthly situation report July 2006
http://www.polioeradication.org/content/general/PolioSi...
(accessed July 17, 2006).
3. WHO. Global eradication of polio by year 2000. Resolution WHA 41.28. Geneva: World Health Organization, 1988:.
Back to top
<!--end simple-tail-->Affiliations
a. Department of Community Medicine, Lady Hardinge Medical College, New Delhi 110001, India