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
World Health Assembly. Global eradication of poliomyelitis by
the year
2000. Geneva, Switzerland: World Health Organization, 1988;
resolution
no. 41.28.
CDC. Certification of poliomyelitis eradication -- the
Americas, 1994.
MMWR 1994; 43:720-2.
CDC. Progress toward global poliomyelitis eradication, 1996.
MMWR 1997;
46:579-84.
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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