More than 400 eminent scientists from around the world have lent their support to a new initiative to eradicate polio in the next five years.
Experts from more than 80 countries have launched the Scientific Declaration on Polio Eradication which states that "an end to the paralysing disease is achievable and endorsing a comprehensive new strategy to secure a lasting polio-free world by 2018". Polio cases are at an all-time low and just 223 new cases due to wild poliovirus were recorded in 2012.
Just 16 cases in 2013
This is down from 350,000 cases in 1988 and only 16 new cases have been reported so far this year as of April 9. India, long-regarded as the most difficult place to eliminate polio, has not recorded a case in more than two years and the disease remains endemic in just three countries - Afghanistan, Nigeria and Pakistan.
Given this scenario, a plan developed by the Global Polio Eradication Initiative (GPEI) estimates that ending the disease entirely by 2018 can be achieved for about $5.5 billion. It looks to address challenges that have posed obstacles to polio eradication in the past, including improving immunisation campaign quality to reach missed children and eliminating rare polio cases originated by the oral polio vaccine. The GPEI plan comes with a timetable to phase out use of oral polio vaccines and introduce inactivated polio vaccines and a call to vaccine manufacturers to provide an affordable supply.
Helen Rees of the Wits Reproductive Health and HIV Institute in South Africa, who signed the declaration, said that “as long as it exists anywhere in the world, polio threatens children everywhere". She added that by "pursuing in parallel all of the steps needed to reach eradication, including the switch to inactivated vaccines, countries have a complete path to eliminate polio’s threat". Emory University's Walter Orenstein claimed that "we have the tools we need and a time-limited opening to defeat polio. The GPEI plan is the comprehensive roadmap that, if followed, will get us there".
However, the declaration also notes recent attacks on health workers in the endemic countries and stresses the need to protect polio vaccination teams as they do their work. Staff have been murdered in Nigeria and Pakistan and in the latter this week a police officer was shot dead while escorting a vaccination team.
One of the problem appears to be that the Taliban in Pakistan has accused the vaccination teams of being American spies and of sterilising children. Polio campaigns have struggled as a result of cultural mistrust among Muslims in the endemic countries and the GPEI plan includes a series of "risk-mitigation strategies for insecure areas, including deepening engagement with community and religious leaders".
David Heymann of the Chatham House Centre on Global Health Security said that "eradicating polio is no longer a question of technical or scientific feasibility. Rather, getting the most effective vaccines to children at risk requires stronger political and societal commitment".
He concluded by saying that “eliminating the last 1% of polio cases is an immense challenge, as is the eradication endgame after that. But by working together we can make history and leave the legacy of a polio-free world for future generations".