UN announces global polio immunization shift to target endemic countries

United Nations agencies today announced an “unprecedented tactical shift” in the global polio eradication campaign, the world’s largest public health initiative, to focus resources on the seven remaining polio-endemic countries and six others considered at high risk of re-infection.

If the campaign is successful, the highly infectious viral disease – which mainly affects children under five and can lead to paralysis within five days – will be the first to be eradicated in the 21st century, and only the second ever after smallpox in 1979.

Only seven countries remain endemic – India, Nigeria, Pakistan, Egypt, Afghanistan, Niger and Somalia – with 99 per cent of all polio cases concentrated in just the first three. Six others are considered at high risk if re-infection – Angola, Bangladesh, the Democratic Republic of the Congo, Ethiopia, Nepal and the Sudan.

“Until we stop transmission of the poliovirus in the seven remaining infected countries, children everywhere will remain at risk of contracting this disease,” the Director-General of the UN World Health Organization (WHO), Gro Harlem Brundtland said in a statement. “Concentrating our resources on these strategic countries is crucial to root out and extinguish the remaining reservoirs of wild poliovirus.”

The new tactic was finalized and adopted yesterday in Geneva by the Technical Consultative Group on the Global Eradication of Poliomyelitis, an initiative spearheaded by WHO, Rotary International, the United States Centres for Disease Control and Prevention (CDC) and the UN Children’s Fund (UNICEF).

It will shift 297 million additional doses of oral vaccine into the new target zone, along with an additional $35 million, with 51 immunization campaigns in 2003. Campaigns will be revised in 93 countries where transmission has already been stopped in order to commit more resources to target countries. New campaigns will be conducted only as an emergency response to importation of the disease. By comparison, the 93 countries held 266 campaigns in 2002.

“Basically we’re tightening the noose,” UNICEF Executive Director Carol Bellamy said in a statement. “Unfortunately, the funding needed to finish the job is extremely tight, too.” She added that at the end of 2002, an additional $275 million was needed to finish the job by 2005, with $33 million urgently required for 2003 alone. “We need that money to make sure this new tactic is fully implemented, and we need it now,” she said.

Public health experts point to the dire consequences if the eradication initiative falters now. Failure to eradicate polio would result in the resources invested being wasted, including over $2 billion and the work of 20 million volunteers worldwide. International confidence in future global public health initiatives would be compromised and the number of annual polio cases would drastically increase.

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