David Salisbury: Polio - a scourge that should be wiped out

If India can stop the spread, why has it not been eliminated everywhere?
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The Independent Online

The UK is privileged to be among nations for whom polio is a distant memory. There are now two generations for whom polio has not been a threat because of the universal availability of routine vaccination. In other parts of the world, there are too many reminders of the devastation of polio in paralysed children and young adults.

Last year, poliovirus from India was imported to Tajikistan where it caused an outbreak of close to 500 paralytic cases and 30 deaths. It spread to neighbouring countries and the outbreak was only stopped by the application of mass vaccination campaigns. After 10 years with no polio in the whole of the European region, its polio-free status was compromised. The human and financial cost was huge.

Here was a stark reminder that until we eradicate it, polio will continue crippling children around the world. Half of the 2011 cases worldwide have come from two countries, Pakistan and Chad, with cases continuing to be reported from other sub-Saharan countries.

Several key developments are giving encouragement. Since 1988 polio cases have been reduced by 99 per cent, from 350,000 cases to less than 1,500 in 2010. In addition, India reported only one case this year thanks to excellent surveillance that would detect the disease if it were circulating. A previous exporter of polio, India has done an outstanding job. But if India can stop the spread of polio, why hasn't it been eliminated everywhere?

We are facing a time-limited opportunity to defeat this disease finally, an opportunity which could be jeopardised if we continue with business as usual. We cannot defeat this disease unless the global community devotes the necessary time, attention and resources. Pakistan, one of the last outposts of polio, has seen 111 cases this year, a 42 per cent increase in cases since this time last year. Globally we need political will, much-improved polio vaccination campaigns and better surveillance systems. With any weaknesses in these areas we will fail to eradicate this disease – with the risk that we will be back to where we were 20 years ago.

This weekend, the Commonwealth Heads of Government Meeting in Australia will bring the UK together with other countries that have played important roles in the polio eradication effort. Despite a doubling of the UK's contribution and the contributions of other partners, £338m is still needed to sustain eradication efforts through 2012. To eradicate polio, we need more money, leadership and committed supporters. Polio eradication is a noble and achievable goal, and one we cannot give up on now. We need to finish the job once and for all.

Professor David Salisbury is the UK's Director for Immunisation and World Health Organisation chair of the European Certification Commission for Polio Eradication