By the end of 2010, polio should have been stamped out in countries where there had been resurgence after elimination. It did not happen. Only two diseases have officially been eradicated in human history and only one that affects our species, smallpox. The hope was that by 2012 polio, an endemic that has even affected U.S. Presidents would be added to that list. However, there appears to be resurgence of the debilitator, and particularly in sections of Africa and Pakistan along with 12 other countries.
A knight from the United Kingdom, Sir Liam Donaldson, has released a special report this week regarding his concerns:
"The difficult and crucial challenge now is to assemble this new surge of staff into a coordinated functioning team with the utmost speed. Both these countries and 12 others where polio cases have been identified had stopped transmission for at least six months. Four countries have not yet succeeded in doing that in India, Nigeria, Afghanistan and Pakistan, polio is still endemic."
Donaldson, the UK's former chief medical officer who now chairs the independent monitoring board of the Global Polio Eradication Initiative, considers the continued transmission of polio to be "a global health emergency". Eradicating the disease, he said, "is still feasible but more urgency is needed to complete it. The plan to stop transmission by the end of 2012 is not on track."
"It is on a knife-edge. Success would be a terrific achievement. To eliminate only the second global epidemic disease [after smallpox] would be a tremendous public health triumph, but failure to do so would have enormous consequences. It is a disease that not only affects individuals and families but erodes economic prosperity in some of the countries affected."
The biggest concerns are for Chad and Democratic Republic of Congo, with 59 and 80 cases respectively this year.
"The milestone was conclusively missed and the program must be judged to have performed poorly in this regard. We are deeply concerned by the situation in DR Congo. The worrying picture revealed by vaccination and surveillance data is confirmed by observations of widespread dysfunction on the ground. Leadership from the highest level is key for polio eradication and we urge the active involvement of the president in this case. Without his active involvement, we cannot believe that the necessary step-change will occur to interrupt polio transmission in DR Congo."
The World Health Organization and UNICEF have sent in 100 extra staff to boost vaccination efforts to the region.
Pakistan is seeing cases on the rise, and the dismantling of a national ministry of health in favor of local control does not help the situation.
According to Donaldson:
"It still looks like it will be the last country to stop transmission, putting its neighbors and the global effort in jeopardy. The country needs to muster up relentless energy to really get to grips with the challenges of implementing its emergency action plan."
There has been some progress in several nations, but not enough to make the 2012 eradication mark.
Excellent progress has been made in India, where mass vaccination days involving more than a million volunteers brought down cases by 94% between 2009 and 2010, from 741 to 42. In the first six months of this year, there has been just one case.
In Afghanistan there is a diminishing of the disease in spite of difficulties caused by conflict. Nigeria also made excellent progress in 2010, but there has been a loss of momentum following elections.
Source: The Global Polio Eradication Initiative
Written by Sy Kraft