Usually one reads about health emergencies when cases are increasing and at high levels but polio has been declared an emergency when cases are decreasing and at record low levels. What explains this ironic situation is that the global effort to eradicate polio from the world population is now down to only three endemic countries, and it is more important than ever to finish the job lest polio resurge as it has done in the recent past when success was within sight.

Leaders Speak

The WHO Director Margaret Chan has said “polio eradication is at a tipping point between success and failure,” and CDC Director Tom Frieden has remarked “We need everyone’s commitment and hard work to eradicate polio and cross the finish line. It won’t be easy, but together we can eradicate polio forever and for everyone.”

In January 2012 finishing the task of polio eradication was declared an emergency by the executive board of the WHO and this action was ratified by the entire World Health Assembly meeting in Geneva last month. A Global Emergency Action Plan 2012-2013 has been developed to assist the three remaining endemic countries –Afghanistan, Nigeria, and Pakistan –to significantly increase vaccination coverage by the end of 2012 to levels high enough to stop transmission shortly afterwards, and increased accountability and coordination at every level of government and within every partner agency. The CDC in the US is also treating the completion of polio eradication as a public health emergency and has activated its Emergency Operations Center as has UNICEF.

Big Victory In India

The most encouraging news in the polio effort of late was the success in interrupting transmission of polio in India in the twelve month period February 2011 to February 2012. This is the first time India has been polio free and, according to CDC, “India’s success proves the technical feasibility of global polio eradication and highlights potential solutions to address operational challenges in other countries.”

In an article in the Atlantic, Bruce Aylward, head epidemiologist of the WHO eradication program, said “if we finish polio eradication, what it will prove is that with a  relatively modest investment in the grand scheme of things, you can achieve real health outcomes.

Halo Effect

Success with polio eradication could have a halo effect on other important causes of morbidity and mortality at the global level, for example with the high burden of chronic diseases. As reported in the Atlantic, India’s prime minister has stated how success in polio has given his government the confidence to tackle other health issues, such as measles and malnutrition, and bolstered his plans to create new public health cadres to work for the prevention and control of disease.