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The polio endgame

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THE WORLD IS closer than ever to eradicating the polio virus. When the effort began in 1988, the disease was endemic in 125 countries, but now just three remain: Nigeria, Pakistan and Afghanistan. In recent months, there have been fewer cases in fewer districts of fewer countries than at any time in history. Margaret Chan, director-general of the World Health Organization (WHO), said recently that the battle against polio is at a “tipping point between success and failure.”

Polio is a highly infectious disease that affects the nervous system and can lead to paralysis. It largely strikes children 5 years old and younger, but there have been more cases involving adults in recent years, with higher lethality. Obliterated in the United States 30 years ago, polio has proved a stubborn foe elsewhere in the world. As recently as the 1980s, polio killed or paralyzed more than 350,000 children each year. But the eradication effort has come a long way. There were only 650 cases last year and only 73 so far this year.

The potential benefits of wiping out polio are improved lives for millions of children. Yet eradicating diseases is immensely difficult. So far, the campaign against smallpox stands as the only success. For years, there was concern that if the transmission of polio could not be halted in India, eradication would be impossible. But India has been free of polio since January 2011. Also, a more effective oral vaccine is targeting the two strains of the virus that are most prevalent.

On May 26, the 194 member states of the WHO declared polio eradication a “programmatic emergency.” The idea is to galvanize work in the remaining polio-infected areas of Nigeria, Pakistan and Afghanistan. All three nations suffered alarming spikes in cases last year, and the goal of delivering oral vaccine to every child is up against the formidable obstacles of war, corruption, weak public health systems and widespread migration. This appears to be another make-or-break moment.

A renewed campaign will be costly. The Global Polio Eradication Initiative, set up in 1988 by the WHO, UNICEF, the Centers for Disease Control and Prevention (CDC) and Rotary International, says that it needs an additional $945 million for a total budget of $2.19 billion this year and next. For the current fiscal year, the United States has boosted support to $151.1 million, up $17.6 million over last year. Rotary International has exceeded its goal to raise more than $200 million to match a $355 million challenge grant over several years from the Bill and Melinda Gates Foundation. The CDC has made polio a top priority; it put some 90 people to work on it every day in its emergency operations center. These examples and the urgency of the cause will hopefully inspire other donors around the world to fill the budget gap.

Stamping out polio is not a sure thing, but this may be the best chance in a generation. It should not be missed for lack of resources.

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