Global poliomyelitis eradication
- John F Modlin, MD
John F Modlin, MD
- Deputy Director, Polio Research
- Global Development
- Bill and Melinda Gates Foundation
Given the availability of an inexpensive oral polio vaccine (OPV) and the success of the Pan American Health Organization polio eradication program in the Americas, the World Health Assembly resolved in 1988 to eradicate polio globally by the year 2000 . This goal proved more challenging than originally foreseen, and important obstacles remain; these obstacles include poor access to children in remaining endemic areas due to insecurity and co-circulation of oral poliovirus vaccine-derived polioviruses (cVDPV). Nonetheless, great progress has been made: the incidence of paralytic polio worldwide has been reduced by more than 1000-fold, two of the three naturally occurring (wild-type) poliovirus serotypes no longer circulate, and type 1 poliovirus disease is now confined to only two countries, Pakistan and Afghanistan .
The Global Poliomyelitis Eradication Initiative (GPEI) expects to interrupt transmission of all wild-type and cVDPV viruses by 2017, introduce inactivated poliovirus vaccine (IPV) into the routine infant immunization schedule in all countries, and phase out of OPV use in a staged manner to reduce the risk of new cVDPV outbreaks following complete interruption [3,4].
Issues related to polio eradication are reviewed here. Issues related to polio infection and routine polio vaccination are discussed separately. (See "Polio and infectious diseases of the anterior horn" and "Poliovirus vaccination".)
GLOBAL ERADICATION PARTNERSHIP
The Global Polio Eradication Initiative partnership was launched in 1988 and is led by five organizations: the World Health Organization, the United States Centers for Disease Control and Prevention, the United Nations Children's Fund, Rotary International, and the Bill and Melinda Gates Foundation. The partnership includes many governmental and nongovernmental donors as well as the ministries of health of all affected nations who plan and carry out the program's initiatives, at an overall cost that exceeds $1 billion per year.
The global eradication program is based on four strategies: routine infant immunization, supplementary immunization activities (SIAs) in at-risk middle- and low-income countries, surveillance for acute flaccid paralysis (AFP), and mop-up campaigns .To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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