Report says notwithstanding the success in India, current stalemate is unsustainable

“It is now or never” for the global polio eradication programme, the Independent Monitoring Board that periodically evaluates the worldwide effort has warned.

Unless an emergency response produced quick results, the programme could “fail monumentally.” Notwithstanding the success in India, the current stalemate in polio eradication, with over $ 1 billion being spent annually to hold polio cases at low levels, was unsustainable, the Board pointed out in its latest report.

In April last, the Board called the need to interrupt polio transmission by the end of 2012 a “global health emergency.” Last month, the World Health Organisation's Executive Board took declared polio eradication a “programmatic emergency for global public health.” The World Health Assembly, WHO's apex governing body, will consider a similar resolution when it meets in May.

Reiterating its view that the Global Polio Eradication Initiative was not on track to meet the goal of stopping polio transmission by this year-end, the Board, meeting recently in London, noted that there were just two possible outcomes.

“Polio will be eradicated from the world, or it will not. The programme will succeed spectacularly or fail monumentally.” If the eradication effort did not succeed soon, funding for it would dry up and country workers risked becoming increasingly fatigued. “Failure would unleash the virus, paralysing hundreds of thousands of children. This prospect seems unthinkable,” the Board said.

Congratulating India on not having polio transmission for more than a year, the Board said this success showed that unswerving political commitment, outstanding public health leadership, clear lines of accountability, intolerance of weak performance and the systematic enforcement of best practice could stop polio. “Elsewhere in affected countries, programmes are falling short in most, if not all, of the areas where India has excelled.”

In sharp contrast, the other three countries where polio was still endemic — Pakistan, Afghanistan and Nigeria — each had more polio cases in 2011 than in 2010. Another three countries had persistent polio transmission.

The Board went out of its way to emphasise the importance of the “humble vaccinator.” Too many of these workers “are underrated, rarely thanked, frequently criticised, often under-paid, poorly motivated and weakly skilled.” It was the eradication programme's responsibility to value, train and inspire this immensely important group of people, arguably the most important in the programme.

Failure will unleash the virus, paralysing hundreds of thousands of children

Programme will succeed spectacularly or fail monumentally