The world's success in eradicating polio now depends on four countries - Afghanistan, India, Nigeria, and Pakistan - according to the Advisory Committee on Polio Eradication (ACPE), the independent oversight body of the eradication effort.
With a targeted vaccine and faster ways of tracking the virus, most countries that recently suffered outbreaks are again polio-free. In parts of the four endemic countries, however, there is a persistent failure to vaccinate all children, and polio-free countries are considering new measures to help protect themselves from future outbreaks.
"With a more effective monovalent vaccine and accelerated lab processes for identifying poliovirus, these countries have the best tools we've ever had," noted Dr Stephen Cochi, Chair of the ACPE and Senior Adviser to the Director of the Global Immunization Division at the US Centers for Disease Control and Prevention.. "Eradicating polio is no longer a technical issue alone. Success is now more a question of the political will to ensure effective administration at all levels so that all children get vaccine." As an illustration, the office of Afghan President Hamid Karzai has already taken direct oversight of polio vaccinations, following the sharp increase in cases in the Southern Region of Afghanistan,.
Given that all children paralysed by polio in the world this year were infected by virus originating in one of the four endemic countries, polio-free countries are now taking new measures to protect themselves. The Ministry of Health of Saudi Arabia, for example, will be enforcing stringent polio immunization requirements for the upcoming pilgrimage to Mecca.