New polio strategy builds on 99% drop in Nigeria cases but faces 50% funding shortfall

In Geneva this Friday, a broad range of stakeholders will formally launch the new Strategic Plan 2010-2012 for eradicating wild poliovirus.

Polio eradication sits at a critical juncture

Across Africa, 10 of the 15 previously polio-free countries re-infected in 2009 have successfully stopped their outbreaks. Key endemic countries are witnessing historic gains against the disease. Nowhere is progress more evident than Nigeria, where case numbers have plummeted by more than 99% - from 312 cases at this time last year, to three in 2010. In India, for the first time ever, the remaining endemic states of Bihar and Uttar Pradesh have not reported any wild poliovirus type 1 cases concurrently for more than six months.

Time to build upon gains already made in 2010

This meeting in Geneva is being held to build on the gains already made in 2010 and to galvanize new action on polio eradication. Last month, the World Health Assembly welcomed the new plan while expressing deep concern about the US$ 1.3 billion funding shortfall (out of a budget of US$ 2.6 billion) over the next three years. This financing shortfall is a serious risk to the eradication of polio - activities are already being cut back or postponed due to a lack of funds.

The Ministers of Health of Nigeria, Afghanistan, Angola and Senegal, among a number of other senior health ministry officials, existing and potential funders, vaccine manufacturers and key partner organizations will attend the meeting - co-hosted by WHO Director-General Margaret Chan and the new UNICEF Executive Director Tony Lake - to discuss the implementation, monitoring, economics and financing of the new plan.

WHO Director-General Dr Margaret Chan called on the international funding community to stand tall for polio eradication. "The next three years, and especially the next 12 months, are critical to the polio eradication initiative and, by extension, the entire international public health agenda."

Plan builds on major lessons learnt

The new plan builds on major lessons learnt to date, including findings from a major independent evaluation examining the remaining barriers to eradication. It introduces district- and area-specific strategies to target the ever-shrinking remaining reservoirs of poliovirus, exploits the game-changing bivalent oral polio vaccine to increase the impact of immunizations, and tackles health system weaknesses. The success of this plan now hinges on implementation of activities at field level and the provision of adequate financing.

Adequate resources needed to eradicate polio

Partners in the Global Polio Eradication Initiative are examining every possible option to seek fresh funding while managing existing cash flow to limit any threat to the immunization plan. The risk of not stopping polio in endemic countries was made clear when a large type-1 outbreak originally from India spread to Tajikistan early in 2010 where, to date, it has paralysed 239 children. Tajikistan had been polio-free since 1997. This highlights the urgency of capitalizing on recent gains made in the polio-endemic countries.

"Polio eradication remains an urgent priority for our foundation," said Tachi Yamada, president of global health at the Bill & Melinda Gates Foundation. "We call on donor governments to also prioritize polio as we seek to eliminate these last, most difficult cases."

"The complete eradication of polio is an absolute goal and it requires absolute commitment from us all," said UNICEF Executive Director Tony Lake.

"Rotary believes the new Strategic Plan provides the blueprint to achieving the goal of polio eradication," said Carl-Wilhelm Stenhammar, 2010-11 Chair, The Rotary Foundation. When Rotary initially launched the effort in 1985, 1 000 children were being paralyzed daily by polio across 125 countries each year. Rotary has since contributed more than US$900 million in that time, and the incidence of polio has fallen by more than 99%.

Global Polio Eradication Initiative

The Global Polio Eradication Initiative (GPEI) is spearheaded by national governments, WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF. Since 1988 (the year the GPEI was launched), the incidence of polio has been reduced by more than 99%. In 1988, more than 350 000 children were paralyzed each year in more than 125 endemic countries. In 2009, 1 595 children were paralyzed in 24 countries. Only four countries remain endemic: Afghanistan, India, Nigeria, and Pakistan.