Science, Lancet articles examine efforts to eradicate polio

In a series of "News Focus" articles in Science, the magazine examines the global effort to eradicate polio. One article examines the Global Polio Eradication Initiative (GPEI) -- a partnership of the WHO, Rotary International, UNICEF, the CDC, and the Bill & Melinda Gates Foundation -- and recent reports on the program by an Independent Monitoring Board (IMB), "an oversight body" that provides feedback and guidance. A second and third article look at efforts to vaccinate children against polio in Pakistan, which "is the perfect case study for why it is so hard to eradicate poliovirus from its last few strongholds -- and what it might take to pull it off." The WHO's Chris Maher "and others attribute the explosion of cases last year to a perfect storm of all the problems that are Pakistan: poverty and illiteracy; a health system in tatters; ethnic and sectarian violence; a government struggling to deal with corruption and dysfunction; huge population movements; and, especially since 9/11, rising extremism and anti-Western views -- not to mention the natural attrition that accompanies any program that has dragged on for so long," according to Science (Roberts, 8/3).

In related news, the Lancet examines how the GPEI, "after 23 grueling years and two failed attempts, is making another high-stakes swing at the eradication of polio." According to the article, "[O]n the face of it, the program's target to stop the transmission of wild poliovirus by the end of 2013 seems tantalizingly achievable. As a result of impressive gains made by the program in recent years, polio is at an all-time low." It continues, "But look a little deeper and the cracks start to appear. The three remaining polio-endemic countries have had 95 cases between them this year ... And intensified efforts of late in these three endemic countries have failed to make the substantial impacts on disease prevalence seen in other countries. Add to this a funding deficit of about $1 billion, which has led to the scaling-back of supplementary polio immunization campaigns in neighboring countries, leaving them vulnerable to explosive re-invasions of the disease" (Mohammadi, 8/4).