Submitted by Ellyn Ogden
USAID Worldwide Polio Eradication Coordinator

Today, representatives from partner countries, donors, non-governmental organizations and the private sector met on polio eradication. I represented USAID.

USAID is working closely with the United Nations (U.N) and partner countries to address this outbreak. The global polio eradication effort is at a critical point in time.  Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, the global number of polio cases has reduced by over 99 percent.  Now, polio is endemic in only four countries (India, Pakistan, Nigeria and Afghanistan) compared to 145 countries before the GPEI began.  Furthermore, GPEI’s efforts have mobilized 20 million volunteers around the world, staged mass immunization campaigns, and vaccinated about 2.5 billion children worldwide.  Cases in India and Nigeria are at their lowest ever – an indication that we can not let up on our efforts now.

Still, significant challenges remain. I just returned from an immunization effort in 34 districts of Tajikistan – a country in the midst of its first importation of wild poliovirus in 12 years and the first case in the WHO European Region since it was certified as polio free in 2002. As of September 15, 2010, there are 456 confirmed cases of polio, in Tajikistan – out of 648 total polio cases confirmed worldwide (compared to 1008 for the same time period in 2009). For each confirmed case, there are hundreds of silent infections.

While the outbreak in Tajikistan appears to have peaked, it is important to note that the outbreak is not over and continued immunization campaign and improved routine immunization are urgently necessary. Outbreak response in Tajikistan is continuing, and to minimize the risk and consequences of further international spread, National Immunization Days (NIDs) are being held in neighboring countries, including Uzbekistan, Turkmenistan, Kazakhstan and Kyrgyzstan. This week four additional cases of polio have been confirmed in the Russian Federation, bringing the total number of confirmed polio cases in Russia to 12.  The last four cases were confirmed in two regions of the North Caucasus, Chechnya (3 cases) and Dagestan (one case).  In response, the Ministry of Health and Social Development announced that they plan to launch two rounds of polio immunization campaigns in all regions of the Southern Federal District (which includes the North Caucasus) among children aged 1-5 years old in September, to be followed by nationwide polio immunization campaigns in October – April 2011. The open sharing of information about cases allows for a comprehensive and rapid response with the support of the international community and reduces the chance of further outbreaks.

To eradicate polio, we must eliminate the persistent reservoirs of this disease including insecurity, inconsistent management and ownership by local governments, sub-optimal communication and community mobilization, and reaching newborns, minority and mobile populations. Because of the need to frequently repeat campaigns, there is often a certain fatigue about seeing yet another vaccination team knocking at the door. Yet these proactive house-to-house campaigns are the only proven way to eliminate polio from a country. And with the world being so close to wiping out polio forever, we can’t afford to give up or to settle for “almost.”

The U.S. is the largest bilateral donor to the GPEI, contributing over $1.4 billion to date. Polio eradication is also a key part of the Administration’s Global Health Initiative (GHI). In 2009, President Obama announced a U.S. commitment to work with the Organization of the Islamic Conference (OIC) on polio eradication during his speech in Cairo in which he called for a new beginning between the United States and Muslims around the world. Read about USAID’s (PDF)approach to polio eradication. The new 2010-2012 GPEI Strategic Plan, recently endorsed by the World Health Assembly, requires a $2.6 billion budget through 2012, with a $1.3 billion funding gap.