The Global Polio Eradication Initiative aimed to stop global polio transmission by the end of 2012. It is now certain to fail. That said, there has been substantial progress this year. There have been 175 polio cases worldwide so far in 2012: half the number of 2011, and less than 0.1% of the 350,000 cases in 1988 (the year when the GPEI began). Just 0.2% of the Earth’s land surface area is now infected with polio. The end of 2012 will not bring the end of polio, but we may now be seeing the polio virus make its last stand.
India has been removed from the list of polio endemic countries: a great achievement in the history of global public health. Angola and DR Congo have not had a polio case for over 10 months. Chad has reported only five cases this year. All four remain vulnerable to future polio importations and outbreaks: surveillance must be sensitive, and immunisation coverage high.
The Programme in Pakistan has improved significantly: less than half the number of polio cases this year than last. This trajectory of improvement must continue. The potential disruption of upcoming elections is of grave concern.
Afghanistan has recovered from a spike in polio cases in 2011 but has a lot more work to do. The rate of improvement is slow. The basic management challenges are clear. The solutions are written down, but need more speedy implementation.Nigeria has hosted over half the world’s polio cases this year. It has reported more than twice as many cases in 2012 as it did in 2011. Cases are concentrated in a small number of Local Government Areas (LGAs). The power to eradicate polio from Nigeria now rests particularly with LGA Chairmen and Traditional Leaders. National & State Government, and GPEI Partners, must do everything to support them. There are green shoots suggesting that Nigeria’s Polio Programme is improving. These need rapidly to bloom, otherwise Nigeria will reinfect other countries as it has done before.