Executive summary below; full text is at:
1. Every country with persistent polio transmission, with
the exception of India and Angola,
has had more cases so far in 2011 than they had by the same time last year. Chad, Afghanistan and DR Congo have
already exceeded their entire 2010 total.
2. The rate of occurrence of new outbreaks serves as an
ongoing reminder that many countries in the world are under threat from the
ease with which polio could be imported across their borders.
3. The 2010-12 Strategic Plan set out four intermediate
milestones. Just two are on track. One is highly unlikely to be attained within
the planned timeframe. One has missed its deadline and remains elusive.
4. The GPEI is not on track to interrupt polio transmission
by the end of 2012 as it planned to. Indeed, unless the fundamental problems
highlighted in this report can be addressed, there is a substantial risk that
stopping transmission will take far longer than the 15 months that remain
between now and the end of 2012.
5. Polio eradication could still be achieved by the end of
2012 if the weaknesses of the Program at both country and global level can be
swiftly corrected, and if political commitment and financial support for the
GPEI can be bolstered.
6. This report assesses progress in each of the countries
with persistent transmission. With the exception of India, none of the endemic
countries is making progress at the rate it needs to:
• India has a good chance of
interrupting transmission this year
• Afghanistan’s program is strongly
managed and innovative, but is still unable to reach one-third of children in
13 high-risk districts
• Nigeria has slipped back on
progress made in 2010; it needs to demonstrably regain the commitment of
political and traditional leaders
• Pakistan has made little tangible
advance over the last 18 months; a fundamental strategy review is needed.
7. Having missed their end-2010 goal, the three countries
with re-established transmission are now showing some progress, though the end
is not in sight for any of them yet:
is making good progress, but Luanda
remains a real vulnerability
• Chad now has the technical capacity
that it desperately needed, and must now deploy this to good effect
• Indicators in DR Congo remain
off-target but are moving in the right direction; the potential for election-related
disruption is of great concern.
8. The surprises of unexpected outbreaks continue to undermine
confidence in the Program. China
had been free of polio for a decade until its current outbreak. The detection
of a case in Kenya is
particularly alarming, because it represents a failure to deal with
long-standing transmission between Kenya
since 2009. The Horn of Africa remains at particular risk of further outbreaks.
9. In addition to our country-specific findings, we describe
five problems that run as common threads through the global Program, reducing
its chances of success. They relate to culture and approach. Tackling each will
require challenging introspection for the Program, but will produce great
gains. The style and approach to management of the global Program needs
10. Our view remains that polio eradication needs to be
treated as a global health emergency. It needs more funding, and broader, more
engaged global political commitment – particularly from non-affected countries.
The challenge remains great, but the other option is to
allow this terrible disease to resurge.