Despite the dramatic drop in polio cases in the last year, the threat of continued transmission due to funding and immunisation gaps has driven the Global Polio Eradication Initiative (GPEI) to launch an Emergency Action Plan.

The plan aims to boost vaccination coverage in Nigeria, Pakistan and Afghanistan, the three remaining polio endemic countries, to levels needed to stop polio transmission.  In parallel, health ministers meeting at the World Health Assembly this week are considering a resolution to declare “the completion of polio eradication to be a programmatic emergency for global public health,” in an acknowledgement of the urgency of the situation.

Polio eradication activities resulted in several landmark successes in 2010-2012.  India, long regarded as the nation facing the greatest challenges to eradication, was removed from the list of polio-endemic countries in February 2012.  Outbreaks in previously polio-free countries were nearly all stopped.

Although the number of polio cases was lower in the first four months of this year than during the same period in any other year, cases continue to occur in Nigeria, Pakistan, Afghanistan, and Chad. Outbreaks in recent years in China and West Africa due to importations from Pakistan and Nigeria, respectively, highlight the continued threat of resurgence.  By some estimates, failure to eradicate polio could lead within a decade to as many as 200 000 paralysed children a year worldwide.

“Polio eradication is at a tipping point between success and failure,” says Dr Margaret Chan, director-general of the World Health Organisation. “We are in emergency mode to tip it towards success – working faster and better, focusing on the areas where children are most vulnerable.”

Once achieved, polio eradication would generate net benefits of $40-billion to $50-billion globally by 2035, with the bulk of savings in the poorest countries, calculated based on investments made since the Global Polio Eradication Initiative (GPEI) was formed and savings from reduced treatment costs and gains in productivity.

“We know polio can be eradicated, and our success in India proves it,” says Kalyan Banerjee, president of Rotary International, a global humanitarian service organisation.  “It is now a question of political and societal will. Do we choose to deliver a polio-free world to future generations, or do we choose to allow 55 cases this year to turn into 200 000 children paralysed for life, every single year?”

Already, funding shortages have forced the GPEI to cancel or scale-back critical vaccination activities in 24 high-risk countries.  This leaves more children vulnerable to contracting the disease, and exposes polio-free countries to the risk of re-emergence.

“All our efforts are at risk until all children are fully immunised against polio – and that means fully funding the global eradication effort and reaching the children we have not yet reached,” says UNICEF executive director Anthony Lake.  “We have come so far in the battle against this crippling disease.  We can now make history – or later be condemned by history for failing.”