Polio eradication is in sight.

The live oral polio vaccine introduced in the 196-s has essentially eliminated poliomyelitis from the US Canada Europe and the industrialized countries of the Pacific. WHOs Expanded Programme on Immunization (EPI) aims to eradicate poliomyelitis. Many people believe that polio is no longer a problem however paralytic polio is quite common in Africa. In 1991 and 1992 outbreaks occurred in polio free countries: Bulgaria the Netherlands and Jordan reminding us that polio continues to be risk to all countries. EPIs universal childhood immunization initiative achieved a poliomyelitis vaccination coverage if 84% of children born in 1990. Thus in 1991 there were just 127000 paralytic poliomyelitis cases. Nevertheless 1 case of poliomyelitis is undesirable. Eradication requires disease surveillance to rapidly detect every case and then immunization of people in the highest risk areas to stop transmission of the virus. Eradication of poliomyelitis will save more than US $100 million each year in the US for elimination of the need for vaccine purchases and for medical care. The last case of wild poliovirus-induced poliomyelitis in the Western Hemisphere was in August 1991 thanks to the eradication initiative strategies developed by the WHO Region of the Americas. UNICEF USAID and Rotary International are leaders of this Americas initiative for eradication of poliomyelitis. Between 1989 and 1991 eradication strategies have reduced reported polio cases by 58% in China. Polio-free zones exist in North Africa southern and eastern Africa the Middle East Europe and the Pacific Rim. India Pakistan and Bangladesh are a significant polio reservoir (they account for 66% of global cases). Major obstacles to the global eradication initiative in Europe Asia and Africa are war and political instability. Most of the funding for logistical support of the initiative comes from in-country resources yet lack of political will remains the major obstacle for the initiative.