05 February 2013


A recent editorial in lancet (381:1) succinctly summarizes the current situation in regard to the eradication of polio.  On Dec 31, 2012, the world misses the latest deadline for the WHO Polio Eradication Initiative.  The goal was to halt all wild poliovirus transmission by the end of 2012.  As the deadline approached there was some encouragement in that cases had dropped from 650 in 2011 to 215 cases in 2012.  Then the global effort to eradicate polio suffered some devastating setbacks.  In mid-December nine health workers were shot dead in Pakistan while going door to door to administer polio vaccine.  On Jan 1st, six Pakistani aid workers and a physician involved in the vaccine program were shot and killed.  Owing to increasing safety concerns the UN and the Pakistani Government were forced to discontinue their vaccination campaign.  Pakistan, along with Afghanistan and Nigeria now remain the last pockets of wild polio cases in the world.  Concerns are raised that the Taliban, who claim responsibility for the killings, will act similarly in Afghanistan and other parts of Pakistan.  Because of the continuing presence of wild polio virus in Pakistan, neighboring countries will also be placed at additional risk.  In 2011 a Pakistani traveling to China caused an outbreak there which caused 18 people to be paralyzed and one died of the disease.  The editorial concludes with the comment that   “To eradicate polio, the work that the brave polio health workers died for must be continued in 2013.  Furthermore, it is imperative not only to ensure immunization workers’ security, but also to address the determinants behind the shooting of polio health workers—i.e., to win the hearts of the public, to go beyond the “polio only” agenda, and to enhance polio vaccination’s integration into the routine health and immunization programme.
Submitted by Roger Boe, M.D.

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