A closer look at the current plan shows, once again, that the remaining bottlenecks tend to be financial, political and sociological as opposed to technological. The few scattered areas where naturally occurring poliovirus still cripples young people tend to be, practically by definition, some of the poorest, most chaotic environments imaginable.
“What’s new [in the 2013-2018 plan] is that this is a coordinated action to interrupt virus transmission,” Stephen Cochi of the U.S. Centers for Disease Control and Prevention said at the journalists’ briefing. Focusing sustained effort on the three remaining endemic countries all at once offers the best chance of ensuring that none of them can rekindle polio’s spread to nearby areas and the rest of the world.
Polio still occurs naturally in tribal regions of northern Pakistan, the northern part of Nigeria and sections of eastern and southwestern Afghanistan. Progress in these areas has been maddeningly uneven at times. The number of polio cases in Nigeria, for example, fell from 798 in 2008 to 62 in 2011 before climbing to 122 last year.
In addition to regular polio campaigns in the more stable areas of Pakistan, for example, health workers focus a lot of attention on travelers and border towns adjacent to insecure areas. And many people living in North Waziristan in Pakistan (where militants have banned polio campaigns and an estimated 240,000 children have not been vaccinated since mid-2012) have traveled 160 kilometers or so outside the tribal area to have their children vaccinated.
Islamic religious leaders are also playing an increasingly prominent role in promoting both vaccination and, ultimately, eradication of polio. A meeting of Muslim scholars from several countries in Cairo earlier this year reaffirmed the importance of polio vaccination for children of the Muslim community, or Ummah. “Crippled children lead to a crippled Muslim Ummah,” Ahmad al-Tayyeb, the Grand Imam of Al-Azhar and one of the most highly respected authorities in Sunni Islamic thought, warned.
Just as important, various polio campaigns in different countries have stepped up their outreach to local communities to find ways that the vaccination program can dovetail with other public health needs. In many areas, for example, polio workers are now also teaching young mothers about the benefits of breast-feeding and spreading the word about good nutrition, hand washing and effective treatments for diarrhea.
Given the nature of infectious diseases and their ability to pop up unexpectedly, the world may never have a better shot at eradicating polio than it has this year. One last coordinated and well-financed effort might just do the trick. And then, perhaps, we can start talking about eliminating measles, which kills about 150,000 children around the world each year.