A plan to stop the transmission of polio by the end of next year looks set to fail, despite billions of dollars having been spent over the past decade to eradicate the disease.
Inadequate funding, weak political leadership and problems in national vaccination campaigns mean efforts to stop new infections by the end of 2012 were “not on track”, warned the Independent Monitoring Board of the Global Polio Eradication Initiative, a group of leading health specialists.
“If the question is asked ‘What will be done differently next month to completely transform progress against the stubborn persistence of active polio?’ there is no convincing answer,” it concluded, while adding “polio eradication is feasible and vital”.
Polio has no cure and can cause life-long disability. The findings will stoke further concerns over the global polio campaign established by the World Health Organisation in 1988 amid a wave of optimism following the eradication of smallpox. Campaigners originally hoped to eliminate the disease by 2000. To date, the campaign has cost $8bn.
Substantial progress had been made in the previous century, said Sir Liam Donaldson, the former UK chief medical officer who chairs the expert group. In 2000, there were six endemic countries and 1,000 annual cases, down from 125 endemic countries and 350,000 annual cases in 1988.
But, he said, there had been a “stalemate” since the turn of the millennium, with about 1,000 new cases reported each year since 2000. Spending on eradication campaigns had tripled from $300m to $900m in the same period.
Critics have argued that it will be difficult to eradicate polio and that the money would be better spent tackling other diseases. Some suggest it would be better to strengthen routine immunisation than to focus on eradication.
Others – including Bill Gates and Rotary, a long-standing funder – say that there is a risk of a sharp resurgence in infection if the campaign is stopped.
Sir Liam said there was as yet no plan to determine the case for broader use in developing countries of a more effective but expensive injected vaccine used in richer countries.
He said he did not know the full details of recent reports that the CIA had supported a partially completed vaccination programme in Pakistan as a way to help track Osama bin Laden ahead of his assassination last May, but cautioned that “anything that triggers resistance in the population is a big concern”.
Nearly $2bn is required to fund continued efforts for 2011-12, of which only two-thirds has been pledged. While praising progress in two endemic countries – India and Afghanistan – the report expressed concern about setbacks in Nigeria and Pakistan.
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