Current status of the global eradication of poliomyelitis.

Substantial progress towards the global eradication of poliomyelitis by the year 2000 has been achieved since May 1988 when WHO Member States adopted this goal at the Forty-first World Health Assembly. Virtually all polio-endemic countries have begun to implement the WHO-recommended strategies to eradicate polio and it is expected that, by the end of 1997, all endemic countries in the world will have conducted full National Immunization Days (NID), providing supplemental oral polio vaccine (OPV) to nearly two-thirds of all children < 5 years. In contrast, although globally acute flaccid paralysis (AFP) surveillance was being conducted in 126 (86%) of 146 countries where polio is or recently was endemic, surveillance remains incomplete and untimely. A global network of polio laboratories, capable of detecting wild poliovirus when and where it occurs, has been developed. Furthermore, in countries where polio virus circulation has been limited to focal areas, and surveillance is adequate, mopping-up campaigns are being conducted to eliminate the final chains of transmission. The process for certification of polio eradication has been established in each WHO region as well as at the global level. The impact of the eradication initiative is evident, with an 88% decrease in the number of reported cases globally since 1988. In order to achieve the goal of eradication, the rapid development of complete and timely AFP surveillance and the continuation of effective NIDs constitute an urgent priority. This is of particular relevance in the remaining polio-endemic countries, especially in those that are affected by war or politically isolated and are important remaining reservoirs from where wild poliovirus continues to spread into bordering or even distant polio-free countries. External support will continue to be required by those countries and regions where the incidence of polio has reached low levels to ensure that final chains of poliovirus transmission are interrupted and to permit the eventual certification of eradication. The year 2000 objective for achieving poliomyelitis eradication remains a feasible target.