Global Polio Eradication Initiative Strategic Plan, 2004

Since the 1988 World Health Assembly resolution to eradicate poliomyelitis, the number of polio-endemic countries has decreased from 125 in 1988 to six in 2003 (i.e., Afghanistan, Egypt, India, Niger, Nigeria, and Pakistan), and the number of cases reported worldwide has decreased from approximately 350,000 to 682. In 2003, approximately 90% of cases were reported from Nigeria (305), India (220), and Pakistan (99); epidemiologic and virologic data demonstrated focal endemic transmission in Afghanistan and Niger, with repeated importations from Pakistan and Nigeria, respectively, and localized transmission in Egypt. On January 15, 2004, the World Health Organization (WHO) released an updated Global Polio Eradication Initiative Strategic Plan outlining activities required to 1) interrupt poliovirus transmission globally, 2) achieve global certification of polio eradication, and 3) prepare for global cessation of childhood vaccination with oral poliovirus vaccine (OPV). The discontinuation of mass vaccination campaigns in the majority of polio-free countries has left these areas vulnerable to importations of wild poliovirus (WPV) from the remaining countries in which polio is endemic. For polio to be eradicated, all remaining poliovirus reservoirs must be eliminated.