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The Politics of Polio Eradication

The barriers to polio eradication are no longer medical; the disease does not occur where vaccination programs operate unhindered. Successful immunization campaigns must secure the support of de facto political leaders – whether of an internationally recognized state or a of vilified militant organization.

CAMBRIDGE – A few years ago, the global campaign to eradicate polio seemed to have stalled. After decades of eradication efforts, the virus remained stubbornly endemic in Pakistan, Afghanistan, and Nigeria. Then, in 2013 and 2014, it was found to have returned to seven previously polio-free countries in Africa and the Middle East, prompting the World Health Organization to declare the disease’s resurgence a “public-health emergency of international concern.”

Despite this recidivism, the world today is closer than ever to eradicating polio. In 2015, there were just 74 new cases of the disease – 80% fewer than the previous year and the lowest annual total ever. And all of the cases were concentrated in just two countries, 54 in Pakistan and 20 in Afghanistan. Moreover, it has been eighteen months since the virus was last detected in Africa.

The reasons behind this remarkable turnaround are instructive, illustrating the challenges facing public-health workers and the best ways to overcome them.