Is Eradicating Polio a Good Idea?

PHILADELPHIA – Polio broke out in Central Asia this year, with 560 cases reported in Tajikistan. Cases have also been diagnosed in Russia and Uzbekistan, apparently transmitted by infected but asymptomatic people traveling from Tajikistan.

The Tajikistan outbreak is especially troubling, because the country had been certified by the World Health Organization as polio-free. Indeed, the drive to eradicate polio, as the Tajikistan tragedy shows, may be putting the entire world at risk. It makes no sense to talk about eradicating diseases like polio if a small outbreak in a remote part of the globe can rapidly spread and imperil billions.

That scenario is not merely hypothetical. The Western Hemisphere was certified as polio-free 20 years ago, but there were cases in Haiti and the Dominican Republic as recently as 2000. Four cases were reported in an Amish community in Minnesota in 2005, and many others have been reported in recent years in Angola, Nigeria, Uganda, Kenya, Benin, India, Nigeria, Somalia, Pakistan, Sudan, and elsewhere.

For many in the field of public health, the greatest triumph achieved by medicine in this century was the eradication of smallpox. This astounding accomplishment has played a key role in leading various national and international governments and organizations, including the WHO, Rotary International, and the Gates Foundation, to mount efforts to eradicate many other infectious diseases, such as measles, malaria, and polio.