Drive to end polio delayed by distrust of vaccine advice

A series of setbacks, including local hostility towards government-sponsored officials, is hampering the last push to eradicate polio from the world, health officials said yesterday.

No further outbreaks of the crippling virus must occur next year if the international community is to achieve its target of total eradication by 2005, they said.

Nevertheless, a 98 per cent decline in the number of children suffering from polio over the past 14 years has demonstrated the overwhelming success of the global vaccine initiative run by the World Health Organisation (WHO) and Unicef.

Gro Harlem Brundtland, director general of the WHO, appealed to all countries to help end the cycle of viral transmission, which is still preventing the elimination of one of the most vicious childhood scourges.

"When we began the eradication effort in 1988, polio paralysed more than 1,000 children each day. In 2001, there were fewer than 1,000 cases for the entire year," Dr Brundtland said. "But we're not finished yet and the past year has reminded us that we live in a world where security and access to children cannot be guaranteed. So I urge the world to finish the job."

In 1988, it was conservatively estimated that at least 350,000 children, from South America to the Far East, were permanently paralysed by polio. In 2001, just 10 countries reported indigenous outbreaks, affecting less than 600 children. Last year alone, scientists and doctors oversaw the distribution of some 2 billion doses of oral polio vaccine in 94 countries.

David Ball, director of Unicef UK, said that although the task of total eradication was still facing significant problems, the overall success of the vaccine initiative was clear. "In 2005, we'll see five million children walking around who otherwise would have been paralysed if this vaccine programme had not happened," Mr Ball said.

Dr Bruce Aylward, co-ordinator of the WHO's global polio eradication initiative, said that of the 10 remaining countries with indigenous polio, three – India, Pakistan and Nigeria – were proving particularly problematic. Taken together, the three countries constitute about 85 per cent of the world's polio cases. India accounts for about half of all outbreaks, Dr Aylward said.

Scientists have identified the three major pockets of transmission in northern India, which are almost entirely confined to Muslim communities where there is a deep distrust of government-appointed officials charged with distributing vaccines.

When the polio eradication campaign was launched in 1988, it was hoped that the virus would be eradicated by 2000. The target has since shifted to 2005.

Several countries – including Afghanistan, Pakistan, Nigeria, India, Somalia and Sudan – are undertaking mass immunisation campaigns this week.

Poliomyelitis is caused by a highly infectious virus that mainly affects children under five. After entering the body, the virus multiplies in the intestines where it can then invade the nervous system, causing irreversible paralysis in one in 200 cases.