Can polio be eradicated worldwide within 2 years?

From Health Zone in Canada:

Polio could be eradicated world-wide within 24 to 36 months, according to a Canadian physician and epidemiologist who heads the polio eradication program at the World Health Organization.

“I could see this thing (polio) being finished in 24 to 36 months,” Bruce Aylward told the Star in a phone interview from his home in Geneva. “There is no reason for children to be paralyzed by the wild polio virus in 24 to 36 months.”

Aylward said that in the past year the odds of achieving full eradication have changed substantially. Even up until last year the odds were in favour of the virus – which can lead to paralysis and death.

But now the odds have turned against the virus this year. That’s thanks to a development of a new oral vaccine that targets Type 1 and Type 3 polio virus, tough new monitoring and oversight, new tactical strategies for delivery and political support from the world’s leaders, he said.

On Friday, the G8 leaders reiterated their commitment to the eradication of polio – a promise that has pleased Aylward.

The communiqué stated: “We stress our continuing commitment to the eradication of polio which is a reachable objective. Our past support has contributed to the 99 per cent decrease of polio cases in the developing countries. We flag the need for a special focus on this issue and renewed momentum. To this end, we will continue to support the Global Polio Eradication Initiative.”

It is a surprise to many that polio still exists in the world. And Aylward recently spoke at the TED lecture series on the campaign to eradicate the disease, giving an insightful history lesson of the disease and a plea for continuing action.

World-wide Type 2 polio has been eradicated since 1999. The last case was in India and it hasn’t been spotted since, he said. But two other types continue to plague parts of the developing world.

Type 1 and Type 3 remain active in two provinces in northern India, northern Nigeria, southern Afghanistan and Pakistan.

But unless the pockets of virus are wiped out the disease will continue to thrive, potentially paralyzing and killing millions, Aylward explained.

So two years ago, international health officials put together a tough new plan, relying on government, community, and religious leaders in India, Pakistan, Afghanistan and northern Nigeria, to help develop individual strategies to get children vaccinated.

In northern Nigeria the governors, who control the levers of state, were called upon to help get the vaccine out. And traditional and religious leaders were asked to buy into the program and tell community members to get vaccinated.

In India, the virus was pinpointed to the Kosi River basin, which is a 100 kilometre area that is often flooded at least half of the year. After satellite mapping of all the cases, the state government helped build temporary facilities to get kids vaccinated there.

In Afghanistan, the international Red Cross played a role in making sure there was safe passage for vaccinators. “In every one of these places there was a different set of solutions,” Aylward said.

And they seemed to work. “What we’ve seen is a 95 per cent drop in total cases of polio (Types 1 and 3) between 2009 and 2010 in India and Nigeria. So that’s a huge drop in cases in both countries. And that’s important because they had the most polio and they were the areas where other countries were getting re-infected from.”

Another amazing thing has also happened, he added. “We’re still scratching our heads – but there has been about a 92 per cent drop in Type 3 globally. These are huge achievements.”

In 2009 there 1,604 cases of polio around the world. And in 2010 there were 1,288 cases – a 20 per cent drop, he reports. But if you look at those 2010 numbers, about 900 cases were in the two countries with big outbreaks – the Republic of the Congo and Tajikistan. So Aylward thinks the back of the virus may be finally broken.

He points to Nigeria where the cases have dropped to 21 and India 40 for 2010. And so far this year, India has had only one case of polio in January and Nigeria only 9 cases. And those cases were Type 1 polio.

The positive stats are fueling Aylward’s optimism. “We haven’t seen Type 3 polio in Pakistan, Afghanistan or India for nearly six months. If that holds then the second type of polio is gone…Type 3 seems to be gone. But we want a good solid 12 months before we can say for sure.”

There is much still to be done, however. Type 1 polio virus has continued to roar along in Pakistan, Aylward said. There are 160 cases globally, and 40 of them are in Pakistan, he explained. And that’s high. Afghanistan has only two cases and India only one.

Aylward will be meeting with Pakistani officials next week to try to come up with a specific plan to deliver the vaccines to those who need it.

Every year the eradication program vaccinates 500 million kids. The program has a budget of $2 billion and has a short fall of $665 million over the next two years. “At the end of the day, it’s a big price tag. But it’s going to pay off massively.”

Aylward points to a recent Harvard study that suggests once polio is eradicated the savings to “low-income” countries will be $40 to $50 billion. And that’s a conservative estimate, he said. “It’s a great buy and you do really great things for humanity.”