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Global Health Matters

March - April, 2008  |  Volume 7, Issue 2

Polio Meeting Report Published in The Lancet

Broad support continues for achieving global eradication of polio, but some new strategies could be critical to the effort's success, according to a report published recently in The Lancet. The article is a summary of the discussions hosted by Fogarty and the National Institute of Allergy and Infectious Diseases last fall on the NIH campus. The two-day meeting, titled "Polio Immunization: Moving Forward," gathered more than 100 scientists from 18 countries to review progress, discuss the remaining challenges and develop a research agenda to advance the eradication effort.

The report's authors--members of the organizing committee and chairmen of the meeting sessions--recommend some new tactics be adopted. They advocate that the inactivated poliovirus vaccine (IPV) be used in conjunction with the oral polio vaccine (OPV) to interrupt disease transmission in high-risk areas. In addition, they suggest stopping use of OPV worldwide when IPV coverage makes it safe to do so, while continuing IPV with routine childhood immunizations. For the near future, the authors call for continued vigilance, surveillance and vaccine response capacity to cover the susceptible populations of some countries.

In addition, they outline the research agenda needed as part of an ever evolving strategy to eliminate the polio threat. They conclude that additional basic and field research into the biology and genetics of the virus should be conducted, the role of antiviral drugs should be investigated, and vaccines must be improved.

Since 1988, the WHO's eradication efforts have eliminated wild poliovirus from more than 100 countries, with only four currently identified as endemic and 13 as reinfected, or having more than two cases in the same transmission, according to the WHO. The number of paralyzed children has dropped by 99 percent since the $5.3 billion effort began.

Immunization against poliomyelitis: moving forward. Ehrenfeld E, Glass RI, Agol VI, Chumakov K, Dowdle W, John TJ, Katz SL, Miller M, Breman J, Modlin J, Wright P. The Lancet 2008:371:1385-7.