European Region marks tenth anniversary of polio-free certification

(lifePR) ( Copenhagen, )
Today, the WHO European Region marks 10 years since it was certified free of poliomyelitis (polio). Stopping transmission of indigenous wild poliovirus in the 53 countries in the Region was a landmark in the effort to eradicate polio globally, and helped accelerate international momentum towards that goal.

Certification followed years of intensive effort by Member States, supported by a public-private coalition of WHO, the United Nations Children's Fund (UNICEF), Rotary International and the United States Centers for Disease Control and Prevention (CDC). Thus, countries demonstrated the value of large, internationally coordinated vaccination campaigns and of special efforts to reach traditionally underserved groups, such as migrants or nomads.

There was much to celebrate on the day the Region received its polio-free certification, and a decade later there are many reasons to applaud the Region's continuing efforts to retain it. Nevertheless, the past 10 years have not been without challenges, as surveillance for polio and immunity against it have waned. While poliovirus could travel to the Region easily from infected areas, this had not led to outbreaks before 2010, thanks to quick detection and a well-vaccinated population. By 2010, however, immunity had dropped to the point where an importation of wild poliovirus type 1 led to a large polio outbreak in Tajikistan and three neighbouring countries. This outbreak paralysed 478 people - including many adults - and killed 29. The risk of further deadly outbreaks is rising, underscoring the urgent need to eradicate polio globally.

"We have had many successes in the past 10 years, and we should recognize and applaud them," said the WHO Regional Director for Europe, Zsuzsanna Jakab. "When we faced challenges, such as the 2010 outbreak, we saw countries and international partners mount a rapid and effective response. While this was a powerful reminder of the success we can achieve when we work together to fight common threats, it is important to emphasize that we cannot afford to become complacent. What we do here in Europe will have a significant impact on both the regional and global fight to eradicate polio."

Following the 2010 outbreak, the European Regional Commission for the Certification of Poliomyelitis Eradication (RCC) commended the affected countries for responding quickly to stop the spread of disease. In August 2011 it confirmed that the Region would retain its polio-free status. At its twenty-sixth meeting this week in Copenhagen, Denmark, the RCC once again confirmed the Region's polio-free status.

David Salisbury, Chairperson of the RCC, cautioned, "The threat of polio importation and outbreaks remains very real. The Region must not ease up on either its action or political commitment to preserving its polio-free status. I feel hopeful that, with ongoing commitment from countries and partner organizations, this Commission will have the evidence necessary to allow us to continue to declare that the European Region is free from polio until the goal of global polio eradication is achieved."

Polio is at its lowest levels since records began, with fewer cases in fewer districts of fewer countries than at any previous time. Poliovirus remains endemic in parts of only three countries, and earlier this year India celebrated its first year without polio. Until polio is eradicated worldwide, however, all polio-free regions, including the European Region, remain at risk of importation. Mathematical modelling predicts that failure now could result in as many as 200 000 new cases every year, within 10 years, all over the world. Fully managing this risk requires maintaining rapid virus detection and high immunity in European countries, as well as helping the remaining countries where polio is endemic stop transmission. As a mark of how seriously the international community is taking this risk, the World Health Assembly adopted resolution WHA65.5, declaring the completion of polio eradication a "programmatic emergency for global public health" in May.

Filling a dangerous funding gap of US$ 945 million will be crucial to success. Lack of critical funds has already forced the cancellation or scaling back of immunization activities in 24 high-risk countries this year, leaving children more vulnerable to polio. An independent monitoring body recently singled out the precarious financial situation as the single greatest risk to eradication.

"Less than 24 months ago, the countries of Europe rallied to respond to a terrible outbreak on the Region's eastern borders," said Bruce Aylward, WHO Assistant Director-General for Polio, Emergencies and Country Collaboration at WHO headquarters. "Today, there are fewer cases of polio in fewer places of the world than ever before, but Europe faces the spectre of similar outbreaks unless it invests in the emergency plan to eradicate polio in the last reservoirs of the virus. The generosity of the people and governments of Europe will be essential to protecting future generations of children in perpetuity."
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