When Ministers of health and representatives from the six remaining polio-endemic countries, namely Afghanistan, Egypt, India, the Niger, Nigeria and Pakistan, declared on 15 January 2004 at a high-level meeting in Geneva that poliomyelitis should be history within the following twelve months, they noted that the success of the initiative rests with the Governments of those countries. The Ministers had unveiled a bold new plan to immunize 250 million children multiple times during a series of massive polio immunization campaigns this year. As of September, with over 700 reported global cases for 2004, their goal, while close to being achieved, may not be met by 2005. The Global Polio Eradication Initiative of the World Health Organization sets 2008 as the target date.
Polio transmission levels are currently at their lowest ever in Egypt, India and Pakistan, providing their Governments with an unprecedented opportunity to stop transmission of the virus in 2004. Data from the six polio-endemic countries show that the virus has been reduced to only a few remaining reservoirs. The ministers concurred on an all-out effort to reach every child with the polio vaccine during the first half of 2004, particularly in India, Nigeria and Pakistan, which together account for more than 95 per cent of all polio cases worldwide. Within these countries, transmission of the disease is further confined to full "polio hotspots": the state of Kano in Nigeria, Uttar Pradesh and Bihar in India, and North West Frontier province and Sindh in Pakistan. They are linked to more than 75 per cent of all new cases worldwide.
As 2004 comes to a close, Nigeria is currently the greatest risk to global polio eradication. In late 2003, immunization against polio was discontinued in Kano, the last major polio reservoir in Africa, because of unfounded rumours that the vaccine was unsafe. As a result, the disease returned to Nigeria and has spread into the previously polio-free countries of Cameroon, Chad and through the Niger, into Benin, Burkina Faso, Ghana and Togo, endangering 15 million children and necessitating a massive immunization campaign across west and central Africa.
As of May 2004, Egypt, India, Pakistan and Afghanistan were on track to meet the year-end target for stopping polio. However, west and central Africa, particularly Nigeria and the Niger, suffered a significant setback due to an outbreak that originated in northern Nigeria, where immunization campaigns...