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In 1988, the World Health Assembly (WHA) the annual meeting of the ministers of health of all Member States of the World Health Organization, voted to launch a global goal to eradicate polio. As a result of the Global Polio Eradication Initiative - the
single largest, internationally-coordinated public health project to date -
by the end of 2006, only four countries remained which had never interrupted
endemic transmission of wild poliovirus (Nigeria, India, Pakistan and
Afghanistan). In 2006, fewer than 2000 cases were reported.
Back when the Global Polio Eradication Initiative was launched, wild
poliovirus was endemic in more than 125 countries on five continents, paralyzing
more than 1000 children every day.
The Global Polio Eradication Initiative (GPEI), spearheaded by national governments, the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF, is the
single-largest, internationally-coordinated public health project the world has ever known. Since 1988,
more than two billion children around the world have been immunized against polio thanks to the unprecedented cooperation of more than 200 countries and 20 million volunteers, backed by an international investment of
more than US$ 5 billion.
2006
- In January, Egypt and Niger are officially removed from the endemic
country list, reducing the number of countries to never have
interrupted endemic transmission of polio to a historic low of four
(Nigeria, India, Pakistan and Afghanistan).
- In February, epidemics in Yemen and Indonesia - which suffered the
largest, single-country outbreaks in recent years - are successfully
stopped.
- In may, polio eradication loses one of its global champions, at the
death of WHO Director-General LEE Jong-wook.
- In June, an outbreak in Namibia is stopped within 50 days, by following
new international outbreak resonse guidlines adopted by the World Health
Assembly (WHA) just one month earlier.
- In July, the Global Polio Laboratory network launches new procedures to
halve poliovirus confirmation time.
- In August, an outbreak of type 1 polio in Uttar Pradesh, India, peaks,
as new cases begin to significantly decline.
- In October, the Advisory Committe on Polio Eradication (ACPE) re-affirms
the technical feasibility of polio eradication at its annual meeting in
Geneva.
- In December, tailored new approaches are adopted in the remaining
endemic countries to raise immunity levels among children in the endemic
areas to the necessary levels to rapidly interrupt transmission of the
virus.
2005
- Two endemic countries - Egypt and Niger - did not report any indigenous
polio cases in 2005, and would - in January 2006, be officially removed from
the endemic country list.
- Outbreaks in most of the countries re-infected from 2003-05 were
successfully stopped. Of note, the outbreaks in Yemen and Indonesia - which
suffered the largest, single-country epidemics in recent years - were
significantly curbed by the end of the year, and would fully stop by early
2006.
- Following a recommendation by the Advisory Committee on Polio
Eradication (ACPE) in late 2004 to strategically use monovalent oral polio
vaccines (mOPV) as part of eradication efforst (which offer higher
protection to type-specific polio than the traditionally-used trivalent
OPV), mOPVs became the new 'workhorse' of the Global Polio Eradication
Initiative.
- In Asia, transmission of type 3 polio continues to decline.
2004
- The Ministers of Health of the then-remaining endemic countries
(Nigeria, India, Pakistan, Niger, Afghanistan and Egypt) publicly committed
to an intensification of immunization campaigns to eradicate polio, by
signing the Geneva Declaration for the Eradication of Poliomyelitis.
- On 31 July 2004, following a twelve-month suspension of polio
immunization activities, polio campaigns resumed across northern Nigeria.
- Following the resumption of activities in northern Nigeria, Africa
launched the largest-ever multi-country immunization campaign. More than 1
million vaccinators across 23 countries across west and central Africa
participated, as more than 80 million children were immunized in Octover and
again in November.
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Somalia passed a full calendar year without polio, reporting its last case in October 2002. Somalia's success in eradicating polio is testimony to the soundness of the polio eradication strategies, which work even in the most challenging country settings.
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By end-2003, only six countries in the world were still polio-endemic, the lowest-ever number: Nigeria, India, Pakistan, Niger, Afghanistan and Egypt. In 1988, the year the Global Polio Eradication Initiative was launched, more than 125 countries were endemic.
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In 2003, 784 polio cases were reported worldwide, a significant reduction over 2002, when 1,918 polio cases were reported. Of the 784 cases, approximately 90% were found in just three countries: Nigeria, India and Pakistan.
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Following an epidemic of 1,600 cases in 2002, India achieved the lowest number of cases ever in 2003 (225 cases), by dramatically accelerating immunization activities, and increasing both the quality and quantity of immunization campaigns.
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In Nigeria, a number of northern states suspended polio immunization campaigns in August 2003, following concerns by some public figures regarding the safety of the polio vaccine. Subsequently, a new outbreak occurred, originating in the state of Kano, and re-infecting previously polio-free areas within Nigeria (including Lagos), as well as eight previously polio-free countries across west and central Africa.
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Rotary International raised US$ 119 million from its membership in a 12-month campaign to help close the funding gap. Rotary's total contribution to polio eradication has exceeded US$ 500 million, and by the time the world is certified polio-free, donations will reach US$ 600 million.
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Member States of the Organization of the Islamic Conference (OIC) and the African Union (AU) adopted resolutions to eradicate polio. The G8 re-affirmed its commitment to close the funding gap for polio eradication activities in Africa.
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In June 2002, the WHO European Region was certified polio-free, joining the WHO Regions of the Americas and the Western Pacific. The result: today more than three billion people - half of the world's population - in 134 countries and territories now live in areas certified polio-free.
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500 million children were vaccinated during more than 300 activities in 100 countries in every WHO region, using two billion doses of oral polio vaccine.
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Only seven countries in the world remain polio endemic - it is the lowest number of polio endemic countries in history.
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The geographic distribution of the wild poliovirus was significantly reduced in 2002. Polio is more geographically restricted than ever. In total, 98% of the world's 1919 reported polio cases in 2002 were located in India, Nigeria and Pakistan. Within India, Nigeria and Pakistan, polio is further geographically restricted, as 80% of all global cases in 2002 were found in only 6 of the 76 states/ provinces of these three countries.
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Two recent poliovirus reservoirs of Ethiopia and the Sudan appear to be polio-free, with no new polio detected for well over a year. This success demonstrates the effectiveness of polio eradication strategies in the most challenging settings.
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The G8 put polio eradication firmly on its agenda during its June Summit, and pledged to provide the funding needed for polio eradication activities in Africa. Canada and the United Kingdom followed up immediately on this commitment, with an additional US$ 32 million from Canada and US$ 25 million from the United Kingdom.
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Rotary International launched a fundraising campaign amongst its membership aiming to raise US$ 80 million by June 2003. The response from Rotary club members has been tremendous, with clubs all over the world working to raise money. Funds received in this campaign will push Rotary's total donation to polio eradication to over US$ 500 million.
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575 million children were vaccinated in 94 countries, with 2 billion doses of oral polio vaccine during over 300 immunization activities.
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The number of polio endemic countries fell from 20 in 2000 to 10 in 2001. The number of cases fell from 719 to approximately 483 in the same period, and the geographic distribution of the wild poliovirus was significantly reduced in the remaining endemic countries.
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35 million children were vaccinated in Afghanistan and Pakistan during two rounds of NIDs in the autumn of 2001. By focusing on cross-border areas, these NIDs helped dramatically reduce poliovirus transmission in these two countries.
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Conflict-affected countries in central Africa, including Angola and the Democratic Republic of the Congo, synchronised NIDs for the first time - vaccinating 16 million children in the region.
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Two traditional poliovirus reservoirs, Bangladesh and the Democratic Republic of the Congo, have not found a single case for over a year.
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The funding gap for 2002-2005 was reduced from US$400 million to US$275 million, thanks to donations from Canada, Japan, the Netherlands, the United Kingdom and the United States. The Global Polio Eradication Initiative also welcomed new partners, including Austria, Ireland and Luxembourg.
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In November 2001, the WHO EURO region (51 countries) celebrated three years polio-free, and was certified on 21 June, 2002.
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Type 2 wild poliovirus has not been isolated since October 1999, and type 3 was isolated only in India, Pakistan, Somalia and Nigeria in 2001.
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There were 719 cases of wild poliovirus in 2000. This represents a 99% reduction in cases since the programme began in 1988, with 350,000 estimated cases.
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The 37 countries and territories of the WHO Western Pacific Region (WPR) are certified polio-free, the second WHO Region to be certified after the Region of the Americas in 1994.
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A record 550 million children - almost one-tenth of the world's population - received oral polio vaccine (OPV).
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More than 240 000 childhood deaths were prevented by the administration of vitamin A during polio National Immunization Days in over 50 countries.
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17 west and central African countries synchronized NIDs and vaccinated 76 million children, including more than two million children never previously immunized.
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UN Secretary General Kofi Annan addressed the Global Polio Partners' Summit in New York, an unprecedented gathering of more than 350 individuals who pledged their commitment to securing a polio-free world in 2005.
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The UK and Netherlands donated an additional US$ 90 million. The UK's DFID provided US$ 50 million for operational costs, surveillance, OPV and personnel. The Netherlands contributed US$ 50 million for surveillance.
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The second anniversary of the last case in the Western Pacific falls in March.
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A large polio outbreak occurs in Angola with more than 800 cases and 50 deaths.
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The UN Secretary-General agrees to negotiate truces for immunization in the Democratic Republic of Congo.
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The World Health Assembly resolves to accelerate the polio eradication effort.
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Dr Gro Harlem Brundtland, Director-General of WHO immunizes children during a National Immunization Day in Côte d'Ivoire and urges the country to set a standard for the region.
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Dr Brundtland appeals to governments and donors to accelerate polio eradication.
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6.5 million children are vaccinated during house to house immunization in Pakistan.
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National Immunization Days are conducted in war-torn Liberia.
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An estimated 470 million children aged under five years are immunized during National Immunization Days.
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National Immunization Days are conducted for the first time in Somalia and South Sudan.
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Nigeria and India improve their surveillance in a matter of months.
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The Rotary International Network of Polio Eradication Advocacy Advisors expands to Europe and Asia.
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An estimated 450 million children aged under five years are immunized during National Immunization Days in 97 polio-endemic countries.
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250 million children are vaccinated during National Immunization Days held simultaneously in China, India, Bhutan, Pakistan, Bangladesh, Thailand, Vietnam and Myanmar.
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134 million children are immunized on a single day in India.
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The last case of polio in the Western Pacific region is found on 19 March. She is a 15-month-old girl called Mum Chanty living near Phnom Penh in the Mekong River area of Cambodia.
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Nelson Mandela officially launches the Kick Polio Out of Africa campaign.
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The Organization of African Unity (OAU) adopts the Yaounde Declaration of Support for the Expanded Programme on Immunization, including polio eradication.
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420 million children are immunized during National Immunization Days.
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A large polio outbreak in Albania, which had been free of wild poliovirus for 18 years, spreads to neighbouring countries.
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The last case of polio is identified in China.
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Operation MECACAR (Mediterranean, Caucasus, Central Asian Republics and Russia) is launched: National Immunization Days are coordinated in 19 adjacent countries of the European and Eastern Mediterranean Regions of WHO. More than 56 million children are immunized.
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Cease-fires are negotiated in Afghanistan (for the third consecutive year) to allow children to be immunized during National Immunization Days.
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The Global Commission for the Certification of Polio Eradication meets for the first time.
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India organizes its first National Immunization Days, immunizing 87 million children.
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The Americas are certified polio-free by the International Commission for the Certification of Polio Eradication.
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China launches its first National Immunization Days, immunizing 80 million children. Prime Minister Jiang Zemin personally administers polio vaccine to some of the children.
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A polio outbreak in the Netherlands, among a group who refuse to be immunized for religious reasons, proves that imported poliovirus still constitutes a threat wherever immunity levels are low.
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The virus spreads to Canada.
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The Global Polio Laboratory Network is formally established to facilitate high quality virologic investigation in all countries.
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The last indigenous case of polio occurs in the Americas in September. He is a three-year old boy called Luis Fermin Tenorio living in Junin, Northern Peru.
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WHO, UNICEF, partner organizations and heads of state of many countries reaffirm their commitment to the eradication of polio at the World Summit for Children.
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The Universal Childhood Immunization Initiative achieves its goal of 80 percent childhood immunization coverage worldwide.
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Mopping-up activities are conducted in the Americas.
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Polio outbreaks occur in China with approximately 5 000 cases reported both years.
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The US government commits funds to polio eradication.
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The World Health Assembly passes a resolution to eradicate polio by the year 2000.
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Rotary International and the Japanese government commit funds to polio eradication.
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Rotary International announces that the fundraising campaign to raise US $120 million has raised US $247 million.
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Rotary International launches a campaign to raise US $120 million to fight polio which provides the necessary impetus to begin the polio eradication initiative.
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The Pan American Health Organization (PAHO) launches an initiative to eradicate polio in the Americas by 1990.
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The Universal Childhood Immunization Initiative is launched jointly by UNICEF and WHO, with the aim of reducing child mortality through effective immunization.
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Lameness surveys demonstrate that polio is widespread in many developing countries, leading to the introduction of routine immunization with OPV in almost all national immunization programmes.
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The last case of smallpox in the world occurs in Somalia.
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A polio outbreak occurs in the Netherlands and spreads to Canada and the US the following year.
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The World Health Assembly passes a resolution to create the Expanded Programme on Immunization (EPI) to bring basic vaccines to the world's children.
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EPI aims to build on the success of smallpox eradication and make immunization for children's diseases available worldwide.
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Dr. Albert Sabin develops a "live" oral vaccine against polio (OPV). OPV rapidly becomes the vaccine of choice for most national immunization programmes in the world.
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Immunization campaigns in Cuba and in Eastern Europe demonstrate that wild poliovirus can be eliminated in large geographic areas, providing the basis for eradication.
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Mass OPV campaigns are conducted in Czechoslovakia and Hungary.
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Dr. Jonas Salk develops the first vaccine against polio, an inactivated (killed), injectable polio vaccine (IPV).
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Thomas Weller and Frederick Robbins succeed in growing poliovirus in live cells, which lays the foundation for the development of any vaccines against polio. Six years later they receive the Nobel Prize for their work.
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The World Health Organization is established.
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The National Foundation for Infantile Paralysis is established in the United States. This later becomes the March of Dimes, a fundraising organization focusing on research to support the fight against polio.
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Sir Macfarlane Burnet and Dame Jean MacNamara identify several types of poliovirus, known as Types 1, 2, and 3.
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An epidemic of polio in New York heightens concern on both sides of the Atlantic Ocean and accelerates research into how the disease is spread.
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Austrian physicians Karl Landsteiner and Erwin Popper make the first hypothesis that polio may be caused by a virus.
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Dr. Ivar Wickman, a Swedish paediatrician, categorizes the different clinical types of polio.
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The first significant outbreak of infantile paralysis, subsequently identified as poliomyelitis, is documented in the United States.
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Dr. Jacob von Heine conducts the first systematic investigation of poliomyelitis, for the first time developing the theory that the disease may be contagious. Von Heine's treatments are used well into the 20th century.
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Dr. Michael Underwood, a British physician, attempts the first known clinical description of polio, entitled Debility of the Lower Extremities.
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An Egyptian stele portraying a priest with a withered leg, leaning on a staff, suggests that polio has been endemic for thousands of years.
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