Abstract

PIP: The World Health Organization resolved 41 years ago to eradicate poliomyelitis by the year 2000. Cost-effectiveness studies estimate that more than $300 million will be saved annually in the US alone by its eradication worldwide. Additional savings will be enjoyed in the indirect costs of pain, suffering, and lost productivity. Even so, the Poliomyelitis Eradication Initiative has been hindered by a lack of urgency, by insufficient donor participation, and a lack of political support in many countries. Moreover, the achievement of the ultimate goal of eradication is hampered by the poor immunogenicity of oral polio vaccine in many tropical areas, high population density, poor sanitation and hygiene, the ability of wild polioviruses to circulate in partly immune populations, and poorly developed epidemiological and laboratory-based surveillance systems to monitor the occurrence of disease. Controversy also remain over the respective merits of and problems with oral and inactivated poliovirus vaccines. Sections discuss prospects for global eradication, choice of vaccine, and development of a common prescription.