Countries should bar entry to travellers from nations still plagued by polio unless they have proof they have been vaccinated, a new report suggests.
The report says the move would safeguard other parts of the world against the possibility of polio spreading from the remaining three endemic countries.
A Pakistani volunteer administers an oral polio vaccine to a boy who survived heavy flooding in Multan, Pakistan, in 2010. Pakistan, Afghanistan and Nigeria haven't stopped the spread of polio within their borders. (K.M.Chaudary/Associated Press) Pakistan, Afghanistan and Nigeria are the only countries in the world that have never managed to stop the spread of polio viruses within their borders.
The recommendation comes from a group of experts which critiques the efforts of the Global Polio Eradication Program.
The Independent Monitoring Board was set up at the behest of World Health Organization Director General Dr. Margaret Chan to identify weaknesses in the polio program and offer expert advice.
In its latest report, the monitoring board says the polio program may be on the cusp of finally conquering the disease, but critical work remains to be done.
"History may look back on 2012 as the beginning of the end for the polio virus," the advisers said in their typically bluntly worded report.
The report acknowledges that some may view as extreme the recommendation that countries should require proof of polio vaccination when citizens of the three endemic countries seek entry at their borders.
But it says the risk that polio viruses from the endemic countries will reignite spread in other nations remains too high. And some countries, particularly in parts of Africa, are highly vulnerable to renewed transmission, because many of their children are not fully vaccinated.
"Besides their human and financial costs, outbreaks are an unhelpful and demoralizing distraction to the pursuit of global eradication," the report says.
"They need to be prevented."
Involve parents to make polio history
The experts suggest the WHO's International Health Regulations expert review committee issue a standing recommendation on the matter by next May. (The IHR, as it is called, is an international treaty aimed at trying to minimize the risk of disease spread from country to country.)
The monitoring board report also suggests polio campaign partners should work harder to link vaccine delivery with other services that would benefit communities.
In many places, it notes, parents are bewildered by repeated visits from polio vaccination teams when their children's other health needs go unmet.
"We recommend that every opportunity be taken to 'pair' other health and neighbourhood benefits with the polio vaccine," the report says, suggesting delivery of things like mosquito nets to prevent malaria or having the trucks transporting vaccination teams clear away garbage while the teams go door to door in delivering vaccine.
The report also urges the polio program to work to involve parents on committees at the local level, saying that if parents could be brought to understand why they should demand polio vaccine for their children, polio would already be history.
The polio program had hoped to stop polio transmission by the end of 2012; this is the third deadline the 24-year-old program has missed. But the monitoring board, which has been harshly critical in some earlier reviews, suggests this year real progress has been made in some countries.
An exception is Nigeria, it says, where polio case numbers have risen in the second half of this year. But the report says the Nigeria efforts may be on the brink of a breakthrough, and will be watched closely over the coming months.
To date this year there have been 193 cases of paralytic polio in the world, the lowest number ever. By this time last year there had been 536 cases, and the count climbed to 650 by the end of 2011.
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