Reuters analyzes why polio is close to be eradicated worldwide but it never happens

From Reuters:

The world is tantalizingly close to wiping out polio, but experts are starting to worry about the high risk of failure and say it could have consequences for confidence in health battles far beyond this crippling disease.

Global health and vaccines experts say they have polio "on the ropes," but are frustrated that the goal of eradicating it continues to elude them more than 20 years after they set their sights on it. They fear failure could crush trust in other major disease projects such as fighting malaria, HIV or measles.

"The failure to eradicate polio so far means there is a smell of a suspicion about all vaccine initiatives," said Professor David Salisbury, former chair of the World Health Organization's Strategic Advisory Group of Experts (SAGE) on Immunization. "That's why we must achieve polio eradication. We need to demonstrate that it can be done."

Salisbury and others point to the emergence of "donor fatigue" in global health projects and say the failure to wipe out polio risks making that worse.

Polio spreads in areas with poor sanitation, attacks the nervous system and can cause irreversible paralysis within hours of infection. Children under five are the most vulnerable to the virus -- a disease that until the 1950s crippled thousands of people every year in rich nations.

In 1988, when the WHO and its partners formed the Global Polio Eradication Initiative to lead the battle, polio was endemic in 125 countries and paralyzed nearly 1,000 children every day. Now it is endemic in just four countries -- India, Pakistan, Nigeria and Afghanistan -- and there has been a 99 percent reduction in cases since 1988.

"We have polio on the ropes, but with an eradication program 99 percent reduction is not good enough," said Walt Orenstein, deputy director for vaccine-preventable diseases at the Bill & Melinda Gates Foundation, which has promised to put $10 billion into developing and delivering vaccines to those most at need over the next decade.

Globally, there have been 706 cases of polio this year, down from 1,126 at this point in 2009, but more than 570 of those have been in countries that had previously managed to banish it and are now fighting outbreaks re-seeded from endemic countries.