Keeping polio in check requires a nonstop global assault. As the world’s largest public-private health endeavor of its kind, the Global Polio Eradication Initiative (GPEI) is a prolific force that has helped nearly wipe out a crippling disease that had reached epidemic proportions.

Since GPEI launched in 1988, a global network of 20 million volunteers has immunized more than 2.5 billion children. As a result, the organization has reduced the instances of the disease by 99.9 percent. Only two countries reported poliovirus cases in 2018.

1955

Dr. Jonas Salk’s polio vaccine approved

1988

Global Polio Eradication Initiative launched

350,­000

Estimated number of poliovirus cases in 1988

33

Number of poliovirus cases reported in 2018

Driving the exhaustive feet-on-the-street, door-to-door vaccination campaign across 200 countries is a galvanized and groundbreaking partnership, bringing together the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC), UNICEF, Rotary International and the Bill & Melinda Gates Foundation.

Combining the medical might of WHO and the CDC plus the vaccine-procurement prowess of UNICEF has polio on the brink of a purge: GPEI reported just 33 cases of polio in 2018. For its part, Rotary has mobilized a network of more than 1.2 million members worldwide for fundraising, volunteering and advocacy.

“Each of our organizations brings something unique to the partnership,” says Carol Pandak, director, PolioPlus, Rotary International. “It’s very much about the complementary roles.”

“We need to find and vaccinate every child. No matter where they live. No matter how remote.”

—Michel Zaffran, World Health Organization

GPEI missing its original goal of global eradication by 2000 speaks to the complexity of wiping out any disease. Regions must go three years without a case to be certified as polio-free, and each confirmed case nudges the eradication further out. GPEI now aims to achieve global eradication by 2023, with new strategies in Afghanistan and Pakistan, where conflicts, mobile populations and weak health systems limit access to children. Nigeria is the third endemic country.

“We need to find and vaccinate every child. No matter where they live. No matter how remote,” says Michel Zaffran, WHO’s director of polio eradication.

125

Number of countries reporting poliovirus cases in 1988

2

Number of countries reporting poliovirus cases in 2018

200,­000

Number of poliovirus cases expected annually within 10 years of a halt in immunization campaigns

10 years

Amount of time the world’s children will need to continue routine polio immunization even after certified global eradication

Finding Every Child

Over the past 30 years, there have been many lessons learned—including the need to evolve.

“We’ve learned there’s not a one-size-fits-all approach to eradication,” Zaffran says. “On one hand, polio eradication is deceptively simple: If you vaccinate enough children in a given area, poliovirus has nowhere to hide and disappears. Where it becomes complicated is why not enough children are vaccinated. The reasons for this vary greatly. It can be due to lack of infrastructure, lack of political ownership, population movement, lack of planning, inadequate vaccine management, insecurity, geographical challenges, nomadic populations or community resistance. The poliovirus only cares about finding an unvaccinated child—and it is very good at finding that child. We need to put in place area-specific tactics to overcome that challenge.”

As GPEI closes in on its goal, the project is a powerful model for other public health efforts.

“The lessons learned and the infrastructure built up to eradicate polio are helping other teams detect and respond to vaccine-preventable disease outbreaks, including measles, yellow fever, Ebola and avian influenza,” Zaffran says. “But perhaps the most important lesson for other public health and development projects is this: Every child can be reached with sufficient will.”