In August 1991, health officials in Peru received notice of a suspected case of polio in the small Andean region of Pichanaki. Immediately, a team led by Dr. Roger Zapata set out on the arduous 10-hour journey through mountainous terrain to investigate the case that would become known as the “first last case of polio” — the very last case of wild poliovirus in the Western Hemisphere.
Thirty years of a polio-free Americas is the culmination of a massive global health mobilization, a milestone worthy of celebration. Yet the world still has not wiped polio from the planet. The success story of the Americas offers lessons on political cooperation and health care integration that can help eliminate wild poliovirus from the two-remaining polio-endemic countries — Afghanistan and Pakistan — once and for all.
Getting to Zero
The vision of a polio-free Americas started in the 1980s, following the incredible global eradication of smallpox in 1979, demonstrating to world leaders that eliminating debilitating childhood diseases was indeed possible. In 1985, the 35 Member States of the Americas unanimously adopted a resolution to eradicate the indigenous transmission of wild poliovirus in the Americas. Three years later, at the 41st World Health Assembly in Geneva, the countries of the Americas committed themselves again, this time with Member States across the world, to press on until polio was eradicated. This historic resolution launched the Global Polio Eradication Initiative (GPEI), spearheaded by the World Health Organization (WHO), Rotary International, the U.S. Centers for Disease Control and Prevention (CDC), and the United Nations Children’s Fund (UNICEF), later joined by the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance.
This powerful new coalition marked the beginning of the end for polio in the Americas. Local governments pledged to invest human and financial resources, strengthen immunization programs in primary health care settings, and improve clinical and laboratory disease surveillance. This commitment also ensured that the polio eradication efforts would bolster other immunization and health services, especially those for women and children.
A generation of visionary and pragmatic men and women on the front lines delivered the care to make this ambitious goal a reality. The countries of the Americas stepped up, providing widespread immunization coverage, creating sensitive disease and outbreak surveillance systems, and increasing laboratory support. Countries began reporting their last cases of wild poliovirus; in 1991, Luis Fermin Tenorio Cortez, whose leg is paralyzed by polio, was the last child in the region to suffer from this terrible disease. Three years later, the International Commission for the Certification of Polio Eradication (ICCPE) declared that the Americas had conquered polio.
Learning from Each Other
Since that landmark moment, the countries of the Americas have accumulated crucial global health knowledge and experience, which have been shared across the region to remain vigilant against a resurgence of polio. These approaches are being implemented worldwide, most recently through GPEI’s new polio strategy, to support global polio eradication and related efforts to eliminate measles and other dangerous childhood diseases.
The tools, expertise, and infrastructure developed by the Pan American Health Organization to fight polio have been sustained over many years and have supported immunization programs, including:
- The PAHO Immunization Newsletter.
- The Polio Weekly Bulletin.
- Meetings of PAHO’s Technical Advisory Group (TAG) on Vaccine-preventable Diseases.
- Meetings of the Regional Certification Commission for the Polio Endgame in the Americas.
Committed to the End
While children across the Americas have remained safe from polio, regional vaccination coverage against polio has decreased dramatically in recent years. WHO and UNICEF coverage estimates show the COVID-19 pandemic slowed or halted childhood immunizations, including polio, for millions of kids worldwide.
As long as there is still one case of polio anywhere, there is a threat to all children everywhere. That is why the Americas, amid recognition of this remarkable accomplishment, must not become complacent. We are proud of these past 30 years, but we cannot stop until the job is done. That means building trust in vaccines among families, delivering holistic care, reaching even the most remote communities, and helping countries take ownership of their immunization programs. Every child, in every corner of the world, deserves to live in a polio-free world.
Dr. Ana Elena Chévez is the Regional Immunization Advisor for polio at the Pan American Health Organization/World Health Organization (PAHO/WHO)
Featured Photo: Armando Waak-PAHO/WHO