Polio is in its final days.
The disease that once paralyzed hundreds of thousands of kids a year around the globe is now down to just a few dozen cases this year. "We are aiming to halt all transmission of wild polio virus next year," says Peter Crowley, the head of UNICEF's global efforts against polio.
If polio is stopped, it will be only the second human disease to be eliminated. Smallpox was the first — the last case was in 1977.
There's reason to be optimistic that this gigantic feat of public health is within humanity's grasp. The World Health Organization says polio transmission has stopped for the first time ever in Africa. Last month, Africa's last bastion of polio — Nigeria — celebrated going an entire year without recording any new cases.
"This is a really major step forward in the effort to eradicate polio from the world," says Kate O'Brien, a professor at the Bloomberg School of Public Health at Johns Hopkins. O'Brien also works with the World Health Organization as an adviser on global immunization policy. She calls ending polio in Nigeria "absolutely massive" in the overall eradication effort.
With Nigeria off the list of countries where the virus is self-sustaining, there are now just two nations in the world where transmission has never been fully stopped: Afghanistan and Pakistan. Of the 51 cases of wild polio detected globally so far this year, all of them have been in those two countries. (Note: The world map at the top of this post also includes cases of vaccine-derived polio, which are easier to control.)
The problem is that until polio is actually stopped in Afghanistan and Pakistan, the multibillion-dollar global effort against the virus is going to have to continue everywhere.
"This is a virus that is fighting for its life," O'Brien says. "It is going to find people and places that are not vaccinated. It's going to find a way to move and it's going to find those places that are vulnerable." Kids will continue to be vaccinated everywhere around the world for at least three years after the last case to make sure that the virus doesn't stage a comeback.
Public health officials have been declaring that polio is on the verge of being wiped out ever since Jonas Salk and Albert Sabin came up with vaccines against it in the 1950s. At that point the world was tallying hundreds of thousands of cases each year. Now, it's just a few dozen cases globally, and polio's demise does appear closer than ever. The disease that in its heyday affected Franklin Roosevelt, Olympian Wilma Rudolph and actors Mia Farrow and Donald Sutherland will be relegated to the history books.
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Polio could be wiped out as early as next year. That's the prediction from people working on the global effort to end the disease. If polio transmission is stopped entirely, it would be the second human disease to be eliminated after smallpox. NPR's Jason Beaubien reports on the challenges of getting the job done.
JASON BEAUBIEN, BYLINE: Polio transmission is now only occurring in one part of the world - the restive border region between Afghanistan and Pakistan. And even there, it's at an extremely low level. There've been only 51 cases reported in 2015 compared to hundreds of cases last year and thousands a few decades ago. And significantly, last month, the World Health Organization celebrated Africa for the first time ever going a full year without a single case of polio.
KATE O'BRIEN: This is a really major step forward in the effort to eradicate polio from the world.
BEAUBIEN: Kate O'Brien is a professor at the Bloomberg School of Public Health at Johns Hopkins, and she also works at the World Health Organization as an adviser on global immunization policy. Up until this year, Nigeria had been the big stumbling block in efforts to rid Africa of polio. Even as it was wiped out elsewhere, polio continued to paralyze kids in Africa's most populous nation.
O'BRIEN: The fact that Nigeria is now a year without wild polio is absolutely massive.
BEAUBIEN: The big challenge now, she says, is stopping it in Afghanistan and Pakistan. Immunization campaigns there have been incredibly difficult after the Taliban banned polio vaccination, even attacking and gunning down vaccinators in the street. O'Brien says the final barriers to wiping out this disease are not medical. They're political.
O'BRIEN: We have the tools to get this job done, and the evidence of that is that every single country around the world except for two countries has gotten rid of this virus.
BEAUBIEN: And until those countries actually stop polio transmission, the multibillion-dollar global eradication effort is going to have to continue everywhere.
O'BRIEN: This is a virus that is fighting for its life. It is going to find people in places that are not vaccinated. It's going to find a way to move, and it's going to find those places that are vulnerable. So until we eradicate it, everybody still has to remain vaccinated in the United States and around the world, and that is going to have to continue until we get to the point of eradication.
PETER CROWLEY: Definitely, we can see light at the end of the tunnel, but the tunnel is a difficult and dangerous place.
BEAUBIEN: Peter Crowley used to be the head of UNICEF's operations in Afghanistan. He now leads the charity's global efforts against polio.
CROWLEY: We're down to some very, very difficult operating environments, whether in the northwest of Pakistan or in the south and east of Afghanistan, which is where we see cases continuing to occur.
BEAUBIEN: But he says there's more cooperation now from local tribal leaders in those areas, and he's confident eradication is possible.
CROWLEY: It's not going to be easy, but we're aiming to try and halt all transmission of wild polio virus next year.
BEAUBIEN: Public health officials have been declaring that polio is on the verge of being wiped out ever since Jonas Salk and Albert Sabin came up with vaccines against it in the 1950s. At that point, the world was tallying hundreds of thousands of cases each year. Now the numbers are down to just a few dozen, and polio's demise does appear closer than ever. Jason Beaubien, NPR News. Transcript provided by NPR, Copyright NPR.