- The Washington Times - Wednesday, April 17, 2002

The world health community is on the verge of dealing polio a "knockout blow," but instability in Africa and central Asia remains the largest obstacle to global eradication, international health experts said yesterday.

The next target, they said, is measles.

"There are reservoirs of polio in inaccessible parts of the world, but the number of cases is dropping dramatically," said Steven Cochi, global immunization director for the U.S. Centers for Disease Control and Prevention.

Dr. Cochi was part of a panel of experts from international health organizations that announced, at a National Press Club briefing, the near extermination of polio and the steps that need to be taken to eliminate the disease.

The panel said that 537 cases of polio were recorded in the world in 2001, down from 2,979 in 2000, and that 575 million children in 94 countries were vaccinated. By the end of this year, officials estimate, the disease will be confined to regions of northern India, Afghanistan, Pakistan, Nigeria and Niger.

The panel said its target for global polio eradication is 2005. The disease already has been eliminated in the Western Hemisphere, Europe and East Asia.

The United States is the largest contributor to polio vaccination programs worldwide, with a commitment to provide more than $129 million to fight the disease next year. But a funding gap of $275 million still must be filled by governments, aid agencies or private donations.

Marie-Otelia Costales, a senior health adviser for UNICEF, said the last incidences of the disease will be the hardest to eradicate because of the volatile political situations in those areas.

"Countries that are at war are countries where it is increasingly difficult to administer vaccines," she said.

Armed conflicts in southern Sudan, Somalia, Ethiopia, Nigeria and Angola make these regions particularly difficult to vaccinate. But Dr. Cochi has been encouraged by measures the Nigerian government has adopted and a recent cease-fire in Angola.

National immunization days, where large groups of children are inoculated at one time, are an important tool. In the fall, two such events in Afghanistan and Pakistan resulted in the vaccinations of 35 million children, including many transients and refugees.

Such populations pose an especially difficult challenge, Dr. Cochi said. But he was encouraged that even in the months after U.S. strikes against the Taliban in Afghanistan, young children fleeing into Pakistan still were being vaccinated. Pakistani police played a vital part by bringing children in for the vaccinations, Dr. Cochi said.

The CDC also announced it is preparing for an international campaign against measles.

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