World close to ending polio, yet it's a tough foe

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Less than four months ago the world was cheered to learn that India had gone a full year with no new cases of polio - a landmark that left only Pakistan, Afghanistan and Nigeria on the World Health Organization's list of countries where the disease is endemic.

But the battle is far from over, judging by the WHO's latest expressions of alarm. It says that in both Nigeria and Afghanistan the number is creeping up, while budget shortfalls are jeopardising the effort to hold polio at bay in 24 other high-risk countries. Right now the numbers of new infections are small.

But Nigeria's total has jumped to 38 in the first five months of 2012 from just 10 in the same period of last year. Afghanistan's went from three to seven. Only Pakistan's number fell back, from 43 to 18.

The polio virus, which usually infects children in unsanitary conditions, attacks the nerves and can kill or paralyse. It can spread widely and unnoticed before it starts crippling children. On average about one in 200 cases will result in paralysis.

In Pakistan's poor northwest one of the newest victims, 13-month old Fariha, cried out as her 6-year-old sister Sana struggled to place her on the floor, mindful of her tiny legs wrapped in plastic braces. A labourer's daughter, Fariha was infected six months after birth. She has to be carried everywhere.

Twice a day her mother exercises her legs, medicines are provided free and a health worker visits occasionally. The braces were donated by a German clinic. There are no guarantees that Fariha will fully recover. Most of the new polio cases in Pakistan are in the northwest, where an insurgency rages, making it difficult for health workers to reach tens of thousands of children.

Elsewhere in the world, a growing number of cases are being discovered and traced back to Pakistan and Nigeria. While the numbers are low today, WHO spokesman Oliver Rosenbauer warned that the disease can quickly regain strength.

"If a polio-free country becomes re-infected, and the virus gets into an area with low population immunity levels, we have seen time and again that it can take off like wildfire," he said.

Both money and manpower is in short supply and if either runs out before the disease can be eradicated in the three holdouts, an epidemic will follow, says Rosenbauer. "Polio eradication is at a tipping point between success and failure," he said.

"We have the emergency plans in place through end-2013, and full implementation and financing of the plans could well result in a polio-free world by that time," he said