The last case of indigenous polio in the Americas was reported from Peru in 1991. Pakistan conducted its first NIDs in April and May 1994. Expanded Program on Immunization, Global Program for Vaccines and Immunization, World Health Organization, Geneva. Major achievements in the coordinated global campaign to eradicate polio include the substantial reduction in the global incidence of paralytic polio, the complete elimination of polio from the Region of the Americas, and the widespread implementation of NIDs and other WHO-recommended strategies. The implementation of AFP surveillance is a critical element of WHO's eradication strategies.
Eradication of disease requires a surveillance system that can detect a single case.
Polio-endemic countries have implemented a system in which any AFP case in a person aged less than 15 years is reported as a suspected polio case. AFP surveillance also is being used to certify eradication at the national, regional, and global levels. Because Southeast Asia remains a major global reservoir of polioviruses, full implementation of the WHO-recommended polio eradication strategies in these countries is a high priority. Although global routine vaccination coverage levels remained stable during 1990-1994, reported polio cases declined substantially, largely because of an increase in the number of countries conducting NIDs. The success of the polio eradication initiative will depend on finding solutions to these financial, managerial, political, and technical challenges.