Disease Elimination vs. Eradication Disease Elimination vs. Eradication By Vincent Iannelli, MD - Reviewed by a board-certified physician. Updated June 16, 2016 News that rubella has been eliminated in the Americas has a lot of people misusing the terms elimination and eradication again. Disease Eradication Of course, eradication is the goal of most immunization programs. Once a vaccine-preventable disease is eradicated, the worldwide incidence of the disease is reduced to zero so that intervention, including immunizations, are no longer needed. So far, small pox is the only disease that has been eradicated. The Thirty-Third World Health Assembly declared that smallpox was eradicated in 1979. Many more diseases have been brought under control with vaccines, including diphtheria, measles, polio, tetanus, whooping cough, and yellow fever. And both measles and polio have been targeted for eradication. Disease Elimination Similar to eradication, when a disease is eliminated, the incidence of disease is reduced to zero, but only in a particular geographic area.

Unlike eradication, since the disease is still around in other areas, interventions must continue so that the disease doesn't come back in that area. To be more clear, when an epidemiologist says that a disease is eliminated in an area, what they are really saying is that the endemic form of the disease has been eliminated - someone has to reintroduce the disease from outside the area for outbreaks to occur. So you can still have cases and even big outbreaks like we continue to see with measles in the United States, however, they always start with someone who initially got infected from outside the country.

In the United States: endemic yellow fever (1905) and malaria (1951), both spread by mosquito bites, were the first diseases to be eliminated endemic polio was declared eliminated in 1979 endemic measles was declared eliminated in 2000 neonatal tetanus was declared eliminated before 2000 endemic rubella and congenital rubella syndrome were declared eliminated in 2004 endemic respiratory diphtheria was declared eliminated in 2009 and the last big outbreak was in the 1970s Again, even though these diseases have been eliminated in the United States, that doesn't mean that you can't get them anymore. If you are not vaccinated or have a problem with your immune system and travel to an area of the world where these diseases are still common, you are at risk to get sick and bring that disease home with you, infecting others. Disease Control Unfortunately, not all diseases can be eliminated and eradicated. This may have nothing to do with how well a vaccine works or whether or not people get their kids vaccinated though.

In some cases, an infection might not be contagious and is simply found in the environment, like Ascariasis (roundworms) or tetanus. To eradicate tetanus, we would have to get rid of the tetanus bacteria at its source - soil. Other reasons that a disease might not be able to be easily eliminated or eradicated could include that: it can also infect animals - rabies, yellow fever, Chagas’ disease the disease causes infections without symptoms - Amebiasis the presence of asymptomatic carriers - diphtheria natural infection doesn't provide life-long immunity - malaria the disease doesn't always have obvious symptoms - polio people are contagious before they have obvious symptoms - measles Hopefully, these challenges will soon be overcome for more diseases, though, especially vaccine-preventable diseases like polio and measles. Goals for Global Elimination and Eradication of Diseases Tragically, we have a long history of not meeting our goals for disease elimination and eradication.

Still, a lot of progress has been made over the years, millions of lives have been saved, and many more deaths will be prevented if we meet our current goals to eradicate or eliminate these diseases: polio - since the initial war on polio was started by President Franklin D Roosevelt in 1938 and the development of the first polio vaccines in the 1950s to the creation of The Global Polio Eradication Initiative in 1988, eradicating polio has been a priority for health experts. Unfortunately, we missed the first goal of eradicating polio by 2000, but are certainly getting close, as only three countries still have endemic polio - Afghanistan, Nigeria and Pakistan - and worldwide cases are at all time lows. The new goal is to have a polio-free world by 2018!

measles - We have missed a lot of the goals on the way to eradicating measles, including the goal to eliminate measles in the United States by 1982 (wasn't met until 2000), the goal of global eradication of measles by 2010 which was first set in 1996, and the goal of reducing global measles mortality by 90% by 2010 over 2000 levels (there was a 74% decrease though!). We will hopefully meet the latest goals of reducing global measles mortality by 95% by 2015 over 2000 levels, eliminating measles in at least five WHO regions by 2020, and setting a target date for measles eradication by the end of 2015. maternal and neonatal tetanus - while many people associate tetanus with stepping on a rusty nail, tetanus can also affect mothers and their newborn babies, especially when hygienic practices aren't available when the baby is delivered or when they care for the baby's umbilical cord.

Although the target dates have been postponed from the initial goals of 1995, 2000, 2005 and 2015, eliminating maternal and neonatal tetanus is still a goal. Considering that at least 49,000 newborns died of neonatal tetanus as late as 2013, which is down from 787,000 in 1988, significant progress continues to be made. Guinea worm disease - although not usually life-threatening, Guinea worm disease is still a serious disease that causes suffering for those who become infected with the Guinea worm larvae that can grow to become adults that are 2 to 3 feet long. Fortunately, Guinea worm disease should be the next disease that is eradicated, with cases at an all time low thanks to the efforts of The Carter Center . lymphatic filariasis (Elephantiasis) - transmitted by infected mosquitoes, lymphatic filariasis is another disabling condition that has been targeted for elimination using insecticidal bed nets and drugs donated by Merck and GlaxoSmithKline, hopefully by 2020.

taeniasis/cysticercosis (tapeworms) - eating undercooked pork that is infected with larval cysts of the tapeworm Taenia solium can cause intestinal tapeworms ( taeniasis ). Swallowing the eggs of these intestinal tapeworms (located in an infected persons feces) can lead to getting cysticercosis, in which the larval cysts can infect brain (neurocysticercosis) and muscle tissue, etc. Although thought to be potentially eradicable, cysticercosis is considered to be of several major neglected tropical diseases. mumps - a vaccine-preventable disease that is thought to be potentially eradicable. leprosy - using expanded multi-drug therapy regimens, leprosy is now in the final push phase of elimination. river blindness (onchocerciasis) - a parasitic infection that is spread through the bite of small black flies, river blindness is targeted for eliminated in select regions using a drug donated by Merck. trachoma - another eye infection that is spread by flies and which can lead to blindness, blinding trachoma is targeted for global elimination by 2020.

In addition to health education and corrective eye surgeries, the effort has been aided by Pfizer donating an antibiotic to fight trachoma . rubella - rubella is also targeted for elimination from at least five WHO regions by 2020. Unfortunately, even as we make progress to control, eliminate, and eradicate these diseases, some are beginning to make a comeback. And no, it is not just because of parents choosing to intentionally not vaccinate their children. In many parts of the world, in addition to the humanitarian crisis and health challenges posed by natural disasters, children are getting sick in war zones and refugee camps and simply can't be vaccinated. Sources: The Carter Center. Disease considered as candidates for global eradication by the International Task Force for Disease Eradication. Updated April 2008. CDC. The Principles of Disease Elimination and Eradication. MMWR. December 31, 1999 / 48(SU01);23-7. CDC. Manual for the Surveillance of Vaccine-Preventable Diseases. Accessed May 2015. Continue Reading Polio To Be Eradicated By 2018?

| HealthMap December 9, 2016 A mumps outbreak in Arkansas continues to grow at an alarming rate. As of December 8th, the total... Polio To Be Eradicated By 2018? Polio meeting organized by Bill and Melinda Gates Foundation by United States Mission Geneva 2001 via Flickr The new Polio Eradication and Endgame Strategic Plan , released on April 11, 2013 and developed by the Global Polio Eradication Initiative , has committed signatories to eradicate polio by 2018. Over four hundred experts worldwide signed the document. The plan outlines the key strategies that will make eradication finally possible. Poliovirus can be spread in several ways: direct person-to-person contact, contact with infected mucus or phlegm or contact with infected feces. While about 95 percent of people exposed to and infected by the poliovirus do not develop symptoms, a small percentage of those infected will experience mild, flu-like symptoms, maybe fever, and stiffness in the neck and back. Less than one percent experience a severe infection. The poliovirus invades the nervous system.

Severe infections usually result in permanent paralysis, and, if the poliovirus hits the respiratory system, the infection can result in death. There is no cure for polio. Jonas Salk created a vaccine in 1955. The polio vaccine is part of the routine childhood vaccination schedule currently used in the United States. Children typically receive four doses of the vaccine before entering elementary school. While polio has been eliminated from most parts of the world, it is still endemic in Pakistan, Afghanistan and Nigeria. The authors of the plan called it a “step forward over previous eradication strategies.” One big change is the scheduled phase out of the oral polio vaccine (OPV) in favor of the inactivated polio vaccine, which is injected (IPV). The OPV has been shown to be more likely to cause polio than the IPV, although the chances of this happening are still extremely small. The plan also calls for targeted vaccination campaigns (rather than mass vaccination campaigns, targeted campaigns focus on a specific population or group that may be more at risk of infection than others) and a scale-up (or improved infrastructure) of routine vaccination programs.

In the future, governments could use the infrastructure developed around routine polio vaccinations to provide other health services, such as better maternal health and other vaccines. Experts believe the plan improves on past vaccination strategies because it specifically emphasizes the importance of community buy-in and involvement. In the past, suspicion about vaccines and campaign volunteers has been a huge obstacle to getting children vaccinated. Many parents are hesitant to let their children be vaccinated because they do not know how the vaccination works or they think that the children has received too many doses. In Muslim countries, some people are concerned that the vaccines are not compliant with Islamic law. A few extreme cases of suspicion have resulted in attacks on polio vaccine campaign workers. On 9 April, 2013 , a man working to protect campaign volunteers was shot and killed in Pakistan. This is not the first attack against health workers in vaccine campaigns. A similar situation occurred in Pakistan in December 2012 when five women were killed. In Nigeria , nine women were gunned down in February while working. Some suspicion about the intentions of vaccine campaigns is not unwarranted.

In July 2012, the legitimacy of public health campaigns was seriously threatened when it was revealed that the CIA had used a hepatitis B vaccination campaign as a cover for reconnaissance on Osama bin Laden in Pakistan. As reported by the New York Times, Dr. Zulfiqar A Bhutta, a vaccine specialist at Aga Khan University in Pakistan, criticized this strategy. “There could hardly have been a more stupid venture, and there was bound to be a backlash, especially for polio.” To ease this suspicion, the Strategic Plan has called on religious and community leaders to sanction these campaigns. The new generation of campaigns will also be low-profile in order to protect health workers from future attacks. If the experts behind the Polio Eradication and Endgame Strategic Plan can overcome this resistance from communities, they are poised to finally eradicate polio by 2018. There were only 223 new cases of polio reported in 2012 and have only been sixteen cases so far in 2013. India, a country where polio has historically been endemic, has seen no cases for the past two years. In a press release for the new polio plan, Dr.

David Heymann, the head and senior fellow at the Chatham House Centre on Global Health Security, explained , “Eradicating polio is no longer a question of technical or scientific feasibility. Rather, getting the most effective vaccines to children at risk requires stronger political and societal commitment” The Global Polio Eradication Initiative team estimates that global eradication will cost $5.5 billion over the next five years. In the past, gaps in funding have slowed campaigns, resulting in lost time and resurging outbreaks. This time, they hope to raise the full amount of money needed before beginning the campaign. Expected donors include Rotary International, the Bill and Melinda Gates Foundation and government aid. Chuck Woolery, the issues director of the Global Health Council from 1995 to 1997, says polio eradication is worth the cost. “We can pay a little more now or pay a great deal more in economic and human costs later.” Vaccines: Vac-Gen/What Would Happen If We Stopped Vaccinations Top of Page Diseases haven't disappeared. The United States has very low rates of vaccine-preventable diseases, but this isn’t true everywhere in the world.

Only one disease — smallpox — has been totally erased from the planet. Polio no longer occurs in the U.S., but it is still paralyzing children in several African countries. More than 350,000 cases of measles were reported from around the world in 2011, with outbreaks in the Pacific, Asia, Africa, and Europe. In that same year, 90% of measles cases in the U.S. were associated with cases imported from another country. Only the fact that most Americans are vaccinated against measles prevented these clusters of cases from becoming epidemics. Disease rates are low in the United States today. But if we let ourselves become vulnerable by not vaccinating, a case that could touch off an outbreak of some disease that is currently under control is just a plane ride away. Top of Page A final example: what could happen. We know that a disease that is apparently under control can suddenly return, because we have seen it happen, in countries like Japan, Australia, and Sweden. Here is an example from Japan. In 1974, about 80% of Japanese children were getting pertussis (whooping cough) vaccine.

That year there were only 393 cases of whooping cough in the entire country, and not a single pertussis-related death. Then immunization rates began to drop, until only about 10% of children were being vaccinated. In 1979, more than 13,000 people got whooping cough and 41 died. When routine vaccination was resumed, the disease numbers dropped again. The chances of your child getting a case of measles or chickenpox or whooping cough might be quite low today. But vaccinations are not just for protecting ourselves, and are not just for today. They also protect the people around us (some of whom may be unable to get certain vaccines, or might have failed to respond to a vaccine, or might be susceptible for other reasons). And they also protect our children’s children and their children by keeping diseases that we have almost defeated from making a comeback. What would happen if we stopped vaccinations? We could soon find ourselves battling epidemics of diseases we thought we had conquered decades ago. References Gangarosa EJ, et al. Impact of anti-vaccine movements on pertussis control: the untold story.

Lancet 1998;351:356-61. Related to: Herd Immunity Thanks to vaccines, polio may officially be eradicated by 2018 – DeadState Comments Last year in 2014, only three countries in the world had cases of Polio: Afghanistan, Pakistan, and Nigeria. This year, we’re down to two — Afghanistan and Pakistan. According to NPR , by 2018, we may be down to zero. Polio, short for poliomyelitis, is a virus that would paralyze 1 out of every 200 people infected. Of those paralyzed, 5 to 10% of them had the muscles in their throat paralyzed, making it impossible to breathe and suffocating them to death. Polio’s eradication has been fairly swift. In 1952 there were 20,000 cases in the United States alone. After the discovery of the vaccine in 1955, polio in the United States was down to 100 cases just 10 years later. By 1973, the number of cases were down to single digits.

By the mid-1990s, the United States was officially free of polio. Children in an iron lung (1937) before the advent of the polio vaccination. #VaccinesWork pic.twitter.com/76GRlfsPey — Lindsey Fitzharris (@DrLindseyFitz) November 7, 2015 The only other virus that has been completely eradicated from the entire world in a similar way was smallpox, back in 1977, again, because of vaccinations. Even now, there are people who still claim vaccines cause autism even after that notion has been thoroughly debunked. They think vaccines are something other than a medical boon that have kept children safe from sometimes deadly diseases that used to be just another fact of life. Anyway, this is incredibly exciting news. Here’s to no more polio in 2018! [ Slate ] Featured image via Twitter Facebook Comment November 9, 2015 at 5:02 pm That’s a thing of beauty right there.

Polio On Track To Be Eradicated By 2018, If Not Sooner Via Jason Heuser / Creative Commons license Completely relevant FDR portrait by Jason Heuser . Polio is in its final days, and it’s starting to look like either polio or dracunculiasis will be the third disease ever to be completely eradicated, proceeded by smallpox (last human case in 1977) and rinderpest (last animal case in 2010). This week, Peter Crowley of UNICEF told NPR , “We are aiming to halt all transmission of wild polio virus next year.” The plan is to continue distributing the vaccine for awhile after then to be certain it’s over. Right now, it’s reasonable to estimate the last case of polio will occur in 2018 or sooner. Considering dracunculiasis eradication has had a recent setback with the disease infecting canines and spreading to humans from there, polio may prove to be the next disease successfully eradicated. There are now only two nations left which have detected wild polio cases this year: Afghanistan and Pakistan.

To put things in perspective, those two countries have had 51 cases reported so far this year. In 1988, when the Global Polio Eradication Initiative launched, there were 350,000 cases annually. And this is a disease which paralyzes one out of every 200 people infected and kills around one out of every 2,000 to 4,000 infected, most of them under the age of five. In 1952 (the year Jonas Salk developed the first effective polio vaccine ), polio permanently paralyzed 20,000 people in the U.S. during only that one year. And we’re this close to wiping it off the face of the Earth, thanks to vaccines. Strategy – GPEI Strategy Polio Eradication and Endgame Strategic Plan 2013–2018 The Polio Eradication & Endgame Strategic Plan 2013-2018 is a comprehensive, long-term strategy that addresses what is needed to deliver a polio-free world by 2018.

The plan was developed by the Global Polio Eradication Initiative (GPEI) in consultation with national health authorities, global health initiatives, scientific experts, donors and other stakeholders, in response to a directive of the World Health Assembly. A mid-term review was conducted for the plan in mid-2015. Working in some of the most difficult environments in the world has presented major challenges to reaching children with vaccines. The review concluded that while the strategic plan remains a strong framework for ending polio, there is an urgent need to re-focus certain priorities and activities. This includes strengthening surveillance, improving the quality of immunization campaigns and building capacity to respond to outbreaks. Based on these recommendations, the review also evaluated the deadline for eradication, and any resulting financial implications. Polio Eradication & Endgame Midterm Review July 2015 The Polio Eradication and Endgame Strategic Plan 2013-2018 addresses the eradication of all polio disease, whether caused by wild poliovirus or circulating vaccine-derived poliovirus, while planning for the backbone of the polio effort to be used for delivering other health services to the world’s most vulnerable children.

The Plan has four objectives: Detect and interrupt all poliovirus transmission Strengthen immunization systems and withdraw oral polio vaccine Contain poliovirus and certify interruption of transmission Plan polio’s legacy FACT FILE ENGLISH The Eradication and Endgame Strategic Plan 2013–2018 is a comprehensive, long-term strategy that addresses what is needed to deliver a polio-free world by 2018. Scientists back roadmap to rid world of polio by 2018 - SciDev.Net Scientists back roadmap to rid world of polio by 2018 New intravenous vaccines will soon replace oral vaccines Copyright: Flickr/Sanofi Pasteur Shares Around 400 scientists from 80 countries have come together to declare that polio could be wiped off the face of the Earth in five years if plans to eliminate both wild and vaccine-derived polioviruses are implemented. In a 'Scientific Declaration on Polio Eradication', published today (11 April), eminent scientists and public health experts emphasise the feasibility of eradicating the disease and endorse a recent draft plan that sets out a roadmap to doing so by 2018.

The 'Polio Eradication and Endgame Strategic Plan 2013-2018' is being developed by the Global Polio Eradication Initiative (GPEI) — an international partnership of the WHO, UNICEF, Rotary International and the US Centers for Disease Control and Prevention. The latest version of the draft plan was published this week (9 April). SPEED READ The scientists' declaration says polio eradication is achievable within five years It backs calls for the phasing out of an oral vaccine that has itself caused outbreaks The scientists also call for extra money to fund the plan's goals "There has been a perception that polio is not eradicable. We developed the declaration to underscore the science behind [this goal] and to say that this is doable," says Zulfiqar Bhutta, head of the Division of Women and Child Health at the Aga Khan University in Pakistan. He is the joint leader of the declaration, along with Walter Orenstein, associate professor at the Emory Vaccine Center in the United States. "The declaration also calls for additional resources to eliminate the gap in funding needed for the eradication plan," Bhutta tells SciDev.Net.

He adds that improved vaccination strategies are needed to address the polio endgame. One of the declaration's signatories, David Heymann, chair of Public Health England's advisory board in the United Kingdom, says that much remains to be done. "GPEI has set a target of 2018 and it has been encouraged by the fact that India has now become polio-free , which was a challenge," he says. "The remaining three countries that are endemic — Nigeria, Afghanistan and Pakistan — have challenges of their own ." "The main challenge is to vaccinate all the children in order to establish immunity in the communities," Heymann says. There were only fewer than 250 polio cases reported from five countries last year, compared with 350,000 from 125 countries in 1988. "The vaccine seems to have worked in most countries, so there's no reason it wouldn't work in the countries that are left," he explains, adding that "the technology that we need to eradicate polio is there". The GPEI plan aims to strengthen routine immunisation programmes and the surveillance of virus transmission.

The declaration supports the plan's objective to stop using the trivalent oral polio vaccine that contains all three types of wild polioviruses — types 1, 2 and 3 — in an attenuated, albeit living, state. The continued use of wild poliovirus type 2, which was eradicated in 1999, in this vaccine has been found to be a major cause of vaccine-derived polio outbreaks .' To avoid further such outbreaks, new inactivated polio vaccines (IPV), which are given intravenously, will be introduced to the routine immunisation programmes in countries that rely on oral vaccines, according to the plan. Recently developed bivalent oral vaccines, lacking the type 2 poliovirus, will then replace the trivalent vaccines. The declaration acknowledges these steps as "strong solutions to challenges". Sona Bari, a spokeswoman for the GPEI in Geneva, Switzerland, tells SciDev.Net the scientists' declaration is a strong endorsement of her organisation's plan. "Polio eradication is a global win, so we need every single country to fund and finance it as well," she says. John L.

Sever, vice- chair of the International PolioPlus Committee of Rotary International, says: "The scientific declaration is consistent with the objectives of the strategic plan and its importance. Scientific support and advice have been vital to the development of the strategic plan and [will be] in its implementation." We encourage you to republish this article online and in print, it’s free under our creative commons attribution license, but please follow some simple guidelines: You have to credit our authors. You have to credit SciDev.Net — where possible include our logo with a link back to the original article. You can simply run the first few lines of the article and then add: “Read the full article on SciDev.Net” containing a link back to the original article. If you want to also take images published in this story you will need to confirm with the original source if you're licensed to use them. The easiest way to get the article on your site is to embed the code below. For more information view our media page and republishing guidelines . The full article is available here as HTML.

Press Ctrl-C to copy <div class="article-wrap"> <div id="article-introduction"> <h1>Scientists back roadmap to rid world of polio by 2018</h1> <h4>By Richa Malhotra</h4> </div> <br /> <br /> <div id="article-body"><p> <!--[if gte mso 9]><xml> Normal 0 false false false EN-GB X-NONE X-NONE </xml><![endif]--><span>Around 400 scientists from 80 countries have come together to declare that polio could be wiped off the face of the Earth in five years if plans to eliminate both wild and vaccine-derived polioviruses are implemented.<br /> <br /> In a 'Scientific Declaration on Polio Eradication', published today (11 April), eminent scientists and public health experts emphasise the feasibility of eradicating the disease and endorse a recent draft plan that sets out a roadmap to doing so by 2018.</span></p> <p> The 'Polio Eradication and Endgame Strategic Plan 2013-2018' is being developed by the Global

 Polio Eradication Initiative (GPEI) — an international partnership of the WHO, UNICEF, Rotary International and the US Centers for Disease Control and Prevention.

The latest version of the draft plan was published this week (9 April).</p> <div class="box" style="margin: 0pt 10px 10px 0pt; background: #ededed; width: 50%; float: left;"> <div class="inherit_box box"> <h3 style="color: #ffffff; margin: 0px;"> SPEED READ</h3> </div> <div> <div> <ul style="list-style: disc outside; margin: 10px 5px 10px 20px;"> <li style="padding: 0 0 5px;"> The scientists' declaration says polio eradication is achievable within five years</li> <li style="padding: 0 0 5px;"> It backs calls for the phasing out of an oral vaccine that has itself caused outbreaks</li> <li style="padding: 0 0 5px;"> The scientists also call for extra money to fund the plan's goals</li> </ul> </div> </div> </div> <p> "There has been a perception that polio is not eradicable.

<span>We developed the declaration to underscore the science behind [this goal] and to say that this is doable," says </span>Zulfiqar Bhutta, head of the Division of Women and Child Health at the <span>Aga Khan University</span> in Pakistan. He is the joint leader of the declaration, along with Walter Orenstein, associate professor at the Emory Vaccine Center in the United States.</p> <p> "The declaration also calls for additional resources to eliminate the gap in funding needed for the eradication plan," Bhutta tells <em>SciDev.Net</em>.<br /> <br /> He adds that improved vaccination strategies are needed to address the polio endgame.<br /> <br /> One of the declaration's signatories, David Heymann, chair of <a href="" title="Health Protection Agency">Public</a> Health England's advisory board in the United Kingdom, says that much remains to be done.<br /> <br /> "GPEI has set a target of 2018 and it has been encouraged by the fact that <a href=""> India has now become polio-free</a>, which was a challenge," he says.

"The remaining three countries that are endemic — Nigeria, Afghanistan and Pakistan — <a href="">have challenges of their own</a>." <br /> <br /> "The main challenge is to vaccinate all the children in order to establish immunity in the communities," Heymann says.<br /> <br /> There were only fewer than 250 polio cases reported from five countries last year, compared with 350,000 from 125 countries in 1988.</p> <p> "The vaccine seems to have worked in most countries, so there's no reason it wouldn't work in the countries that are left," he explains, adding that "the technology that we need to eradicate polio is there".<br /> <br /> The GPEI plan aims to strengthen routine immunisation programmes and the surveillance of virus transmission.<br /> <br /> The declaration supports the plan's objective to stop using the trivalent oral polio vaccine that contains all three types of wild polioviruses — types 1, 2 and 3 — in an attenuated, albeit living, state.<br /> <br /> The continued use of wild poliovirus type 2, which was eradicated in 

1999, in this vaccine has been found to be a major cause of <a href="">vaccine-derived polio outbreaks</a>.' <br /> <br /> To avoid further such outbreaks, new inactivated polio vaccines (IPV), which are given intravenously, will be introduced to the routine immunisation programmes in countries that rely on oral vaccines, according to the plan.<br /> <br /> Recently developed bivalent oral vaccines, lacking the type 2 poliovirus, will then replace the trivalent vaccines.

<br /> <br /> The declaration acknowledges these steps as "strong solutions to challenges".<br /> <br /> Sona Bari, a spokeswoman for the GPEI in Geneva, Switzerland, tells <em>SciDev.Net</em> the scientists' declaration is a strong endorsement of her organisation's plan.<br /> <br /> "Polio eradication is a global win, so we need every single country to fund and finance it as well," she says.<br /> <br /> John L. Sever, <span>vice- chair of the International PolioPlus Committee </span>of Rotary International, says: "The scientific declaration is consistent with the objectives of the strategic plan and its importance.

Scientific support and advice have been vital to the development of the strategic plan and [will be] in its implementation."<br /> <br /> <a href="" target="_blank">Link<span> to the draft polio eradication strategic plan</span></a><span> </span></p> <p> <span><!--[if gte mso 9]><xml> Normal 0 false false false EN-GB X-NONE X-NONE MicrosoftInternetExplorer4 </xml><![endif]--></span></p> <p> <a href="" target="_blank">Link to the scientific declaration</a></p> <!--[if gte mso 9]><![endif]--><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-style-parent:""; font-size:10.0pt;"Calibri","sans-serif";} </style> <![endif]--></div> <br /> <p>This article was originally published on <a href="" target="_blank">SciDev.Net</a>.

Read the <a href="" target="_blank">original article</a>.</p> </div> <script type="text/javascript">(function(e,t,n,r,i,s,o){e["GoogleAnalyticsObject"]=i;e[i]=e[i]||function(){(e[i].q=e[i].q||[]).push(arguments)},e[i].l=1*new Date;s=t.createElement(n),o=t.getElementsByTagName(n)[0];s.async=1;s.src=r;o.parentNode.insertBefore(s,o)})(window,document,"script","//","ga");var _gaq=_gaq||[];var _gaq=_gaq||[];_gaq.push(["_setAccount","UA-3223906-1"],["_trackEvent","article interaction","republished","/global/health/news/scientists-back-roadmap-to-rid-world-of-polio-by-2018.html",null,true])</script> Related topics: We encourage you to republish this article online and in print, it’s free under our creative commons attribution license, but please follow some simple guidelines: You have to credit our authors.

You have to credit SciDev.Net — where possible include our logo with a link back to the original article. You can simply run the first few lines of the article and then add: “Read the full article on SciDev.Net” containing a link back to the original article. If you want to also take images published in this story you will need to confirm with the original source if you're licensed to use them. The easiest way to get the article on your site is to embed the code below. For more information view our media page and republishing guidelines . The full article is available here as HTML.

Press Ctrl-C to copy <div class="article-wrap"> <div id="article-introduction"> <h1>Scientists back roadmap to rid world of polio by 2018</h1> <h4>By Richa Malhotra</h4> </div> <br /> <br /> <div id="article-body"><p> <!--[if gte mso 9]><xml> Normal 0 false false false EN-GB X-NONE X-NONE </xml><![endif]--><span>Around 400 scientists from 80 countries have come together to declare that polio could be wiped off the face of the Earth in five years if plans to eliminate both wild and vaccine-derived polioviruses are implemented.<br /> <br /> In a 'Scientific Declaration on Polio Eradication', published today (11 April), eminent scientists and public health experts emphasise the feasibility of eradicating the disease and endorse a recent draft plan that sets out a roadmap to doing so by 2018.</span></p> <p> The 'Polio Eradication and Endgame Strategic Plan 2013-2018' is being developed by the Global

 Polio Eradication Initiative (GPEI) — an international partnership of the WHO, UNICEF, Rotary International and the US Centers for Disease Control and Prevention.

The latest version of the draft plan was published this week (9 April).</p> <div class="box" style="margin: 0pt 10px 10px 0pt; background: #ededed; width: 50%; float: left;"> <div class="inherit_box box"> <h3 style="color: #ffffff; margin: 0px;"> SPEED READ</h3> </div> <div> <div> <ul style="list-style: disc outside; margin: 10px 5px 10px 20px;"> <li style="padding: 0 0 5px;"> The scientists' declaration says polio eradication is achievable within five years</li> <li style="padding: 0 0 5px;"> It backs calls for the phasing out of an oral vaccine that has itself caused outbreaks</li> <li style="padding: 0 0 5px;"> The scientists also call for extra money to fund the plan's goals</li> </ul> </div> </div> </div> <p> "There has been a perception that polio is not eradicable.

<span>We developed the declaration to underscore the science behind [this goal] and to say that this is doable," says </span>Zulfiqar Bhutta, head of the Division of Women and Child Health at the <span>Aga Khan University</span> in Pakistan. He is the joint leader of the declaration, along with Walter Orenstein, associate professor at the Emory Vaccine Center in the United States.</p> <p> "The declaration also calls for additional resources to eliminate the gap in funding needed for the eradication plan," Bhutta tells <em>SciDev.Net</em>.<br /> <br /> He adds that improved vaccination strategies are needed to address the polio endgame.<br /> <br /> One of the declaration's signatories, David Heymann, chair of <a href="" title="Health Protection Agency">Public</a> Health England's advisory board in the United Kingdom, says that much remains to be done.<br /> <br /> "GPEI has set a target of 2018 and it has been encouraged by the fact that <a href=""> India has now become polio-free</a>, which was a challenge," he says.

"The remaining three countries that are endemic — Nigeria, Afghanistan and Pakistan — <a href="">have challenges of their own</a>." <br /> <br /> "The main challenge is to vaccinate all the children in order to establish immunity in the communities," Heymann says.<br /> <br /> There were only fewer than 250 polio cases reported from five countries last year, compared with 350,000 from 125 countries in 1988.</p> <p> "The vaccine seems to have worked in most countries, so there's no reason it wouldn't work in the countries that are left," he explains, adding that "the technology that we need to eradicate polio is there".<br /> <br /> The GPEI plan aims to strengthen routine immunisation programmes and the surveillance of virus transmission.<br /> <br /> The declaration supports the plan's objective to stop using the trivalent oral polio vaccine that contains all three types of wild polioviruses — types 1, 2 and 3 — in an attenuated, albeit living, state.<br /> <br /> The continued use of wild poliovirus type 2, which was eradicated in 

1999, in this vaccine has been found to be a major cause of <a href="">vaccine-derived polio outbreaks</a>.' <br /> <br /> To avoid further such outbreaks, new inactivated polio vaccines (IPV), which are given intravenously, will be introduced to the routine immunisation programmes in countries that rely on oral vaccines, according to the plan.<br /> <br /> Recently developed bivalent oral vaccines, lacking the type 2 poliovirus, will then replace the trivalent vaccines.

<br /> <br /> The declaration acknowledges these steps as "strong solutions to challenges".<br /> <br /> Sona Bari, a spokeswoman for the GPEI in Geneva, Switzerland, tells <em>SciDev.Net</em> the scientists' declaration is a strong endorsement of her organisation's plan.<br /> <br /> "Polio eradication is a global win, so we need every single country to fund and finance it as well," she says.<br /> <br /> John L. Sever, <span>vice- chair of the International PolioPlus Committee </span>of Rotary International, says: "The scientific declaration is consistent with the objectives of the strategic plan and its importance.

Scientific support and advice have been vital to the development of the strategic plan and [will be] in its implementation."<br /> <br /> <a href="" target="_blank">Link<span> to the draft polio eradication strategic plan</span></a><span> </span></p> <p> <span><!--[if gte mso 9]><xml> Normal 0 false false false EN-GB X-NONE X-NONE MicrosoftInternetExplorer4 </xml><![endif]--></span></p> <p> <a href="" target="_blank">Link to the scientific declaration</a></p> <!--[if gte mso 9]><![endif]--><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-style-parent:""; font-size:10.0pt;"Calibri","sans-serif";} </style> <![endif]--></div> <br /> <p>This article was originally published on <a href="" target="_blank">SciDev.Net</a>.

Read the <a href="" target="_blank">original article</a>.</p> </div> <script type="text/javascript">(function(e,t,n,r,i,s,o){e["GoogleAnalyticsObject"]=i;e[i]=e[i]||function(){(e[i].q=e[i].q||[]).push(arguments)},e[i].l=1*new Date;s=t.createElement(n),o=t.getElementsByTagName(n)[0];s.async=1;s.src=r;o.parentNode.insertBefore(s,o)})(window,document,"script","//","ga");var _gaq=_gaq||[];var _gaq=_gaq||[];_gaq.push(["_setAccount","UA-3223906-1"],["_trackEvent","article interaction","republished","/global/health/news/scientists-back-roadmap-to-rid-world-of-polio-by-2018.html",null,true])</script> Latest articles Control, Eliminate, Eradicate: Global Efforts to Wipe Out Disease | Global Washington Home / Issues / 2016 / Control, Eliminate, Eradicate: Global Efforts to Wipe Out Disease Control, Eliminate, Eradicate: Global Eff

orts to Wipe Out Disease In 1980, the World Health Organization (WHO) announced the eradication of smallpox, the first and only infectious disease to meet this fate.

Eradication of a disease is defined as the permanent reduction to zero of the worldwide incidence of infection. The road to eradication includes stops at control, the reduction of disease incidence, prevalence, morbidity or mortality to a locally acceptable level, followed by elimination, the reduction to zero of the incidence of infection in a defined geographical area. Smallpox has several characteristics that made eradication possible: an effective vaccine which could prevent infection with a single dose, highly visible symptoms with a short incubation period, and transmission occurring only human-to-human. Since the last known case of smallpox, The International Task Force for Disease Eradication has been coordinating efforts to rid the world of infectious diseases. However, each disease is unique and has its own set of challenges on the path to eradication. To illustrate how diseases differ in treatment, interventions and challenges, this article will focus on global efforts to eradicate polio, guinea worm and malaria. Polio, also called poliomyelitis, is believed to be the next infectious disease in line for eradication because it has been eliminated everywhere except for Afghanistan and Pakistan. Polio is a viral infectious disease transmitted from person to person through the fecal-oral route.

The virus primarily affects children under age five, and one in 200 infections can lead to irreversible paralysis. Polio cases have decreased by 99 percent since 1988, and in 2015 there were only 22 reported cases of polio worldwide. This reduction is due to coordinated efforts of The Global Polio Eradication Initiative (GPEI). In order to tackle the two remaining endemic countries with polio, the GPEI developed the Polio Eradication and Endgame Strategic Plan 2013-2018 to rid the world of polio by 2018. Polio eradication strategy involves the immunization of every child, strong surveillance to detect and interrupt transmission and a long-term plan to ensure vulnerable countries do not see reemergence of infection. In April, a new bivalent oral polio vaccine started being distributed globally. This new vaccine protects against polio types 1 and 3 (type 2 was eradicated in 1999) and is stronger than the previous oral vaccine. Many of the challenges to eradicating polio are due to instability in Afghanistan and Pakistan.

The remaining areas with polio infection are isolated and people have limited access to vaccines, and face security problems. Guinea worm disease, also known as dracunculus medinensis, is caused by a parasitic worm which enters the body through ingestion of contaminated water. When a person drinks the worm larvae living in nearby water sources, the larvae migrate through intestinal walls, mate, and after 10 to 14 months the pregnant female extracts itself painfully from the foot of the host. The adult female worm carries three million embryos, and can measure 60 to 100 centimeters in length. For pain relief, infected people place the affected area in water, releasing the larvae back into the water source for the next victim. There is no treatment to prevent infection or heal a person of guinea worm. While rarely fatal, a person can suffer from infection at the site of extraction leading to skin ulcers and permanent disability. Eradication of guinea worm depends solely on access to clean drinking water. The good news is that, in 2015, there were only 22 reported cases of guinea worm in four countries (Chad, Mali, South Sudan and Ethiopia).

Eradication efforts include detecting cases within 24 hours, health education and ensuring access to safe drinking water. Since 1986, The Carter Center has led the international campaign for guinea worm eradication, and today cases have been reduced by 99.99 percent. Once eradicated, it will be the first parasitic disease to meet this fate, as well as the first disease eradicated without the use of vaccines or medications. Challenges to guinea worm eradication include infections in remote areas where interventions can not reach people, as well as dogs hosting the parasite which has led to increased human transmission in Chad and Ethiopia. Malaria is an infectious disease of the blood caused by the plasmodium parasite and is transmitted from person to person by the female anopheles mosquito. Once the parasite enters the body, it lodges in the host’s liver, multiples, and enters the blood stream to infect red blood cells. Without treatment, malaria leads to death. In Africa, a child dies every two minutes from malaria and, in 2015, there were an estimated 214 million cases of malaria worldwide (mostly in pregnant women and children).

In 2015, sub-Saharan Africa accounted for 88 percent of malaria cases and 90 percent of malaria deaths. Approximately half of the world’s population is at risk of malaria, but the disease is preventable and curable. The Global Malaria Eradication Program launched by WHO in 1955 was the first attempt at eradicating malaria. The program was criticized for its one-size-fits-all approach, lack of community involvement and lack of research and evaluation on intervention methods. It was abandoned in 1970. Since 2000, improved interventions have decreased the incidence of malaria by 37 percent globally, and mortality rates in children under age five have fallen by 58 percent. Interventions today include rapid diagnostic tests, malaria medications for treatment and prevention, availability of insecticide treated bed nets (since mosquitos carrying the virus feed at night) as well as indoor insecticide spraying. A malaria vaccine is also in development. The new goal is a major reduction of malaria cases and deaths by 2030 and the WHO Global Technical Strategy for Malaria 2016-2030 outlines a plan to achieve this.

Malaria has a longer and more challenging road to eradication when compared to polio and guinea worm, but important achievements are being made in the fight to end malaria. In April, Europe was the first region in the world to be certified as malaria-free by the WHO. This is defined as zero locally acquired malaria cases for three consecutive years. Two major challenges to other regions of the world becoming malaria-free are insecticide resistance by mosquitos and medication resistance by strains of the virus. Another challenge is that a majority of transmissions start with asymptomatic people, requiring medical professionals to diagnose patients who have yet to show symptoms, and then treat them before transmission can occur. Polio, guinea worm and malaria are unique diseases each with their own unique challenges, much like other infectious diseases that are causing death and disability around the world. While the road to eradication for each disease has many paths and varies in length, global health organizations must continue to collaborate and pursue solutions. Below are several GlobalWA members working towards eradication of infectious diseases. Learn more about these organizations and others on our interactive member map.

Health and Hope Foundation – Health & Hope Foundation (HHF) provides dental, vision, non-surgical medical care and preventative healthcare education tools to impoverished communities who otherwise lack access or means for care. Clinics are on-site and portable allowing for access to rural areas. By teaming with local leaders, specific community needs such as disease prevention, clean water, light, education, sexual safely, safe living conditions and sustainable business are illuminated. Local leaders are developed to address these needs within HHF programs or by linking them with specialized NGOs. Malaria No More – Malaria No More (MNM) is working to create a world where no child dies from a mosquito bite. Using strategic advocacy and innovative partnerships to engage global leaders, rally the public and deliver lifesaving tools and education to families across Africa, MNM aims to create the political will and mobilize the global resources required to achieve malaria eradication within our generation. They work with leaders of malaria-endemic countries in Africa, Asia and Latin America to increase the amount of attention and funding they commit to malaria each year, elevating it on the global health and international development agenda.

Medical Teams International – Medical Teams International works to stem the tide of communicable diseases among vulnerable populations in locations where access to health care and medicine is lacking. In Uganda, this means curbing malarial infections, particularly among refugees. Medical Teams was instrumental in quelling the deadly cholera outbreak that swept through Haiti following the devastating 2010 earthquake, and preventing further outbreaks. And in Liberia, Medical Teams has worked to build durable partnerships to strengthen health systems in the fight against Ebola. Through clinical case management, prevention, education and early diagnosis, Medical Teams aims to stamp out the spread of deadly diseases around the globe. PATH – PATH is a leader in global health innovation. An international nonprofit, PATH saves lives and improves health, especially among women and children, and works alongside countries primarily in Africa and Asia to tackle their greatest health needs. With a network of partners, both in the Pacific Northwest and around the world, PATH advances high-impact, low-cost approaches to not only manage and control stubborn diseases, but to end them completely. Recently, PATH and their partners helped vaccinate more than 235 million people against meningitis A in sub-Saharan Africa — nearly eliminating it as a major health threat in the span of five years.

Through the PATH Center for Malaria Control and Elimination, the organization is building on their unparalleled portfolio of malaria tools and projects — including cutting-edge research and development of malaria drugs, diagnostics, and vaccines — to advance efforts toward elimination. PATH’s work in disease elimination also includes diagnostics and other tools to fight polio and neglected tropical diseases like river blindness and lymphatic filariasis. . Pilgrim Africa – With over 16 million cases of malaria per year in a population of only 34 million, Ugandans have the highest malaria transmission rates in the world, and status quo measures are not reducing malaria fast enough. In partnership with Uganda’s Ministry of Health, Rotary International, Seattle #4 Rotary Club and Peace Corps Uganda, Pilgrim Africa is charting a course for the most cost-effective, safest and fastest way to reduce malaria in high transmission settings. Pilgrim Africa’s newest operational research project combines and sequences the most effective malaria interventions for mosquito control and medical management in order to rapidly reduce malaria transmission and maintain the new lower rates. This intervention is predicted by mathematical modeling to remove over 90% of the death and disease caused by malaria and to provide a cost-effective solution at scale.

The Bill and Melinda Gates Foundation – Founded in 1997, the Bill & Melinda Gates Foundation works in developing countries to improve people’s health and to lift them out of extreme poverty. The Foundation’s global health and development work uses advances in science and technology, and works with partners in developing countries to deliver vaccines, drugs and diagnostics. The Gates Foundation works to find new solutions and interventions to improve efficiency and effectiveness and ensure these methods reach those most in need. The Foundation also invests in vaccines for HIV, polio and malaria, as well as supports integrated health solutions for family planning, nutrition and maternal and child health. U.S. Fund for UNICEF – UNICEF, the world’s largest buyer of vaccines, provides immunization for forty percent of the world’s children. Today, infant and childhood vaccination saves up to 3 million children’s lives a year. Conflict, displacement and poverty keep some of the most vulnerable children from getting the vaccines they need. If all children were immunized with existing vaccines, by 2020 we would save nearly 25 million lives. Thanks to UNICEF and partners’ global immunization and vaccine efforts, polio has almost — but not quite — disappeared.

In 2014, India joined the ranks of the polio-free, a major achievement thanks to lifesaving polio vaccines, and in 2015, Nigeria reached a milestone when it went a full year without a single case of polio. VillageReach – VillageReach increases access to quality healthcare by improving the capacity and efficiency of health systems in the world’s most underserved communities. With a particular emphasis in last mile supply chain systems, VillageReach has developed innovative approaches to improve transport and logistics for vaccine delivery and other essential medicines, including HIV medicines and other related supplies to test and treat infectious diseases.

Question: What disease is projected to be eradicated worldwide by 2018, thanks to vaccines?
Answer: Polio