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Polio eradication faces three main challenges:
Access: Securing access to all children, especially those in conflict-affected countries, is crucial. The success in establishing access, cease-fires and "Days of Tranquillity" for countries such as Afghanistan and the Democratic Republic of the Congo demonstrates the feasibility of working successfully in conflict-affected areas. These efforts must be expanded, drawing upon the strengths of the United Nations Secretary-General's office, many UN agencies, the International Red Cross and Red Crescent movement, and other new and existing partners.
Funding: Necessary financial resources must be secured to purchase oral polio vaccine (OPV), plan and implement national immunization days and mop-up campaigns, and cover surveillance and laboratory costs. The total external financial support needed to the end of 2005 – the target date for certification – is US$ 1 billion. The funding gap is US$ 400 million. A failure to interrupt transmission in time for polio-free certification in 2005 will increase the cost of the programme by an estimated US$ 100 million for every year the programme runs beyond the deadline.
Political commitment: Sustaining political commitment from the highest levels of government is particularly challenging in the face of a disappearing disease. In polio- endemic countries, personal monitoring by the head of state of the progress towards eradication is key to improving the quality of activities. In polio-free countries, political commitment is needed for sustaining certification-standard surveillance and achieving laboratory containment of poliovirus.
In addition, priority reservoir countries require a special effort, including extra national immunization days and house-to-house mop-up campaigns. Certification-standard surveillance is needed to find the last cases in every country and evaluate the status for certification.
Once polio is eradicated, the laboratories of the world will be the only remaining location of the virus. As an increasing number of countries become polio-free, the virus needs to be safely and securely stored in laboratories to ensure no inadvertent release occurs after eradication.
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