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1 1 (November 4, 2016)

handle is hein.crs/govcevz0001 and id is 1 raw text is: FF. , -iE SE.$. - & , Global Polio Eradication Efforts November 4, 2016 Poliomyelitis (polio), formerly a widespread global health challenge, is now endemic in only a handful of countries. Efforts to fully eradicate polio by a target date of 2018 are challenged by a variety of factors, including regional instability. Congress supports polio eradication efforts through USAID and CDC global health appropriations and through the World Health Organization (WHO). Polio is an infectious disease that affects the nervous system and can cause irreversible paralysis within hours. There are three natural or wild types of polio virus (WPV, numbered 1 through 3). There is no cure for polio, but it can be prevented through immunization. About one in 200 cases results in paralysis. Among those who are paralyzed, between 50% and 10% may die after their breathing muscles become immobilized if mechanical ventilation is not available. Polio is spread primarily through ingestion of contaminated water or food, or after placing one's hands in one's own mouth after touching items contaminated with the virus. The disease primarily affects children aged younger than five years. In 1998, the World Health Assembly adopted a resolution to eradicate polio worldwide and launched the Global Polio Eradication Initiative (GPEI) to advance that effort. GPEI is led by national governments, the U.S. Centers for Disease Control and Prevention (CDC), Rotary International, WHO, and the United Nations Children's Fund. When GPEI was launched, there were an estimated 350,000 cases in 125 countries. In 2014, the disease was endemic (meaning that it is habitually present and domestically transmitted) in only two countries (Afghanistan and Pakistan) and a total of 359 cases were reported. By 2015, only 51 wild poliovirus cases were detected and the Global Commission for the Certification of Poliomyelitis Eradication determined that wild poliovirus type 2 had been eradicated worldwide. In August 2016, two polio cases were identified in Nigeria, two years after the last wild polio case was detected. As of October 28, 2016, only 11 wild poliovirus cases have been identified worldwide. Global health experts are optimistic that polio eradication is imminent. The CDC indicated that no type 3 wild poliovirus infections have been detected globally since November 2012, suggesting that transmission of the strain has likely been interrupted in the remaining two endemic countries. Type 1 wild poliovirus is believed to be the only strain currently in circulation. Between 1985 and April 1, 2016, governments, nongovernmental organizations (NGOs), and public and private donors have donated more than $13 billion in support of GPEI. The United States has provided roughly 20% of these funds, with U.S. funding exceeding $200 million annually since FY2014. GPEI estimates that it would cost roughly $3.2 billion from 2016 through 2019 to eliminate polio and, based on global funding trends, has projected a funding gap of roughly $580 million. WHO contends that if funding goals are met and efforts are maintained, polio could be eradicated by 2018. On the other hand, WHO warns that failure to eradicate polio in countries where the disease persists could lead to a resurgence of nearly 200,000 new cases per year within 10 years. WHO estimates that eradicating polio could save $40-$50 billion over the next 20 years, primarily in low- income countries. Palkis , A f Skf While the international community has made significant gains in reducing the global spread of polio, efforts to eradicate the disease have been stymied by a variety of factors, including religious objections, misinformation, and intermittent conflict. These obstacles have been largely overcome in recent years but remain problematic in Pakistan and Afghanistan. Instability has also contributed to the resurgence of polio in Nigeria (Figure 1). Figure I. Global Polio Cases: 2015 and 2016 ......... ........ ......... ........ ........ .................... . .......... llhw i i' ,,'' ,' ,,'' ' ,,ii,'', ii i , , , '' ' i i! ' !,'i' ,,i i - :; :........... 7 . ... Source: Adapted by CRS from Global Polio Eradication Initiative webpage on polio cases at http://polioeradication.org, accessed on October 28, 2016. Acronyms: wild poliovirus (WPV); circulating vaccine-derived poliovirus (cVDPV) In 2014, 91% (304) of the world's 332 wild polio cases occurred in Pakistan. Significant gaps in vaccination coverage persist across the country, particularly in Peshawar, Karachi, and in the Federally Administered Tribal Areas (FATA). These areas have ongoing polio N.: z:O&X:2$' ~.Ct fl:OC~qK~'$ p\w -- , gnom goo mppm qq\ M , q 'M I 11LULANJILiM,

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