http://www.nytimes.com/2003/07/29/health/29CND-POLI.html?ei=5070&en=508c034795bdc076&ex=1060315200&pagewanted=print&position=

World Health Organization Seeks Eradication of Polio by 2005

By LAWRENCE K. ALTMAN
 

ENEVA, July 29 — Preparing for the end of polio, the World Health Organization is focusing on learning where stocks of the virus exist and encouraging laboratories to tighten controls to prevent accidental release, officials said here today.

The W.H.O. aims to eradicate polio by 2005, and its new director, Dr. Jong Wook Lee, declared today that goal "is a doable job," but that the organization needs $210 million to sustain the effort.

So far this year, only 235 cases of paralytic polio have been reported. Nearly all are from India, Nigeria and Pakistan. These countries are expected to immunize 175 million children by the end of the year.

The cases this year represent a 99 percent reduction from 350,000 cases in 125 countries when the W.H.O. undertook polio eradication in 1988. So far the program has cost $3 billion through support from the W.H.O., Unicef, the Centers for Disease Control and Prevention in Atlanta, Rotary International and other partners.

As long as a single case exists, the crippling disease can spread within a country and be exported, said Dr. David L. Heymann, the epidemiologist appointed by Dr. Lee to eradicate polio. Dr. Heymann led the W.H.O. team that fought the epidemic of SARS last spring.

The risk of the polio virus getting loose is one reason why W.H.O. has asked countries to conduct inventories to determine which of their laboratories have kept polio virus in freezers. So far 80 countries have provided such lists..

Oman and Vietnam have destroyed all known domestic stocks of the virus. Many laboratories in Albania, Bahrain, Cambodia, Hong Kong, Mongolia, Morocco, New Zealand and Singapore have destroyed polio stocks as well, although the W.H.O. had not required them to do so.

Even if the W.H.O. stops transmission of polio, many countries are expected to continue polio immunizations until they are confident that the virus is not lurking undetected. Because polio virus is needed to manufacture the vaccine, a number of countries will need to maintain stocks of polio virus, Dr. Heymann said in an interview.

The W.H.O., a United Nations agency, is encouraging laboratories to destroy stocks of polio virus unless they are conducting priority scientific projects or have a clear scientific reason for keeping the virus.

Also, to help prevent accidental infection or escape of the virus, the W.H.O. is encouraging scientists to work with polio only in laboratories that are rated as P-3, the second strictest of the four levels of bio-security.

Chris Wolff, a member of Dr. Heymann's team, said that in asking countries for an inventory, "W.H.O. is trying to make the laboratory community aware of the implications of holding stocks of polio virus."

Dr. Bruce Aylward, another polio expert at W.H.O., said that obtaining reliable inventories "is proving to be a big logistical challenge but very definitely a manageable one."

The 235 case total reported so far this year is the second lowest for the comparable period of any year, and seems to be dropping rapidly, Dr. Lee said.

The fewest cases were the 101 reported in 2001. Last year, the polio eradication program suffered a serious setback when the worldwide total rose to 1,918. The surge resulted from a large outbreak in Uttar Pradesh in India. Cases spread to other states, including Gujarat, Rajasthan and West Bengal.

In the last four years, polio has been exported 12 times into areas that had been polio-free, Dr. Heymann said. Five of the exports came from India.

Of this year's cases, three are believed to be exports to Ghana from Nigeria, and one to Lebanon from India). It was Lebanon's first case in 10 years. Epidemiologists are investigating additional possible exported cases in Africa.

Copyright 2003 The New York Times Company