http://www.nytimes.com/2002/05/10/health/10SWIS.html

Number of Global Polio Cases Hit Its Lowest Point Last Year

By ELIZABETH OLSON

ENEVA, May 8 — The number of polio cases worldwide dropped to its lowest recorded point last year, but the campaign to eradicate the virus could be undermined by regional conflict and a funding shortfall, the World Health Organization has warned.

Only 537 cases of polio, an infectious disease that mainly affects children under 5, were reported in 2001, down 82 percent from a year earlier, when the number was 2,979, the United Nations agency said. It also reported that the number of countries reporting continued polio transmission was cut in half, to 10.

The health organization began its campaign against polio in 1988, when it still cut a swath through more than 125 countries, paralyzing children at the rate of 1,000 every day. The group says it aims to eliminate polio by the end of this year and certify the world polio-free at the close of 2005.

But those goals could be hindered by conflict or unstable conditions in the countries where polio is still found, the W.H.O. has warned.

"The past year has reminded us that we live in a world where security and access to children cannot be guaranteed," said Dr. Gro Harlem Brundtland, the director general of the agency. "So I urge the world to finish the job. Eradicate polio while we still have the opportunity."

Dr. Bruce Aylward, who coordinates the agency's Global Polio Eradication Initiative, explained that "in four or five of the high-transmission areas, we have very fragile access," adding, "We need international backing to press ahead to reach these children."

The agency also warned that the campaign — which is run in tandem with the United States Centers for Disease Control and Prevention, the United Nations Children's Fund and Rotary International — lacks $275 million necessary to complete its job. That amount could rise if new polio cases emerged.

An outbreak two years ago in Hispaniola, a Caribbean island that had been free of the disease for a decade, increased worry that mutated forms could spread. The W.H.O. has intensified its vaccination campaigns, sending workers door to door to reach as many children as possible.

The agency's warning came last month as a three-day countrywide inoculation campaign began in Afghanistan to give oral polio vaccine to some six million children. Afghanistan, whose polio surveillance system has suffered during the fighting there, is along with its neighbor Pakistan among the countries with the highest transmission rates.

Another is India, the world's hardest-hit country. Two recent outbreaks in other countries were traced to India, where in the northern area as many as 75 percent of Muslim children under 2 have yet to receive polio vaccine, Dr. Aylward said.

Although the polio extermination campaign reached 575 million children in 94 countries last year, Dr. Aylward said, there are geographic and worrisome demographic pockets of unvaccinated children like those in northern India. He also cited other geographic "holes," one around the Somali capital, Mogadishu, and another in eastern Angola, where conflicts had prevented comprehensive inoculation programs.

Yet despite the instability, the eradication campaign has made strides in unsettled areas like Congo, which has not reported any polio for a year, and Sudan, which has not reported any new cases for almost that long, the agency said.

The countries of the Western Pacific and the Americas (despite the Hispaniola case) have been found free of polio.

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