The global polio eradication initiative is at a critical crossroads. Some 25 years ago, the World Health Organization (WHO), supported by Rotary International, launched a global goal of eradicating polio from the world by 2000.1 Although the eradication target may not have been achieved, there has been remarkable progress. From more than 350 000 cases of poliomyelitis globally spread over 125 countries with endemic disease in 1990, a mere 223 cases were reported in 2012, with the disease largely restricted to a few regions of Nigeria, Pakistan, and Afghanistan. These hotspots of polio, with a total population exceeding 380 million, include geographic diversity, conflict, and population displacement. Although all 3 countries have made tremendous strides in controlling endemic disease affecting thousands of children annually, they face many residual pockets of polio and widespread virus circulation.
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