In 2004, the world has its best – and perhaps last – chance to stop polio forever. There is a historic, one-time only opportunity to stop transmission of poliovirus. If the world seizes this opportunity and acts immediately, no child will ever again know the crippling effects of this devastating disease.

After a fifteen-year effort that has galvanized more than 200 countries, 20 million volunteers, and an international investment of US$3 billion, the success or failure of the Global Polio Eradication Initiative, the worldÂ’s largest public health campaign, is now within reach. Never before has the world been so close to success, with only six countries remaining polio-endemic.

On 15 January 2004, ministers of health from the six polio-endemic countries – Nigeria, India, Pakistan, Niger, Afghanistan and Egypt – publicly pledged an all-out effort to end a disease that in recent memory crippled more than a thousand children every day. Ministers gathered at WHO Headquarters to sign the Geneva Declaration for the Eradication of Poliomyelitis, marking a historic step toward stopping poliovirus transmission in their countries by the end of 2004.

Progress and opportunities

Tremendous progress has been made in the global fight against polio since 1988, when the World Health Assembly resolved to eradicate the disease. The number of polio cases worldwide has decreased from 350 000 in 1988, to under 700 cases in 2003. Three-quarters of all cases globally are linked to a handful of polio “hot spots” in Nigeria, Pakistan and India.