The polio eradication end game: what it means for Europe.

Had these and other issues been clearly understood in 1988 when the World Health Assembly passed the resolution that committed all countries to polio eradication by the year 2000, the decision to eradicate would have been more difficult. But fortunately, buoyed by the then recent success in the eradication of smallpox, active debate on whether to use inactivated or live polio vaccines, awareness that many countries had already interrupted polio transmission, and unawareness of the difficult eradication end game, the resolution was passed by consensus of the World Health Organization (WHO)’s member states [1]. Although progress towards eradication has been slower than anticipated in 1988, paralytic polio has decreased from an estimated 1,000 children per day during 1988, to approximately 400 during 2013. Today there remain only three countries with endemic polio, Afghanistan, Nigeria and Pakistan, and the recent risk assessment from the European Centre for Disease Prevention and Control (ECDC) reminds us that Europe must remain vigilant with strong surveillance and sustained laboratory capacity [2].