It has been one full year since polio was detected anywhere in Africa, a significant milestone in global health that has left health experts around the world quietly celebrating. The goal had seemed tantalizingly close in recent years, but polio always managed to roar back, particularly in Nigeria. Then officials embraced a vigorous new approach to vaccination and surveillance in that country, hiring thousands of community “mobilizers” to track down the unvaccinated, opening operations centers nationwide to monitor progress and seeking out support from clerics and tribal chiefs. The result has been remarkable. The last African case of polio was detected in Somalia on Aug. 11, 2014, the final sign of an outbreak with its roots in Nigeria — the one country where the virus had never been eradicated, even temporarily. But the last case in Nigeria was recorded on July 24, 2014. “This is a big success, but it’s still fragile,” said Dr. Hamid Jafari, the initiative’s World Health Organization director. “There’s always a worry that there could be an undetected case in a population you’re not reaching.” The case count has been below 2,000 annually since 2001, and eradication efforts now cost about $1 billion a year. But to the frustration of epidemiologists, the virus is a master of the cross-border jailbreak. Thirty-four cases have been found this year, all in Pakistan or Afghanistan, the last places in which the virus is known to persist. Many scientists now say a worldwide victory over polio is in sight. Even assuming there are no more cases, Africa will not be officially declared polio-free for two more years. The W.H.O. requires three case-free years because surveillance is difficult in a continent of isolated villages and nomadic herders. Reaching the milestone is a testament to the persistence, deep pockets and adaptability of the eradication initiative, which is led by the W.H.O., the Centers for Disease Control and Prevention, the United Nations Fund for Children, Rotary International, the Bill and Melinda Gates Foundation and the United Nations Foundation.
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