The 99 percent drop: how the world is chasing the end of polio

Health · Published 18 October 2026 Swipe more like this →

In short: Since 1988, a massive global effort has slashed polio cases by over 99 percent. While we have successfully eradicated two strains of the wild virus, the final stretch remains a complex battle against geography, conflict, and mutating vaccine strains.

The Global Polio Eriodication Initiative (GPEI) was established in 1988 following a World Health Assembly resolution. Since its launch, the initiative has prevented an estimated 20 million cases of childhood paralysis. Progress has been significant: the WPV2 strain was eradicated in 2015, and WPV3 followed in 2019. Today, wild poliovirus remains endemic in only two countries: Afghanistan and Pakistan. The campaign is a massive multinational effort led by the WHO, UNICEF, and the Rotary Foundation, alongside partners like the CDC and the Gates Foundation. This global coordination aims for the permanent cessation of poliovirus circulation worldwide.

Two primary tools drive this campaign: the oral poliovirus vaccine (OPV) and the inactivated poliovirus vaccine (IPV). OPV is inexpensive, easy to administer, and can create 'contact immunity' as it spreads through populations. However, in under-vaccinated areas, the weakened virus in OPV can mutate into circulating vaccine-derived poliovirus (cVDPV). In 2024, cVDPV caused 312 confirmed paralytic cases across 21 countries. While the US has transitioned to using only the injectable IPV since 2000, the oral version remains the global standard for eradication. This is because the oral vaccine is particularly efficient in environments where sanitation and clean water access are limited.

The final eradication faces immense logistical hurdles. In regions like South Khyber Pakhtunkhwa, Pakistan, vaccination teams face attacks and community boycotts. To counter this, health workers use novel tactics like mobile teams, ring-fencing insecure areas, and integrating polio services with broader health camps. While smallpox is the only human disease to be fully eradicated, the World Health Assembly has officially declared polio a candidate for the same fate. Success requires a three-pronged approach: strengthening routine immunization for infants under one, ensuring rapid detection of new cases, and launching high-quality vaccination campaigns. This strategy is essential to prevent the importation of the virus into new regions.

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