Via The Lancet: Mandatory polio vaccination for travellers: protecting global public health. Excerpt from a long comment:
After the World Health Assembly resolution in 1988, initial progress towards polio eradication was good: by 2002, polio had been eliminated from 118 countries, leaving just seven.13 In 1988, there were 350 000 cases of polio in these countries. By the year 2000, this had fallen to below 2000 cases, a reduction of more than 99%.14
But after these initial years of progress, the Global Polio Eradication Initiative has spent 13 years trying to deal with the “last 1%”.15 The programme has to work in geographical areas and confront problems that would be deemed simply too difficult or dangerous by most public health programmes. The fact that more than 20 frontline workers associated with the polio programme have died since December, 2012, is a tragic reminder of these difficulties.3
In disease control terms, the idea of requiring vaccination before travel from infected countries is surely an obvious one. It could usefully have been implemented many years ago.
There are obvious political and financial ramifications for the governments affected: no country wants to be regarded as a hazard to the world. This was evident with the 2009 influenza A H1N1 pandemic; in the past, the place of origin was applied to the name of a new virus but although the early cases occurred in Mexico, the first influenza pandemic of the 21st century was officially simply called A(H1N1)pdm(09).16
WHO's latest recommendation on mandatory polio vaccination is a victory for sensible disease control over excessive political sensitivity. Diplomacy and bureaucracy are major forces in global health; essential in many ways, they also create an inertia that is at odds with ambitious goals like global polio eradication.
Bold global health goals inspire, motivate, and galvanise action. It is right that humankind should eradicate diseases; that the benefits of vaccination, clean water and air, and eventually universal health care, should be felt worldwide.
Bold goals demand bold action. WHO's new recommendation on polio should not be controversial; nor should it be seen as some political sanction. When a disease control imperative risks bruising national pride, the former must win out.