Image: Boy in Emerson respirator (iron lung) c. 1955. Otis Historical Archives National Museum of Health and Medicine [CC BY 2.0], via Flickr
Worldwide eradication programme on tenterhooks amid US science turmoil
As countries including the US and the UK slash foreign aid budgets, leaders of the Global Polio Eradication Initiative have warned of a “public health disaster” if efforts to rid the world of the disease fail.
They are calling on funders and governments to either “step up” or continue funding, as some nations’ investment in the GPEI is uncertain or looks set to end.
Funding from the US and the UK—significant donor countries—is currently under review and the GPEI has been in talks with government officials. This included meeting with UK Foreign, Commonwealth and Development Office officials in mid-March to discuss £100 million in potential funding. The programme is still awaiting a decision.
The eradication programme is a public-private partnership. Its partners include the World Health Organization, Rotary International, Unicef, the Gates Foundation, the US Centers for Disease Control and Prevention (CDC) and the Gavi vaccine alliance.
“If the eradication programme fails, within a decade we’ll be back to hundreds of paralytic cases around the world,” Hamid Jafari, director for polio eradication at the WHO for the eastern Mediterranean region, told Research Professional News in an interview.
Lifelong paralysis is a complication of the potentially deadly disease, affecting 1 in 200 cases, and was commonly seen decades ago when polio was more prevalent.
Jafari said: “We can’t snatch defeat from the jaws of victory—we are so close. This would be a public health disaster. This is extremely, extremely important.”
Epidemic-prone disease
If the GPEI succeeds in its mission, polio will be only the second human infectious disease to be globally eradicated, after smallpox. Last year, the programme came tantalisingly close to eradication, with 19 weeks clear of any reported cases worldwide.
However, there has since been a resurgence, with 99 cases of polio in 2024 in the last endemic strongholds of the wild disease in Pakistan and Afghanistan, which fall under Jafari’s WHO jurisdiction, along with cases in conflict areas including Gaza and Yemen.
Jafari described polio as an “epidemic-prone” disease, which is why he is concerned about a potential global resurgence if eradication efforts fail.
The US CDC has been hit by the federal agency freezes and cuts instituted by US president Donald Trump’s administration. And last week, the New York Times reported that the US is likely to cut its funding of Gavi. Trump had already followed through on a campaign pledge to pull the US out of the WHO, doing so on his first day in office.
Living ‘month to month’
Jafari said: “Gavi is an important GPEI partner. They provide funding for the inactivated polio vaccine to resource-poor countries and support immunisation services.
“Loss of funding for Gavi will have adverse impacts on vaccination of children, including against polio.”
Jafari said that more than 130 staff on the eradication programme are funded by the CDC, and 28 of those are in Pakistan, where the final push for eradication of the wild disease is focused, along with Afghanistan.
Funding for these staff “is uncertain, so we are living month to month because we don’t know whether it will continue”, he said, adding that the GPEI is having to “adjust flexible funding” for this.
Moreover, the technical scientific expertise the CDC offers has been crucial to the polio programme, with its experts seconded or embedded in the WHO, said Jafari. “They’ve been asked not to work right now,” he added.
Jafari explained that the CDC poliovirus laboratory in Atlanta, Georgia, is the global reference laboratory for polio, describing it as the “nerve centre of the programme” and a “sort of uber supporting laboratory” for the 145 labs of the Global Polio Laboratory Network.
The CDC lab standardises reagents, quality control and accreditation. And if a local lab has difficulty characterising a virus sample, it can send it to the CDC lab for advanced testing and assessments.
“So we are making alternative arrangements to make sure that the testing of samples, both human samples and environmental samples, continues,” said Jafari.
Cautious optimism
A substantial slice of the eradication programme’s funding—14 per cent, or around $125m (£96.6m), according to Jafari—comes from the US each year. This has historically had bipartisan congressional support, he said, and has come through the CDC and USAid, which was also hit by the White House cuts.
While funding discussions with officials in Washington DC are ongoing, Jafari and Stephanie Urchick, president of Rotary International, say they are “cautiously optimistic”.
And while “funding is a global issue”, Urchick is resolute. “As in any other challenge with polio eradication, we approach it by looking at how we can overcome that challenge, to find other funding sources if we need to increase funding from some additional ways. So, we’ll look at ways to make up the gap. We won’t be stopped,” she told RPN.
The programme has had some good news. At the end of February, Saudi Arabia pledged $500m.
Urchick added that the Gates Foundation is also continuing its offer to match-fund, two to one, money raised by Rotary. “So when we reach $50m, which is the baseline we have to reach, they will give us $100m on top of that,” she explained.
Jafari called on global leaders to “model good public health” for worldwide wellbeing.
“Nobody’s safe until everybody is safe,” he said, noting that the “world is getting smaller and smaller”, with polio “only a flight away”.
He urged: “We’re in this together, and I think if one government threatens to withdraw [funding] or has uncertainty and is still deciding, it’s very important that other major governments step up.”
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