Strategy for rapid elimination and continuing control of poliomyelitis and other vaccine preventable diseases of children in developing countries.

Estimates of a recent yearly incidence of 400 000 cases of paralytic poliomyelitis, 2.5 million deaths from measles and its complications, over 1 million deaths from neonatal tetanus, and 735 000 deaths from pertussis in Asia, Africa, and Latin America now pose a greater challenge for new action than did the worldwide eradication of smallpox several years ago. By virtue of the conditions obtaining in the developing countries mere expansion or acceleration of what is being done now--even with modifications that may achieve a temporary increase in vaccine coverage--cannot achieve the desired rapid elimination and continuing control of these diseases. A new strategy--namely, bringing the vaccine to the people during annual national days of vaccination--has already been used successfully in some small and large developing countries of Latin America for the rapid elimination and continuing control of polio. This strategy could be adapted to include vaccination against measles, pertussis, and neonatal tetanus by additional training of community volunteers in the large auxiliary health armies that work with the existing health services each year.