Poliomyelitis eradication in Europe: programme and activities.

The WHO Regional Office for Europe is committed to the eradication of poliomyelitis in Europe, as a part of the WHO effort to achieve the world eradication of polio by the year 2000. The European Advisory Group on EPI has adapted in 1993 the operational targets for the regional eradication of polio, which focus on surveillance, outbreak response, and immunization coverage. Policies recommended by WHO have been translated into plans for action by 9 European countries among those which still reported cases of polio. The Regional Office for Europe of WHO has concentrated its efforts in the following areas: 1. Implementation of essential strategies on immunization (mopping-up or national immunization days) in countries having high-risk areas with endemic transmission of wild poliovirus. 2. Improvement of surveillance, which is a major strategic component. Its key element is the surveillance of acute flaccid paralysis. Its implementation started in Europe in 1991. 3. Development of a regional laboratory network involved in the routine diagnosis of poliomyelitis. The network began to be operational in 1991. In 1992 polio morbidity, reported by 17 countries, has shown a downward trend as compared to 1991. Anyhow, some foci of wild poliovirus activity still persist in the Balkan countries, the Trans-Caucasian region, and several Central Asia republics of the former Soviet Union. The main limitations to progress in polio eradication in Europe are: absence of strong political support at the national level; lack of financial support, which may delay the translation of WHO recommendations into proper action at the national level; availability of polio vaccine, which may become a problem in the absence of adequate support; and the unsatisfactory pace of improvement of the polio surveillance.