CASE 5: Eliminating polio in Latin America and the Caribbean

Map showing Latin America and the Caribbean

How do we know

Precise data about the incidence of polio in the Americas was gathered through a surveillance system of over 22,000 health units and 8 diagnostic laboratories. In 1994, the International Commission for Certification of the Eradication of Poliomyelitis in the Americas declared that the transmission of the wild poliovirus had been interrupted in the Americas.


Health Condition: Today, polio is on the verge of being erased from the globe. As recently as 1988, 125 countries were endemic for polio, with an estimated 350,000 cases. Through the first half of 2006, just four countries were re­ported endemic for polio, and fewer than 700 cases were reported worldwide. This dramatic reduction is the result of massive OPV immunizations through a global eradication campaign. In the 1970s, Latin America had an estimated 15,000 paralysis cases and 1,750 deaths each year due to polio. The oral polio vaccine was introduced in the region in 1977.

Intervention or Program: In 1985, the Pan American Health Organization began a polio eradication campaign in Latin America and the Caribbean, to complement the routine immunization efforts of the newly formed Expanded Programme on Immunization. To increase immunization coverage in areas with weak routine health services, all endemic countries in the region implemented national vaccine days twice a year to immunize every child under 5 years of age, regardless of vaccination status. In the final stages of the campaign, "Operation Mop-Up" was launched to aggressively tackle the disease with house-to-house vaccinations in communities reporting polio cases and with low coverage. An extensive surveillance system helped track outbreaks.

Impact: In 1991, the last case of polio was reported in Latin America and the Caribbean. The disease reemerged briefly in 2000 when 20 vaccine-associated cases were reported in Haiti and the Dominican Republic, but no other cases have been reported since 1991. Today, polio has been eliminated from Latin America and the Caribbean.

Cost and Cost-Effectiveness: The first five years of the polio campaign cost $120 million: $74 million from national sources and $46 million from international donors. Taking into consideration the savings from treatment, these donor contributions would pay for themselves in just 15 years. The administration of the vaccine is highly cost-effective, at just $20 for a healthy year of life in a high-mortality environment.