History of Polio
From hundreds of thousands of cases worldwide to near eradication — how the Global Polio Eradication Initiative brought the world to the edge of ending polio.
The history of polio
In the early 20th century, polio was amongst the most feared diseases in the world. It paralysed hundreds of thousands of children every year. The introduction of effective vaccines in the 1950s and 1960s brought the disease under control in developed countries. By the 1970s, the threat was recognised in developing countries too, and immunisation programmes were rolled out globally.
Where eradication began: Rotary International and the birth of GPEI
The global drive to eradicate polio was initiated by Rotary International, with Rotary volunteers administering polio vaccines to children in the Philippines in 1979.
In 1985, Rotary launched the PolioPlus programme — the largest privately led international public health initiative — with an initial pledge of USD 120 million. Later in 1988, Rotary International joined hands with the World Health Organization (WHO), UNICEF and the Centers for Disease Control and Prevention (CDC) for the inception of the Global Polio Eradication Initiative (GPEI). The Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance, later joined as core partners.
At the time of the GPEI launch, poliovirus paralysed more than 1,000 children across 125 countries every single day. Today, thanks to the efforts of the GPEI and governments of around 200 countries, the number of cases has decreased by more than 99%.
What has been achieved — and what remains
Two of the three known strains of wild poliovirus (WPV) have been eradicated: type 2 was declared eradicated in September 2015 (last case detected in 1999), and type 3 was declared eradicated in October 2019 (last case detected in 2012).
Pakistan and Afghanistan remain the only two countries in the world where wild poliovirus transmission has never been fully interrupted. As long as the virus circulates here, it poses a risk to children everywhere — including in countries that have been polio-free for decades.
Why is WPV1 still circulating in Pakistan?
Polio eradication in Pakistan faces multiple challenges, including security-related access issues, hard-to-reach populations, vaccine hesitancy, sub-optimal routine immunization coverage, and cross-border movement from Afghanistan.
Similarly, eradication efforts in Afghanistan are affected by access issues, the failure to implement house-to-house coverage in certain geographies, and poor routine immunization coverage. Poor health service provision and weak health-seeking behaviour also contribute to polio endemicity.
Pakistan's roadmap to zero: NEAP 2025–26
Building on lessons from the 2024–25 campaign season, Pakistan has developed its National Emergency Action Plan (NEAP 2025–26), which includes a three-phased extended roadmap for interrupting all WPV1 transmission.
Phase I
Jul–Sep 2026
Maintaining the pressure
Phase II
Oct 2026–Apr 2027
SIA phase
Phase III
Mar–Jun 2027
Final battle to achieve interruption
Each phase has a set of activities under all programme components, designed specifically to meet the objectives of that phase and contribute to interrupting all WPV1 circulation by mid-2027.