The news on polio eradication — the almost 30-year up-and-down struggle to make polio the second human disease, after smallpox, to be eradicated from the planet — recently has been wonderful. The case numbers are seesawing — fewer in the four countries where the disease remains endemic, more in the countries where has recently crept back — but overall much lower than just a few years ago. The game-changer has been the entry into the eradication fight of the Gates Foundation, which has declared polio one of its major priorities. That infuses a huge bolus of cash into an effort that was always short of funds, but even more it shines a spotlight of international attention on a mostly neglected disease. Where Gates goes, governments and the media follow.

But before expectations of success rise too high, it is important to say that there is a largely unexplored and difficult end-game to polio eradication. It is smartly captured in an essay by Debora MacKenzie of New Scientist, who reminds us that ending all cases of wild-type polio will only be the end of the beginning — because we will still have to protect the world from the virus that we have been using all these years in the vaccine. [Read more…]