The human qualities needed to complete the global eradication of polio

a Embracing the goalAll landmark achievements in science and its application require imagination.For example, although the enthusiasts for human genome sequencing in the 1980s were often considered wildly optimistic or hopelessly deluded, sequencing of the human genome was completed in 2001 9 thanks, in large part, to the imagination and vision of the enthusiasts.Similar imagination and vision -as well as a sound strategy and a strong likelihood of technical feasibility -are needed by those attempting to globally eradicate an infectious disease.Efforts to eradicate malaria, yaws and yellow fever all foundered on the "rock" of doubtful technical feasibility.Polio eradication is, however, based on a sound and adaptable strategy, similar to the one used to eradicate polio in the Americas in 1994 (Table 1), and on technical feasibility.10,11 A few years ago, the persistent pockets of poliovirus transmission in the Indian states of Uttar Pradesh and Bihar were regarded as a "stress test" of the technical feasibility of polio eradication.Certain technical difficulties in achieving high enough immunity levels to halt poliovirus transmission in the affected areas were observed.One was low vaccine immunogenicity.These problems had been exacerbated by Abstract Although the 99% decrease seen in global polio incidence between 1988 and 2000 represented remarkable progress towards polio eradication, tackling the last 1% of polio has proved tantalizingly difficult.Pockets of endemic transmission currently persist both on the border between Afghanistan and Pakistan and in northern Nigeria.These pockets have permitted the reinfection of countries that were previously polio-free.Global strategic plans for polio eradication set out the activities, resources and financing needed to overcome the managerial, technical and security challenges faced by those tasked with the interruption of poliovirus transmission.However, polio eradication also depends on the less tangible but equally important human qualities of energy, realism, articulacy, determination, imagination, collaboration, adaptability, tactical awareness, innovation, openness and nimbleness (the initial letters of which give the acronym "ERADICATION").By paying attention to these human qualities, the stakeholders involved may be more likely to achieve global polio eradication.