Global Polio Eradication: Lessons Learned from China’s Experience

Poliomyelitis (polio) remains a pressing global health challenge, primarily threatening young children and leading to irreversible paralysis and respiratory failure. Since the launch of the Global Polio Eradication Initiative in 1988, wild poliovirus cases have declined by over 99%, yet eradication remains incomplete, with wild poliovirus type 1 (WPV1) endemic in Afghanistan and Pakistan and outbreaks of circulating vaccine-derived polioviruses persisting in under-immunized populations. China has been certified polio-free since 2000, but its experience during the post-certification period, particularly the 2011 outbreak in Xinjiang caused by WPV1 imported from Pakistan, revealed that high nationally reported vaccination coverage can mask localized immunity gaps and highlighted limitations in early warning capacity. This article examines China's polio eradication experience across four domains: vaccine strategy, surveillance systems, government commitment and public health investment, and international cooperation. Drawing on the lessons from the 2011 outbreak and subsequent policy adjustments, including the progressive introduction of inactivated poliovirus vaccine, the expansion of environmental surveillance, and strengthened multi-sectoral coordination, this article identifies key system-level functions that have enabled China to sustain its polio-free status. It also considers the extent to which these lessons may inform the global polio endgame, while recognising that transferability is contingent on health system capacity, governance structures, and operational context.