2012年，克什米尔（Kashmir）一名卫生工作者在印度斯利那加（Srinagar）为儿童接种小兒麻痺症疫苗。印度于2011年发现最后一例小兒麻痺症。

华盛顿—从印度洋到太平洋广大地区的 11个国家经有关机构认证，成为已消灭小兒麻痺症的地区。3月27日，世界卫生组织（World Health Organization）下属的一个独立委员会宣布印度、孟加拉国和泰国等地已经消灭小兒麻痺症，这个地区总人口达18亿。

通过消灭小兒麻痺症的认证需3年内整个地区未发现一例脊髓灰质炎病毒引发的病例。以往人们认为，在这个人口周密的广大地区，这个标准几乎不可能达到，特别是在印度。

世界卫生组织东南亚区域主任辛格（Poonam Khetrapal Singh）说，“对于与各地政府、非政府组织、公民社会和国际伙伴为根除这个地区的小兒麻痺症一起努力的数百万卫生人员来说，这是一个巨大的胜利。这表明，我们共同努力就可以为我们的孩子们造福千秋。”

据世界卫生组织的文件，各地区和各国通过认证获得消灭小兒麻痺症的地位还需要满足其他条件，例如必须有进行脊髓灰质炎病毒监测的实验室条件，监测能力需达到“优等”，同时有关国家必须一贯表现有能力发现和报告输入型脊髓灰质炎病例并采取对策。此外，有关国家必须按照世界卫生组织认证委员会的要求，拥有充分的程序和设施对脊髓灰质炎病毒进行控制，防止病毒重新向广泛的地区传播。

这次通过认证的国家有孟加拉国、不丹、朝鲜人民民主主义共和国、印度、印度尼西亚、马尔代夫、缅甸、尼泊尔、斯里兰卡、泰国和东帝汶，总人口18亿。

这些国家通过认证一事说明，全世界80%人口的居住区已经不受这种疾病的威胁。全球在25年前开始消灭小兒麻痺症的工作，当时每年有数十万小兒麻痺症病例。

世界卫生组织、美国疾病控制和预防中心（U.S. Centers for Disease Control and Prevention）、服务性组织国际扶轮社（Rotary International）和联合国儿童基金会（UNICEF）作为这场国际性运动的主要伙伴，要求普遍为儿童持续接种抗小兒麻痺症疫苗。

自上述组织发起全球根除脊髓灰质炎计划（Global Polio Eradication Initiative）以来，在200多个国家和2,000万志愿者提供合作的情况下，25亿儿童已经接种了抗小兒麻痺症疫苗。国际捐助方已为根除这种世界性疾病投入80多亿美元。

目前只有阿富汗、巴基斯坦和尼日利亚等3个国家仍然出现小兒麻痺症病例。小兒麻痺症由在自然环境下滋生的脊髓灰质炎病毒引起。据全球根除脊髓灰质炎计划提供的资料，2013年这3个国家出现160例小兒麻痺症。2014年，迄今在这些国家出现41例小兒麻痺症。

但是，在以往已宣布消灭小兒麻痺症的国家，每年仍然出现小兒麻痺症病例，这是因为旅客在一个存在小兒麻痺症的国家接触到病毒，然后携带病毒到另一个国家，而这个国家的疫苗接种覆盖面还不够广泛。

美国疾病控制和预防中心主任托马斯•弗里登（Thomas Frieden）说，“世界任何地方存在小兒麻痺症，都对任何其他地方造成威胁。”他强调，在全球根除脊髓灰质炎计划进入最后阶段之际，必须时刻保持警惕，利用各种公共场合宣导接种疫苗的工作。

为儿童接种疫苗必须不间断地进行。如果不积极彻底地开展接种工作，每年的新生婴儿就可能受到感染。在存在冲突、局势不稳定和发生自然灾害的情况下，这方面的责任尤其巨大，而且十分艰难。

但是据卫生专家说，为了发展这种能力，有关方面已经取得了很大的成绩。为最偏远的农村地区儿童接种疫苗的工作说明，即使存在各种巨大的障碍，提供卫生护理服务的任务仍然可以完成。

辛格在世界卫生组织的新闻公告中指出，现在小兒麻痺症项目已经成功地覆盖任何地区的儿童，每一轮活动都促使小兒麻痺症病例下降，但没有理由不开始考虑其他重要的卫生服务，例如如何保证婴儿安全出生，获得肺结核治疗和防止艾滋病感染等。

通过参加根除小兒麻痺症的工作，卫生工作者和社区工作人员得到了为提供其他卫生服务所需要的训练和才能。据世界卫生组织提供的资料，全球根除脊髓灰质炎计划已经建立的全球实验室和通讯网络现在可以为抗击其他疾病提供帮助。最近，这些网络为抗击有可能大规模传播的流感发挥了重要作用。

A Kashmiri health worker gives polio drops to a child at lakeside in Srinagar, India, in 2012. India detected its last case of polio in 2011.

Washington — An 11-member group of nations representing a combined population of 1.8 billion people from the Indian Ocean to the Pacific Ocean is certified polio-free by an independent panel of medical experts. The March 27 certification from a panel sanctioned by the World Health Organization (WHO) declares that nations ranging from India to Bangladesh to Thailand have defeated the crippling disease.

The certification comes after three full years have passed without a single illness being caused by wild poliovirus across the region, an achievement once thought almost impossible in this populous wide-ranging area, especially India.

“This is a momentous victory for the millions of health workers who have worked with governments, nongovernmental organizations, civil society and international partners to eradicate polio from the region,” said Poonam Khetrapal Singh, WHO’s regional director for Southeast Asia. “It is a sign of what we can bequeath our children when we work together.”

Other conditions must also be met for a region or nation to achieve polio-free status, according to WHO documents. Laboratory-based surveillance for poliovirus must be in place, with a performance deemed “excellent,” and countries must consistently demonstrate that they can detect, report and respond to imported cases of poliomyelitis. Further, the nations must satisfy the WHO certification panel that sufficient procedures and facilities are in place to properly contain polioviruses and prevent their redistribution in the environment at large.

The declaration covers the following nations, with a combined population of 1.8 billion: Bangladesh, Bhutan, Democratic People’s Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste.

Certification of these nations as polio-free means that 80 percent of the world’s population is now protected from the disease, a global undertaking that began more than 25 years ago, when polio cases numbered in the hundreds of thousands each year.

WHO, the U.S. Centers for Disease Control and Prevention (CDC), the service organization Rotary International and UNICEF have been the leading partners in this international campaign to achieve universal and continual vaccination of children against polio.

Since these organizations launched the Global Polio Eradication Initiative (GPEI), 2.5 billion children have been immunized against polio, with the cooperation of more than 200 countries and 20 million volunteers. International donors have backed this attempt to rid the world of this disease with investments of more than $8 billion.

Only three nations — Afghanistan, Pakistan and Nigeria — still experience cases of endemic polio, that is, strains of the virus that exist in the wild in the environment. Wild virus caused 160 polio cases in 2013 in those three countries, according to GPEI reporting. In 2014 so far, 41 cases have been detected in the endemic countries.

However, cases still occur each year in countries previously declared polio-free. This happens when a traveler is exposed to wild virus in one of the endemic countries and then carries it to another country where the blanket of vaccination has not stretched far enough.

“Polio anywhere in the world is a risk everywhere in the world,” according to CDC’s director, Dr. Thomas Frieden, who has emphasized the importance of maintaining vigilance in inoculation campaigns at various public appearances as the GPEI enters its endgame.

Inoculation of children must remain a never-ending campaign. Every year’s newborn children will be susceptible to exposure if vaccination campaigns are not rigorous and thorough. It’s a huge responsibility — and a difficult one to fulfill in times of conflict, instability or natural disaster.

But much has been gained in achieving that capability, health experts say. Efforts to reach every child in the most remote and rural areas have shown that health care services can be delivered amidst challenging obstacles.

“Now the polio programme has successfully reached [children everywhere] with polio drops in every round, there is no excuse not to go back with other critical health services, from how to have a safe birth, to where to get access to tuberculosis treatment and how to prevent HIV infection,” said Khetrapal Singh in a WHO press release.

Through the effort to eradicate polio, health personnel and community workers are trained and equipped to provide other health services. WHO reports that GPEI has put global laboratory and communication networks in place that are now available for use in outbreaks of other diseases. Most recently, these networks played a critical role in responding to influenza outbreaks, which have the potential to escalate into wide-scale epidemics.