Progress towards polio eradication: an African perspective.

Despite daunting competing health priorities, Africa has made significant progress in polio control. Northern and Southern Africa appear to be polio-free and may shortly be certified as such; however, polio still remains endemic in West and Central Africa and the Horn of Africa. Countries "in difficult circumstancess", wracked by major civil wars, have particularly low routine vaccine coverage, although NIDS have been carried out during negotiated days of tranquillity. AFP surveillance has also improved, although the quality of stool specimens is still far from ideal. There is, nevertheless, an extraordinary political commitment to the eradication campaign. Lessons from the history of polio in the continent need to be heeded in designing end-game strategies. Obstacles on the path to successful eradication are undoubtedly more formidable on the African continent--perhaps the most serious of all are the continuing wars. International political commitment and focussed and empowering developmental aid are urgently needed.