Research history

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## What happened

In 1985 Rotary International launched PolioPlus, its program to end polio. In May 1988 the World Health Assembly committed the World Health Organization to eradicating polio by the year 2000, which launched the Global Polio Eradication Initiative. That year there were an estimated 350,000 cases in more than 125 countries where the virus was endemic. The partnership grew to include WHO, Rotary, the U.S. Centers for Disease Control and Prevention, UNICEF, the Gates Foundation and Gavi, among others. Rotary members alone have contributed more than $2.7 billion, and more than a million of them have volunteered.

The results are enormous. Wild polio cases have fallen by more than 99 percent. Wild poliovirus type 2 was declared eradicated in 2015 and type 3 in 2019. Every WHO region except the Eastern Mediterranean has been certified free of wild polio, Africa most recently, in 2020.

## Why it’s mixed

The year-2000 deadline passed long ago. Wild poliovirus type 1 still circulates in Afghanistan and Pakistan, which had reported 39 cases for 2025 by the end of the year, down from 99 in 2024, with a backlog of samples still untested. A second problem comes from the oral vaccine itself. Its weakened virus can regain the ability to cause paralysis and spread where too few children are vaccinated. There were 202 such vaccine-derived cases in 2025, down from 463 in 2024. WHO links them to insecurity, displacement and large numbers of unvaccinated children. A newer oral vaccine is much less likely to revert.

Measurement has been hard too. In late 2025 an independent audit in Karachi found that the program’s data did not give an accurate picture of campaign quality, that coverage was being overestimated and that more children were being missed than the data showed. Funding has tightened, and the partnership adopted a leaner plan for 2026.

## Where it sits in the system

Eradication removes a disease for good, which makes it **source** work (level 4) on the [depth scale](/method/#depth), like the eradication of [smallpox](/record/case-studies/smallpox-eradication/). Until the last virus is gone, though, every vaccination round is prevention that has to be repeated.

The campaign is also a working answer to [Fragmentation](/diagnosis/fragmentation/). Very different organizations share one target and one scoreboard. The Karachi audit shows the [Measurement Gap](/diagnosis/measurement-gap/) inside even a data-rich program, and four decades of work is a long test of funders’ patience against the [Short Horizon](/diagnosis/short-horizon/).

## What carries over

A shared, measurable goal can hold a coalition together for a generation. The last steps of an eradication campaign happen in the hardest places, so funders need patience, flexible money and outside checks on the numbers. A program that is 99 percent finished is not finished.

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    "body": "\n## What happened\n\nIn 1985 Rotary International launched PolioPlus, its program to end polio. In May 1988 the World Health Assembly committed the World Health Organization to eradicating polio by the year 2000, which launched the Global Polio Eradication Initiative. That year there were an estimated 350,000 cases in more than 125 countries where the virus was endemic. The partnership grew to include WHO, Rotary, the U.S. Centers for Disease Control and Prevention, UNICEF, the Gates Foundation and Gavi, among others. Rotary members alone have contributed more than $2.7 billion, and more than a million of them have volunteered.\n\nThe results are enormous. Wild polio cases have fallen by more than 99 percent. Wild poliovirus type 2 was declared eradicated in 2015 and type 3 in 2019. Every WHO region except the Eastern Mediterranean has been certified free of wild polio, Africa most recently, in 2020.\n\n## Why it’s mixed\n\nThe year-2000 deadline passed long ago. Wild poliovirus type 1 still circulates in Afghanistan and Pakistan, which had reported 39 cases for 2025 by the end of the year, down from 99 in 2024, with a backlog of samples still untested. A second problem comes from the oral vaccine itself. Its weakened virus can regain the ability to cause paralysis and spread where too few children are vaccinated. There were 202 such vaccine-derived cases in 2025, down from 463 in 2024. WHO links them to insecurity, displacement and large numbers of unvaccinated children. A newer oral vaccine is much less likely to revert.\n\nMeasurement has been hard too. In late 2025 an independent audit in Karachi found that the program’s data did not give an accurate picture of campaign quality, that coverage was being overestimated and that more children were being missed than the data showed. Funding has tightened, and the partnership adopted a leaner plan for 2026.\n\n## Where it sits in the system\n\nEradication removes a disease for good, which makes it **source** work (level 4) on the [depth scale](/method/#depth), like the eradication of [smallpox](/record/case-studies/smallpox-eradication/). Until the last virus is gone, though, every vaccination round is prevention that has to be repeated.\n\nThe campaign is also a working answer to [Fragmentation](/diagnosis/fragmentation/). Very different organizations share one target and one scoreboard. The Karachi audit shows the [Measurement Gap](/diagnosis/measurement-gap/) inside even a data-rich program, and four decades of work is a long test of funders’ patience against the [Short Horizon](/diagnosis/short-horizon/).\n\n## What carries over\n\nA shared, measurable goal can hold a coalition together for a generation. The last steps of an eradication campaign happen in the hardest places, so funders need patience, flexible money and outside checks on the numbers. A program that is 99 percent finished is not finished.\n",
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      "depth": 4,
      "era": "1985–present",
      "kind": "mixed",
      "lessons": [
        "A precise goal with a shared scoreboard, zero cases, has held governments, agencies and a volunteer movement together for decades.",
        "A civic network can be funder, fundraiser and advocate at once. Rotary helped start the effort, and its members have contributed more than $2.7 billion.",
        "The last 1 percent can be harder than the first 99. A deadline set at the start rarely survives the hardest places.",
        "Program data can look better than reality. Independent audits are how a campaign finds out what its own numbers miss."
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      "place": "Worldwide",
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        {
          "note": null,
          "publisher": "World Health Assembly",
          "title": "Global eradication of poliomyelitis by the year 2000 (resolution WHA41.28)",
          "url": "https://www.archive.polioeradication.org/wp-content/uploads/2016/07/19880513_resolution-2.pdf",
          "year": 1988
        },
        {
          "note": null,
          "publisher": "World Health Organization",
          "title": "Poliomyelitis, fact sheet",
          "url": "https://www.who.int/news-room/fact-sheets/detail/poliomyelitis",
          "year": 2025
        },
        {
          "note": null,
          "publisher": "Global Polio Eradication Initiative",
          "title": "History of Polio: Key Milestones & Global Eradication",
          "url": "https://polioeradication.org/about-polio/history-of-polio/",
          "year": null
        },
        {
          "note": null,
          "publisher": "Global Polio Eradication Initiative",
          "title": "Partners",
          "url": "https://polioeradication.org/who-we-are/partners/",
          "year": null
        },
        {
          "note": null,
          "publisher": "World Health Organization, report by the Director-General",
          "title": "Update on the ongoing public health emergencies of international concern: poliomyelitis (EB/SCHEPPR/8/2)",
          "url": "https://apps.who.int/gb/scheppr/pdf_files/SCHEPPR8/EB_SCHEPPR8_2-en.pdf",
          "year": 2026
        }
      ],
      "summary": "Since 1988 a global partnership has cut wild polio cases by more than 99 percent and eradicated two of the three wild strains. The original deadline was the year 2000, and the last stretch has proved the hardest.",
      "title": "The campaign to eradicate polio"
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