Poliomyelitis is a devastating, highly infectious viral disease. It is spread from person to person or through poor sanitary conditions. It can kill those infected or result in permanent paralysis to the limbs and chest. The best “treatment” is prevention, and the best available means of prevention is vaccination.

A great deal of effort has been invested in large-scale programmes across the world, by the World Health Organisation (WHO), UNICEF and the GAVI Alliance, particularly in those few countries where the disease remains endemic. Polio eradication has been a priority since it was declared to be a global aim by the World Health Assembly resolution of 1988. Until just a few months ago, the co-ordinated effort to eradicate polio was progressing well, with most of the world declared polio free. However, just three weeks ago the WHO used its powers under the International Health Regulations (2005) to declare the current situation in relation to polio a public health emergency of international concern.

This is a rare and important event. The fear is that polio will once again be out of control and will spread rapidly across the world. What has happened to reverse the eradication efforts? The simple answer is that too few children are receiving polio vaccination. A full answer is, of course, more complex.

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