In the West, the news media tends to spotlight terrorism risks emanating from failed states, to the exclusion of other important threats. As I discuss in my book Failed States: Realities, Risks, and Responses, state failure is not necessarily linked with terrorist activities, and especially globally significant terrorism. One theme of state failure that deserves more attention is public health. And recent information about polio is a prime example of the key link between state decay and global health threats.
Only three states in the world still have endemic polio. The last holdouts are Nigeria, Pakistan, and Afghanistan. All three are familiar names to readers of this blog. And the lingering problem of polio strikes a strong chord with me because I have seen the victims of polio-related paralysis first-hand in Nigeria.
These weak and failed state holdouts are remarkable when compared with the global progress on polio eradication. Much has been accomplished since the 1988 launch of the Global Polio Eradication Initiative (GPEI). Here I quote from the World Health Organization:
Overall, since the GPEI was launched, the number of cases has fallen by over 99% . . . In 1994, the WHO Region of the Americas was certified polio-free, followed by the WHO Western Pacific Region in 2000 and the WHO European Region in June 2002 . . . More than 10 million people are today walking, who would otherwise have been paralysed. An estimated more than 1.5 million childhood deaths have been prevented . . .
The situation in Pakistan is particularly troublesome, given that polio vaccination rates have declined in Balochistan and other regions bordering Afghanistan over the last decade. In Nigeria, cultural resistance to vaccination has been party of the story.
Lingering pockets of endemic polio remain a global threat. The World Health Organization warns that these last remaining strongholds could lead to widespread public health problems in much of the world. As WHO’s October 2012 fact sheet states, “Failure to stop polio in these last remaining areas could result in as many as 200,000 new cases every year, within 10 years, all over the world.”