In 1988, health groups and governments around the world launched the Global Polio Eradication Initiative (GPEI), a public-private partnership aimed at eradicating the poliovirus by 2000. That year has come and gone, and still the contagious virus plagues many parts of the world, with ongoing outbreaks in China, Pakistan and Madagascar, just to name a few countries.

The program has made great progress over the past 23 years, though. For example, the number of polio infections worldwide has decreased by more than 99% since 1988, with only around 1,350 cases of wild polio in 20 countries last year. Buoyed by that success, in June 2010 the GPEI published a new strategic plan, laying out guidelines to terminate polio in two of four endemic countries (Afghanistan, India, Nigeria and Pakistan) by the end of 2011 and to end wild polio transmission in countries that had active outbreaks in 2009 by 2012.

But the end is not yet in sight, according to an independent evaluation of the strategic plan published earlier this month. Virus control in India has made great strides, the new report notes, with only one case reported in 2011 thus far — a considerable accomplishment considering that, less than a decade ago, India accounted for 85% of polio cases worldwide. However, Afghanistan and Nigeria, two of the three remaining endemic countries, have had more cases in the first nine months of this year than in 2010 altogether. Several other countries targeted by the plan have also seen more cases to date this year compared to this time in 2010. Additionally, polio had popped up in countries where it had previously been eradicated — notably China, which went polio-free for 11 years until this summer.

With so little progress, the report concludes that “the GPEI is not on track to interrupt polio transmission by the end of 2012 as it planned to.”

Problems with the GPEI “run so deep,” the report continues, “that nobody should believe that ‘more time’ is the solution to them.” Instead, the evaluation recommends that the program should receive higher priority — in other word, more funding. But is throwing more money at the problem really going to wipe out polio for good? As we’ve noted many times before in the pages of Nature Medicine, millions have been invested to make polio history, but the virus remains. On this World Polio Day, shouldn’t we be searching for novel solutions?

Image: Oral polio vaccination in Guinea in 2009. By Julien Harneis via flickr under Creative Commons