Science 3 January 1997: Vol. 275. no. 5296, pp. 40 - 41 DOI: 10.1126/science.275.5296.40 PERSPECTIVES Pax Polio Harry F. Hull The author is with the Global Programme for Vaccines and Immunization, World Health Organization, CH-1211 Geneva 27, Switzerland. Our dictionary defines millennium both as a period of a thousand years and as "a hoped for period of joy, peace, serenity, prosperity, and justice" (1). In both senses of the word, one of the early achievements in the approaching millennium will be the global eradication of poliomyelitis. Polio eradication will eliminate disease, reduce disability, and produce direct savings of at least $1.5 billion per year U. The eradication initiative has also led combatants to lay down their arms. In 1988, the nations of the world established a goal of global polio eradication by the year 2000. Progress since then has been exceptional (3). Reported polio cases have declined by 80% since 1988. Wild polioviruses were eradicated from the Western Hemisphere in 1991. Eradication is close in China. In an unprecedented display of international cooperation, 18 contiguous nations of the Middle East, Caucasus, and the Central Asian Republics, including current and former combatants, united in 1995 to conduct Operation MECACAR, immunizing 56 million children. Almost half the world's children under 5 years of age were immunized during polio campaigns in 51 countries that year. India immunized 93 million children on a single day in January 1996. Although the strategies are proven effective (4), not all the tools necessary for eradication are in place. An estimated $600 to $800 million still need to be mobilized. Political commitment remains weak in several countries where the disease is highly endemic. Probably the greatest threat to polio eradication, though, is war and civil strife. As clinics are destroyed, health workers killed, and the civilian population turned into refugees, war zones become fertile fields