Africa's leaders demonstrated unprecedented cooperation and commitment to carry out a series of synchronized immunization activities in 2009 and in March and April, 2010, following the spread of the disease from Nigeria which came to infect 24 countries across west and central Africa and in the Horn of Africa.

As a direct result of these immunization campaigns, the polio outbreaks have slowed to a trickle. Across West Africa, only Liberia and Mali have recorded any cases in the past five months, while Nigeria - the only country in Africa never to have stopped polio transmission - has slashed polio by 98% in the past year.

However, recent weeks have shown the very real risks of not completing eradication, with a September case in Liberia confirming residual transmission, a new importation of type 3 wild polio virus into Mali (the first since 2001), and a case in Uganda, which had been polio-free for more than a year.

In all countries, rapid assessments are being conducted to formulate an emergency response plan in which two additional mop-up rounds will be held. All countries in the West Africa sub-region will again conduct two full campaigns in February and March, 2011, but high-quality immunization campaigns must be complemented by enhanced routine immunization and strong disease surveillance.

With the outbreak in Angola (25 cases) having spilled over the border into neighboring provinces of the Democratic Republic of the Congo (28 cases) - these two countries now represent the greatest threat to polio in Africa, having recorded 48 of Africa's 58 cases in the past six months. However, the virus in DR Congo remains geographically restricted and in Angola, steps by the Federal Government to close vaccination coverage gaps in the most recent campaign - which started on 1 October - saw the percentage of missed children in the key reservoir of Luanda fall from nearly 30% to 13%, while nationally, the percentage of missed children fell from 15% to 8%.

The World Health Organization's African Regional Director, Dr Luis G. Sambo, acknowledged the recent steps taken by Angola and DR Congo to close vaccination coverage gaps, with the Angolan Minister of Health personally vaccinating children on the streets of Luanda during the October campaign. "In Africa," Dr Sambo said, "we are seeing the essential government support that can make the difference between success and failure. But much more remains to be done to fill the gaps if we are to protect the stunning gains made this year."

"We are on the cusp of an exciting possibility here," said Dr. Gianfranco Rotigliano, UNICEF's Regional Director for West and Central Africa. "Political leaders across Africa answered the challenge posed by this dreadful disease and the results are before us. It shows what can be done when there is leadership and dynamic partnership with donor support around such an important health issue. We need to continue efforts to vaccinate and to put the needs of children in Africa first."

Many volunteer vaccinators in these vaccination campaigns will be Rotarians, who have themselves given almost $1 billion to the polio eradication effort since 1985. Mr Ambroise Tshimbalanga Kasongo, chair of Rotary's African PolioPlus Committee, called on international donors to stay the course to finish the job by filling the $810 million funding gap in the Global Polio Eradication Initiative Strategic Plan that aims to eradicate polio globally by 2013.

"Rotary's catch phrase is 'End Polio Now'," he said. "In Africa, the end of polio is in sight, but we are not there yet. To think we could not reach the finishing line because of lack of financial resources is unacceptable."

The 15-country synchronized activities will cost approximately USD$42.6 million, and are funded by the Bill & Melinda Gates Foundation, the US Centers for Disease Control and Prevention (CDC), USAID, Rotary International, UNICEF and the Governments of Germany and Japan.