The World Health Report 2003 received similar support -most noticeably when the G8 Heads of Government discussed their role in closing the funding gap for eradication activities during their meetings of 2002 and This high-level visibility has been critical to achieving the second, and perhaps most impor- tant goal of political advocacy: access to government and nongovernmental resources which lie outside the health sector. Because of the huge numbers of people and vehicles that are required to implement NIDs, such activities are beyond the logistic and communication capacity of the health sector in many countries. Consequently, countries have drawn heavily on ministries of information, transport, defence and others to help solve the challenge of rapidly reaching all children, in all corners of a country. Countries have also engaged the private sector, often on an extraordinary scale. In the Philippines, for example, more than 14 private companies have regularly donated personnel, vehicles, facilities and financial sup port. The effective mobilization of such support has been possible only when the highest political leadership, at both national and subnational levels, endorsed the initiative publicly and took the necessary steps to put these resources at the disposal of health authorities. Thus, the delivery of this health service became a government and societal responsibility, with the responsibility of the health sector moving from implementation to management and monitoring. This personal engagement of political leaders in the oversight and implementation of activi- ties leads naturally to the third goal of political advocacy: heightened accountability, both Box 4.1 Progress towards polio eradication in the Eastern Mediterranean All countries of the Eastern Mediterranean Region are rapidly progress. poliovirus, the certification of polio eradication and the development of on g towards the eradication of poliomyelitis. The number of cases has post-certification immunization policy decreased relatively regularly, as shown by the well-developed and effi National containment coordinators have been nominated in 19 of cient surveillance system. By the end of 2002, poliovirus transmission the 23 countries of the region, 16 of which have also established na- had been interrupted in 18 countries of the region for more than three tional containment committees. By the end of 2002, 18 countries had ars; in addition, Sudan has not reported a single polio case since April prepared a national containment plan; three of the remaining five coun- only four countries(Pakistan: 90: Afghanistan: 10: Egypt: 7; and Soma. has been successfully completed in seven countries and is currenty o 2001. During 2002, 110 confirmed cases of polio were reported from tries still have ongoing virus transmission. The first containment ph lia: 3). During the first eight months of 2003, 61 cases were reported ing implemented in another 11 (Pakistan: 57: Afghanistan: 2; and Egypt: 1); a further case, in Lebanon, All countries of the region except Somalia have established Na- proved to be imported and genetically linked to the virus strains from tional Certification Committees(NCCs) with appropriate membership. Eighteen countries with no viral circulation have submitted reports and Intensified national immunization days(NIDs)are continuing in national documentation to the Regional Certification Committee(RCC). 2003, with technical support from WHO, both in endemic countries which has already reviewed 15 of these reports and provided appropri- Afghanistan, Egypt, Pakistan and Somalia) and in Sudan which was ate feedback. The RCC is also reviewing annual updates provided by recently decared polio-free. All these countries conduct more than two countries whose initial reports were satisfactory. These annual updates NIDs and one or more rounds of sub-national immunization days(SNIDs) will be submitted annually until regional certification is achieved in high-risk districts each year, reaching all children through house-to. Despite the significant achievements in remaining endemic areas, house immunization. Acute flaccid paralysis(AFP) surveillance contin. the eradication programme still faces a number of challenges and con- ued to improve throughout the region. The non-polio AFP rate has further straints that must be overcome to reach the final goal. The main focus increased in 2003 to reach 2.39 per 100 000 children under 15 years of now is Pakistan, where several outbreaks occurred during 2002-2003 age, while stool specimen collection has reached 90% It seems that the youngest children in tribal and conservative populations As the polio eradication initiative moves into its final phase, tech- are likely to be missed if the vaccination team does not include a woman nical advisory groups for the priority countries regularly review the epi- In order to overcome these difficulties, the emphasis is on enlisting fed In addition, a regional technical advisory group was established to pro. target all transmission zones. New international staff are being mobi- vide leadership for eradication activities in the remaining polio-endemic lized in districts with no previously assigned consultants, to help provid countries and to advise Member States on other technical issues. In. the needed technical support to ensure high-quality performance in sur- creasing attention is being given to the laboratory containment of wild veillance in all areas.62 The World Health Report 2003 received similar support – most noticeably when the G8 Heads of Government discussed their role in closing the funding gap for eradication activities during their meetings of 2002 and 2003 (6). This high-level visibility has been critical to achieving the second, and perhaps most impor￾tant goal of political advocacy: access to government and nongovernmental resources which lie outside the health sector. Because of the huge numbers of people and vehicles that are required to implement NIDs, such activities are beyond the logistic and communication capacity of the health sector in many countries. Consequently, countries have drawn heavily on ministries of information, transport, defence and others to help solve the challenge of rapidly reaching all children, in all corners of a country. Countries have also engaged the private sector, often on an extraordinary scale. In the Philippines, for example, more than 140 private companies have regularly donated personnel, vehicles, facilities and financial sup￾port. The effective mobilization of such support has been possible only when the highest political leadership, at both national and subnational levels, endorsed the initiative publicly and took the necessary steps to put these resources at the disposal of health authorities. Thus, the delivery of this health service became a government and societal responsibility, with the responsibility of the health sector moving from implementation to management and monitoring. This personal engagement of political leaders in the oversight and implementation of activi￾ties leads naturally to the third goal of political advocacy: heightened accountability, both Box 4.1 Progress towards polio eradication in the Eastern Mediterranean All countries of the Eastern Mediterranean Region are rapidly progress￾ing towards the eradication of poliomyelitis. The number of cases has decreased relatively regularly, as shown by the well-developed and effi￾cient surveillance system. By the end of 2002, poliovirus transmission had been interrupted in 18 countries of the region for more than three years; in addition, Sudan has not reported a single polio case since April 2001. During 2002, 110 confirmed cases of polio were reported from only four countries (Pakistan: 90; Afghanistan: 10; Egypt: 7; and Soma￾lia: 3). During the first eight months of 2003, 61 cases were reported (Pakistan: 57; Afghanistan: 2; and Egypt: 1); a further case, in Lebanon, proved to be imported and genetically linked to the virus strains from India. Intensified national immunization days (NIDs) are continuing in 2003, with technical support from WHO, both in endemic countries (Afghanistan, Egypt, Pakistan and Somalia) and in Sudan which was recently declared polio-free. All these countries conduct more than two NIDs and one or more rounds of sub-national immunization days (SNIDs) in high-risk districts each year, reaching all children through house-to￾house immunization. Acute flaccid paralysis (AFP) surveillance contin￾ued to improve throughout the region. The non-polio AFP rate has further increased in 2003 to reach 2.39 per 100 000 children under 15 years of age, while stool specimen collection has reached 90%. As the polio eradication initiative moves into its final phase, tech￾nical advisory groups for the priority countries regularly review the epi￾demiological situation and national plans and provide technical advice. In addition, a regional technical advisory group was established to pro￾vide leadership for eradication activities in the remaining polio-endemic countries and to advise Member States on other technical issues. In￾creasing attention is being given to the laboratory containment of wild poliovirus, the certification of polio eradication and the development of post-certification immunization policy. National containment coordinators have been nominated in 19 of the 23 countries of the region, 16 of which have also established na￾tional containment committees. By the end of 2002, 18 countries had prepared a national containment plan; three of the remaining five coun￾tries still have ongoing virus transmission. The first containment phase has been successfully completed in seven countries and is currently be￾ing implemented in another 11. All countries of the region except Somalia have established Na￾tional Certification Committees (NCCs) with appropriate membership. Eighteen countries with no viral circulation have submitted reports and national documentation to the Regional Certification Committee (RCC), which has already reviewed 15 of these reports and provided appropri￾ate feedback. The RCC is also reviewing annual updates provided by countries whose initial reports were satisfactory. These annual updates will be submitted annually until regional certification is achieved. Despite the significant achievements in remaining endemic areas, the eradication programme still faces a number of challenges and con￾straints that must be overcome to reach the final goal. The main focus now is Pakistan, where several outbreaks occurred during 2002–2003. It seems that the youngest children in tribal and conservative populations are likely to be missed if the vaccination team does not include a woman. In order to overcome these difficulties, the emphasis is on enlisting fed￾eral, provincial and local political leaders and expanding the SNIDs to target all transmission zones. New international staff are being mobi￾lized in districts with no previously assigned consultants, to help provide the needed technical support to ensure high-quality performance in sur￾veillance in all areas