The World Health Report 2003 By 1988, the year in which the World Health Assembly voted to launch a global initiative to eradicate polio(3), four agencies had begun to form the core of the"polio partnership": the World Health Organization, Rotary International, the United Nations Childrens Fund (UNICEF)and the United States Centers for Disease Control and Prevention(CDC). Over the following 15 years, the polio partnership has grown to become an extensive network of national governments, international agencies, private corporations, foundations, bilateral do- nors, humanitarian organizations, nongovernmental organizations and development banks The work of the partnership continues to be governed by a common, multiyear strategic plan and overseen by international technical committees at the country, regional and global levels The close relationship between national health authorities and this international partnership was critical to the extremely rapid scaling-up of eradication activities in the mid-1990s, as the initiative began building on the early momentum in the Americas and the Western Pacific Region and extended its activities to all countries of all regions By the end of the decade, over 500 million children were regularly being reached with OPV through the efforts of 10 million volunteers in every low-income and middle-income country in the world. From the outset, this partnership sought to bring a new efficiency to international support for national health efforts. It relied heavily on strategies and management processes that had been established by the Pan American Health Organization(PAHO)in its work to achie regional elimination of polio. This goal was realized in 1991, when a young Peruvian boy named Luis Fermin Tenorio became the last child ever to be paralysed by a wild poliovirus in the Region of the Americas. The global partnership adopted PAHOs proven four-pronged strategy: high coverage with routine OPV immunization, national polio immunization days, surveillance and laboratory investigation of acute flaccid paralysis(AFP)cases, and massive house-to-house"mop-up"campaigns(4). PAHOs Interagency Coordinating Committee (ICC)mechanism brought together partner inputs at the country level to ensure sufficient resources, while promoting transparent budgeting and efficiencies. The ICCs, convened regu larly by national ministries of health, ensured that national authorities were always at the centre of key decisions on strategy implementation. The global partnership also emphasizes engagement at the highest political levels in both donor and endemic countries Effectively engaging political leaders The most visible element of the polio eradication initiative has been the National Immuniza- tion Days(NIDs), as they require the immunization of every child under 5 years of age(nearly 20% of a country's population)over a period of 1-3 days, several times a year for a number of years in a row. In many countries, the scale and logistic complexity of these activities were even greater than those of campaigns undertaken during the height of the smallpox eradica tion effort. Consequently, the commitment of political leaders has been central to their suc- cess.This support has been generated by actively and continuously advocating for such leaders to play a role in three key areas: oversight, access to non-health resources, and accountability. The oversight of polio activities by political leaders has often begun with their personal pa ticipation in highly visible events such as the launching of NIDs and, ideally, has continued with their monitoring of progress. Following the example of South America, most countries have had their NIDs launched by the head of state or other prominent political figure. For example, in China, President Jiang Zemin immunized the first child in the national polic campaign in 1993. In the same year, King Sihanouk played a similar role in Cambodia. In 1996, President Nelson Mandela of South Africa launched the "Kick polio out of africa campaign at the Organization of African Unity(OAU)meeting in Yaounde, Cameroon, and committed the oau to regularly monitoring progress(5). Among donor countries, polio has60 The World Health Report 2003 By 1988, the year in which the World Health Assembly voted to launch a global initiative to eradicate polio (3), four agencies had begun to form the core of the “polio partnership”: the World Health Organization, Rotary International, the United Nations Children’s Fund (UNICEF) and the United States Centers for Disease Control and Prevention (CDC). Over the following 15 years, the polio partnership has grown to become an extensive network of national governments, international agencies, private corporations, foundations, bilateral do￾nors, humanitarian organizations, nongovernmental organizations and development banks. The work of the partnership continues to be governed by a common, multiyear strategic plan and overseen by international technical committees at the country, regional and global levels. The close relationship between national health authorities and this international partnership was critical to the extremely rapid scaling-up of eradication activities in the mid-1990s, as the initiative began building on the early momentum in the Americas and the Western Pacific Region and extended its activities to all countries of all regions. By the end of the decade, over 500 million children were regularly being reached with OPV through the efforts of 10 million volunteers in every low-income and middle-income country in the world. From the outset, this partnership sought to bring a new efficiency to international support for national health efforts. It relied heavily on strategies and management processes that had been established by the Pan American Health Organization (PAHO) in its work to achieve regional elimination of polio. This goal was realized in 1991, when a young Peruvian boy named Luis Fermin Tenorio became the last child ever to be paralysed by a wild poliovirus in the Region of the Americas. The global partnership adopted PAHO’s proven four-pronged strategy: high coverage with routine OPV immunization, national polio immunization days, surveillance and laboratory investigation of acute flaccid paralysis (AFP) cases, and massive house-to-house “mop-up” campaigns (4). PAHO’s Interagency Coordinating Committee (ICC) mechanism brought together partner inputs at the country level to ensure sufficient resources, while promoting transparent budgeting and efficiencies. The ICCs, convened regu￾larly by national ministries of health, ensured that national authorities were always at the centre of key decisions on strategy implementation. The global partnership also emphasizes engagement at the highest political levels in both donor and endemic countries. Effectively engaging political leaders The most visible element of the polio eradication initiative has been the National Immuniza￾tion Days (NIDs), as they require the immunization of every child under 5 years of age (nearly 20% of a country’s population) over a period of 1–3 days, several times a year for a number of years in a row. In many countries, the scale and logistic complexity of these activities were even greater than those of campaigns undertaken during the height of the smallpox eradica￾tion effort. Consequently, the commitment of political leaders has been central to their suc￾cess. This support has been generated by actively and continuously advocating for such leaders to play a role in three key areas: oversight, access to non-health resources, and accountability. The oversight of polio activities by political leaders has often begun with their personal par￾ticipation in highly visible events such as the launching of NIDs and, ideally, has continued with their monitoring of progress. Following the example of South America, most countries have had their NIDs launched by the head of state or other prominent political figure. For example, in China, President Jiang Zemin immunized the first child in the national polio campaign in 1993. In the same year, King Sihanouk played a similar role in Cambodia. In 1996, President Nelson Mandela of South Africa launched the “Kick Polio Out of Africa” campaign at the Organization of African Unity (OAU) meeting in Yaoundé, Cameroon, and committed the OAU to regularly monitoring progress (5). Among donor countries, polio has