The vast majority of new cases are in Pakistan, a country which an independent monitoring board set up by the WHO has called “a powder keg that could ignite widespread polio transmission.”
Dozens of polio workers have been killed over the last two years in Pakistan, where militants accuse them of spying for the U.S. government. Those suspicions stem at least partly from the disclosure that the CIA used a Pakistani doctor to uncover Osama bin Laden’s hideout by trying to get blood samples from his family under the guise of a hepatitis vaccination program. U.S. commandos killed the al-Qaida leader in May 2011 in the Pakistani garrison town of Abbottabad.
At the end of last month, there were 68 confirmed polio cases worldwide, compared with just 24 at the same time last year. In 2013, polio reappeared in Syria, sparking fears the civil war there could ignite a wider outbreak as refugees flee to other countries across the region. The virus has also been identified in the sewage system in Israel, the West Bank and Gaza, although no cases have been spotted.
In February, the WHO found that polio had also returned to Iraq, where it spread from neighboring Syria. It is also circulating in Afghanistan (where it spread from Pakistan) and Equatorial Guinea (from neighboring Cameroon) as well as Nigeria, Ethiopia, Somalia and Kenya.
Officials also worry countries torn by conflict, such as Ukraine, Sudan and the Central African Republic, are rife for polio reinfection.
Some critics say it may even be time to accept that polio may not be eradicated, since the deadline to wipe out the disease has already been missed several times. The ongoing effort costs about $1 billion a year.
“For the past two years, problems have steadily, and now rapidly mounted,” Henderson said in an email. “It is becoming apparent that there are too many problems (for the polio eradication effort) to overcome, however many resources are assigned.”