"We Can't Give Up Now": global health optimism and polio eradication in Pakistan

The Polio Eradication Initiative, the largest coordinated public health project in history, is currently facing serious difficulties. For years, it has tried and failed to eliminate polio from its last strongholds in Afghanistan, Pakistan, and Nigeria. Drawing on document analysis as well as participant observation and interviews in Pakistan, Atlanta, Geneva, and Montreal, I explore how officials in the Polio Eradication Initiative systematically devalued or quieted evidence that eradication was not achievable and emphasized evidence that it was achievable, thus creating a string of optimistic projections. Polio eradication's culture of optimism ensures the continuation of the project by convincing donors and officials alike that eradication is immanent. At the same time, it prevents open, objective analysis of the problems the project faces.