Can we agree on a prescription? A view from the perspective of the developing countries

There are serious obstacles, particularly on the African Continent, to the application of the official strategy for eradication of poliomyelitis. Outbreaks in countries where a potent OPV was used keep raising the question of its efficacy in routine programs. Based on the South American strategy, 200 million doses of OPV are needed for the 11 million children born each year. Such quantities of vaccine can hardly be procured for the rest of the world. Organization of vaccination campaigns will be competing with other public health programs. Studies in Africa and in the Middle East have shown the good performance of one or two doses of eIPV combined with DTP. At the current price of the quadruple vaccine DTP-eIPV, its cost effectiveness not only in money, but in practical terms, especially for the inventory, the cold chain, and the delivery, would be extremely attractive.