UNICEF's Carl Tinstman discusses eradicating polio worldwide.

(CNN) -- In the 12 years since an ambitious health initiative was launched to eliminate polio worldwide by the end of the year 2000, there are still some 30 countries to go. By the end of last year, the number of cases had fallen by more than 95 percent, world health authorities reported at a Global Polio Partners Summit that began Wednesday. Leaders from government and the private sector took part in the global polio summit. A new deadline has been set to eradicate polio by 2005.

Carl Tinstman is currently UNICEF Senior Advisor (polio eradication), a post he has held since September 1999, with responsibility for managing the partnership for the Global Polio Eradication Initiative.

Chat Moderator: Welcome to CNN.com News Chat, Carl Tinstman.

Carl Tinstman: Well, we are certainly pleased to be participating in this chat room from here at the United Nations headquarters in New York, where this morning we have had the Global Polio Partners Summit. This is a large meeting, about 250 persons taking part in the summit, to talk about how the world is going to eradicate polio, and certify the world polio-free by the year 2005. So, we've had speeches in the last hour by Kofi Annan, the UN Secretary General; by Ted Turner, the chair of the UN Foundation; by Mia Farrow, who is a UNICEF special representative for polio eradication; by the director general of the World Health Organization, Dr. Brundtland; and by the executive director of UNICEF, Carol Bellamy.

Question from CharliGirl: Mr. Tinstman, is polio still as big a concern for people now as it was in the past?

Carl Tinstman: It's not as big a concern as it was in the early 1950s, here in America, because the world has made great progress over the last 12 years, since the goal to eradicate was declared by the United Nations. We've gone in the last 12 years from 125 countries that were polio-endemic in 1988 to less than 30 countries today. We hope by the end of this year to be down to less than 20 countries, and we hope to finish the job by the end of 2002.

It will then take us another 3 years of being totally polio-free throughout the world, and having surveillance to prove that we're totally polio-free, so that we can certify the world in 2005. That's our objective, and that's what the meeting was about this morning, making sure we can get there, and overcoming the obstacles we face in getting there.

Question from Sunny1-CNN: What areas of the world have the most outbreaks of polio?

Carl Tinstman: Currently, we're looking at two major areas. One is in South Asia, including India, Pakistan and Bangladesh. The second major area is in Africa, particularly west and central Africa, where there are about 20 countries that still have polio.

One of the things we are about to do, actually next month, beginning October 16, is to do something we've never done before in Africa. We're going to synchronize the immunization days in 17 countries across Africa. That means that in 17 countries in the same week in October, and again a month later during the same week in November, we're going to attempt to reach every single child under the age of 5 in all 17 countries across west and central Africa. We'll reach them with two drops of oral polio vaccine. This has never been done before. But this is the kind of coordinated action that the eradication of polio is going to require.

Chat Moderator: How exactly do you accomplish this surveillance that is needed to prove that the world is polio free?

Carl Tinstman: This gets kind of technical, but it's something called AFP surveillance. AFP stands for Acute Flaccid Paralysis surveillance. What it means is that we have teams of people across polio-endemic countries looking for children under the age of 5 who exhibit signs of paralysis that could be polio. Now, in many, many cases, it is not polio, because there are other diseases that can cause paralysis that mimic polio. But in some cases, it is polio, and we prove that by laboratory testing. But the surveillance technique allows us to establish whether the number of paralysis cases we're seeing is appropriate to the number of the population, and then when we test those cases, and we find that there is no polio, and we find it consistently for three years, then we are able to certify that country or region, and eventually the world, as polio-free.

I'd like to make the point that as long as there is polio in any country of the world, then all of the world's children are at risk. In the United States, your children are immunized against polio today, even though we've had no polio in the U.S. for over 15 years. The reason we must continue to do that in the U.S., or in Western Europe or in Latin America, in all of these areas we must continue to immunize against polio, because polio can so easily cross international borders and infect populations.

Once we wipe out the wild poliovirus, we expect to have savings by ceasing polio immunization of around $1.5 billion per year. So, it's simply a matter now of finding the financial resources, gathering the political commitment, and getting the access to children in war zones across the world that will allow us to finish the job of eradicating polio between now and 2005.

Question from Candyce-CNN: Many areas of Africa continue to live under the shadow of civil strife and war. Will you be able to reach children in these areas?

Carl Tinstman: Yes, we are able to, and we will be able to, in most areas of Africa. Let me cite as an example the Democratic Republic of Congo, which is a country that is engulfed in war in central Africa, and it's a country where we have managed to access something in excess of 80 percent of the children, possibly more. We've done this in 1999 because of days of tranquility advocated for by Secretary-General Annan, and we did so again this year, in 2000, by putting more and more people into the field. I should add that they are at some risk to their lives. Most of these people are volunteers who are carrying out these national immunization days. In the case of the Democratic Republic of Congo, tens of thousands volunteered for their immunization days. It's through those kinds of efforts that we are able to reach children even in war zones. Having said that, I don't want to minimize the problems of finding children in war zones. In Angola, for instance, there are still many children that we are not getting to. We've had difficulty reaching children in Mogadishu in Somalia, and even in D.R.C. that I was just talking about, there are some areas that we have not gotten to. And so, access to children in these zones of war and conflict is indeed a major challenge facing the eradication effort.

Chat Moderator: Is there any resistance because of fears of the polio vaccine itself?

Carl Tinstman: Not significant resistance. The fact is that we must use oral polio vaccine, rather than the injectable kind of vaccine used here in the United States, because if you're going to reach every single child in India, for example, in a period of 2-3 days, that means 150 million children have to be reached in that 3 day period. If you have to inject vaccine into that many children in 3 days, it simply can't be done. We don't have enough workers. Therefore, the eradication initiative relies on volunteers who can put drops of oral vaccine into children's mouths.

Chat Moderator: Do you have any final thoughts for us today?

Carl Tinstman: One final thought. That is, the reason this effort is going to succeed, and make no mistake, polio will be the second disease in the history of the world to be eradicated (smallpox being the first), the reason is the quality of the partnership of U.N. agencies with Rotary International. Rotary has done more than any other organization in the world to pursue the eradication initiative with literally millions of volunteers, and with so far $378 million that Rotary has raised for the polio eradication mission. It's the quality of the partners, like Rotary, like the U.S. government, and like the World Health Organization. And finally, with ordinary people like you and me, working on this effort. One of the most moving statements this morning here at United nations headquarters was by Mia Farrow, who most people don't realize had polio herself as a child, and by her son, Thaddeus, who has polio today, and will spend the rest of his life in a wheelchair. It's because of people like this, and the partners we have in this effort, that we will succeed in wiping polio off the face of the earth.

Chat Moderator: Thank you for joining us today, Carl Tinstman.

Carl Tinstman: Thank you!

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UNICEF
World Health Organization: Global Polio Eradication Initiative
International Polio Network

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