With recent outbreaks in Syria and Horn of Africa silent circulation of wild poliovirus type 1 (WPV1) in Israel West Bank and Gaza and fresh spate of violence against vaccinators and their security personnel in Pakistan the globe is facing a turbulent last ascent towards the summit of polio eradication. an eventful 10 years in India can be a very significant development. Now there is definitely a parallel pursuit against WPV and vaccine-derived poliovirus (VDPV). Endgame would also involve integration of at least one dose of affordable inactivated polio vaccine (IPV) to up-scaled routine immunization (RI) switch from trivalent oral polio vaccine (tOPV) to bivalent oral polio vaccine (bOPV) in 144 countries before 2018 stockpiling of Ruxolitinib mOPV and simultaneous global cessation of bOPV before 2020. Part of antivirals in post-eradication era is still unclear. Some specific risks emerging at this stage are as follows: Global buildup of new birth cohorts in non-endemic countries with fragile RI and downscaled supplementary immunization activities (SIAs) incredible pressure on peripheral health workers and fatigued systems. Cultural resistance to transnational programs is certainly going for a violent shape in a few specific areas. Differential interpretations of ‘correct to state no’ on both edges of the separate are damaging a worldwide cause. Amidst each one of these concerns why don’t we remember to underline the sacrifice created by frontline vaccinators employed in some of the most complicated circumstances. may fall unwell and would want a healer also. I give thanks to my Association to be in the solid of this irony. I have chosen to speak on polio eradication for two reasons-India reports third consecutive polio-free 12 months on January 13 2014 and the world witnesses some worrisome developments affecting the polio endgame. As the Lancet Infectious Disease captured the sentiment of the year that was its editorial in the January issue of 2014 entitled ‘A wake-up call for polio eradication’ underscored Ruxolitinib the gravity of wild poliovirus type 1 (WPV1) outbreak in Syrian Arabic Republic.(1) A total of 23 cases most recent being on December 17 2013 were reported from this country disturbed by civil strife. The geographical distribution of computer virus indicated to a common circulation in the country ranging from eastern province to Aleppo in the north (one case reported from Damascus was later found to be Sabin-like). The source of infection originated in Pakistan and was detected in Egyptian sewage in January 2013 It is relevant to mention here that Syria has been polio-free since 1999. The country is usually facing a war-like situation for a Ruxolitinib couple of years resulting into a perilous combination of devastated public health system poor sanitation quick decline in polio immunization rates-from 91% in 2010 2010 to 68% in 2012- and massive displacement. Nearly 3 Ruxolitinib million people have crossed international borders to migrate to Lebanon Jordan Iraq Israel Turkey and Egypt. The Ruxolitinib migration is Slc4a1 usually posing threat to other continents including Europe that has been polio-free for over a decade. With a collective resolve the world can turn this crisis-like situation into an opportunity to address the funding gaps to avoid a 2012-like programmatic emergency to minimize the immunity gaps by carrying forward the supplementary immunization activities (SIA) in endemic countries and raising the alarm to strengthen routine immunization (RI) almost everywhere and to rigorously maintain the sensitivity of acute flaccid paralysis (AFP) surveillance. But the cardinal question is as follows: Do we need a Syria-like experience for any wake-up call when 2013 was punctuated with several worrisome events arguably much bigger in significance and gravity? Let us take a rundown through the events of a turbulent 2013. On December 31 2012 the world missed the deadline to stop WPV transmission once again. Set in 1988 Global Polio Eradication Initiative’s (GPEI) initial deadline of 2000 experienced already been extended several times.(2) The new 12 months started with fatal attacks on vaccinators by Islamic extremists mainly in Khyber Pakhtunkhwa and Waziristan provinces of northwest and Sindh in south. On January 1 2013 six female health workers and a male doctor were shot dead and this tragic event experienced a history. Since mid 2012 over 30 health workers have been killed in Pakistan. Several security staff on polio duty have also been shot lifeless or bombed.(3 4 Similar threats have been reported from Nigeria as well. What offset the case count in 2013 was the WPV1 outbreak in Horn Ruxolitinib of Africa mainly including Somalia (190 cases) Kenya (14 cases) and Ethiopia (9 cases) from May through December. This resulted in a situation where annual quantity of WPV cases from non-endemic countries outnumbered the.