Unfortunately, if you look at the situation with type 2, you will see what happens when OPV stops too early (and type 2 is a much less aggressive disease than type 1). In a perfect world, OPV cessation happens in most healthy communities rather soon, while the people who are in need of a much stronger vaccine continue to get OPV.
Also, Gates's pet project of a novel OPV has been shown to have caused a few confirmed cases of VAPP now, so it seems that project won't save OPV.
Essentially the best hope for eradicating polio within 20 years seems to be giving out a lot of OPV to places like Afghanistan and the DRC and forcing the local warlord to give it to the kids who need it (the latter has generally been a total failure of the Gates project). Once OPV gets wild-type and cVDPV outbreaks under control, a global switch to IPV seems safe to prevent future outbreaks. But, to get there, it seems a very aggressive OPV campaign is necessary compared to where we are now. It may take a militarized organization to do this, also, given the fact that you necessarily have to deal with tribal warlords. Shame we don't have USAID any more...
We aren't going to do that because it seems we generally aren't capable of doing that. So we're likely stuck with a decent amount of polio for a long time.
Also, Gates's pet project of a novel OPV has been shown to have caused a few confirmed cases of VAPP now, so it seems that project won't save OPV.
Essentially the best hope for eradicating polio within 20 years seems to be giving out a lot of OPV to places like Afghanistan and the DRC and forcing the local warlord to give it to the kids who need it (the latter has generally been a total failure of the Gates project). Once OPV gets wild-type and cVDPV outbreaks under control, a global switch to IPV seems safe to prevent future outbreaks. But, to get there, it seems a very aggressive OPV campaign is necessary compared to where we are now. It may take a militarized organization to do this, also, given the fact that you necessarily have to deal with tribal warlords. Shame we don't have USAID any more...
We aren't going to do that because it seems we generally aren't capable of doing that. So we're likely stuck with a decent amount of polio for a long time.