The world is close to wiping out polio, and that in itself is close to miraculous. Of the thousands of diseases that afflict humans, only one, smallpox, has ever been eradicated before.
But despite tremendous progress, polio isn’t going down without a fight. Budget cuts, vaccination gaps, and difficulties reaching hard-to-access communities keep pushing the finish line further back. As cases creep upward, virus strains have re-emerged in countries that were long ago declared polio free — including Germany.
What makes that even more worrying? Germany is one of the latest countries to cut down its international aid budget, planning to trim €17 million from polio vaccination efforts alone in 2025 and 2026. These financial shortfalls could end up accelerating polio’s spread, ushering in a future where resurgences become the norm.
We spoke with the World Health Organization (WHO) to find out exactly how Germany’s budget cuts could spell future trouble for all of global health.
But First — What Exactly Is Polio?
Poliomyelitis, or polio, is a highly infectious virus that spreads mainly through contaminated water and food, mostly striking children under five. It usually settles in the gut but can eventually attack the central nervous system. Its symptoms are brutal, ranging from fever, headaches, and vomiting, to irreversible paralysis in about 1 of every 200 infections. In the worst cases it can even paralyze breathing muscles, causing suffocation. In fact, a horrific outbreak of polio in Copenhagen in 1952 prompted doctors to create the first ‘iron lung’ — a precursor to today’s hospital intensive care units (ICUs).
Before vaccines entered the picture in the 1960s, there were more than 600,000 cases recorded worldwide each year. There’s still no cure — but it can be prevented, which is partially why global health advocates set their sights on the goal of eradicating it entirely.
As Dr. Shahin Huseynov, Regional Advisor at the WHO Regional Office for Europe, explained, “The chance of success in eradicating polio is unique.” While the virus is incredibly contagious, unlike coronaviruses or monkeypox, it can’t infect animals — eliminating a loop of cross-contamination and putting victory within reach.
How the World United to Fight Back
In 1988, the Global Polio Eradication Initiative (GPEI) launched as a partnership between major global health heavy-hitters like WHO, UNICEF, the US Center for Disease Control, the Gates Foundation, Rotary International, Gavi, and others. With two powerful vaccines introduced — the cheap, accessible oral polio vaccine (OPV) delivered by drops, and the highly effective injectable inactivated polio vaccine (IPV) — global immunization campaigns began, driving infections down by 99%.
In the 1980s, wild poliovirus paralyzed about 1,000 children daily. But by 2021, cases had dwindled to single digits. “To date, 20 million cases of paralysis have been prevented — one of humanity’s greatest achievements in global health. The eradication of the second disease in history after smallpox seems within reach,” said Dr. Huseynov.
In wealthy nations with strong healthcare systems and widespread vaccination resources, fears of polio have largely become a relic of history. Germany, for instance, saw its last case of wild polio decades ago in 1990.
So How Has Polio Stuck Around?
Total eradication requires closing every elusive immunization gap worldwide at once — a daunting task. At-risk communities face a litany of obstacles including faltering funding, conflict, weak infrastructure, misinformation, and slipping vaccination rates, leaving openings for the virus to proliferate.
Still, GPEI has scored some major triumphs. India was declared polio-free in 2014, as well as the entire African continent in 2020. And as Dr. Huseynov emphasized: “The polio program is more than just a vaccination program. It strengthens local health systems and achieves success even in crisis areas.”
“GPEI health workers have provided the infrastructure for COVID-19 vaccination campaigns, fought Ebola outbreaks, taken malaria prevention measures, and continuously improved disease surveillance. Even in the recent conflict in the Gaza Strip, a humanitarian pause allowed children to be vaccinated — a measure that was only possible thanks to the existing infrastructure of the polio program.”
Yet challenges remain. Wild polio is still endemic in Afghanistan and Pakistan, where political instability, misinformation, and rural inaccessibility fuel setbacks. COVID-19 also paid polio a huge favor by disrupting global childhood immunization campaigns. “If the international community fails now, the virus will return. Models predict 200,000 children will be paralyzed each year if this happens, including in Europe,” added Dr. Huseynov.
If that happens, decades of effort and billions of dollars will have been effectively wasted.
How Polio Bounces Back
Another chilling complication? Variant, or vaccine-derived poliovirus (VDPV). Though rare, this emerges when weakened strains from the OPV are able to spread and end up mutating and strengthening, threatening unvaccinated communities and immunocompromised individuals. In 2024, variants of poliovirus were found in 38 countries worldwide, including Palestine and Yemen. Since 2022, VDPV has been found everywhere from Jerusalem, London, Finland, Spain, Poland, and New York City — where an unvaccinated young man subsequently developed polio, leaving him paralyzed.
And as Dr. Huseynov warned, Germany has also found VDPV in wastewater across major cities since late 2024, including Munich, Berlin, Bonn, Cologne, Hamburg, Dresden, Düsseldorf, Stuttgart, and Mainz. “This is an alarming signal. It highlights the fact that even in Germany and other high-income countries of Europe, there is a risk of infection for people who are not adequately protected against the virus. Combating the disease at its source is therefore crucial also for the protection of public health in Germany.”
The Cost of Cutting Budgets
Currently, polio eradication campaigns are like a game of whack-a-mole — but to finish the job, every outbreak everywhere must be stopped, all at once. That requires steady international coordination, along with harmonious synchronization of vaccine supply, access, political will, public demand, and crucially, funding to back it all up.
GPEI relies primarily on governments and NGOs for its financial support. Dr. Huseynov explained, “Significant reductions to the GPEI’s budget mean certain activities, like disease surveillance and critical immunity building, may not be able to continue everywhere… Not least, the withdrawal of the US from key areas of global health financing once again highlights that multilateral solutions are more important than ever.”
Germany is GPEI’s historic third-largest donor. Since its founding, it has donated €854 million — proportionally, this means Germany has helped GPEI immunize 123 million children and avert 824,000 cases of paralysis since 1988. At the 2022 World Health Summit in Berlin, it pledged €72 million over 2022–2026. But now it’s looking to cut €17 million over the next two years — nearly half its commitment for that time frame. “These cuts not only send the wrong signal to other countries, but also jeopardize the successes achieved by GPEI.” Based on previous calculations, this cut could result in 2.6 million fewer vaccinated children around 17,700 children at risk of lifelong paralysis.
Dr. Huseynov also explained that Germany’s funding isn’t earmarked for any specific region or program, making its contribution extra impactful as it gives GPEI flexibility to direct resources where they’re needed most. With less to work with, campaigns could face delays and difficult trade-offs. And left unchecked, viruses will inevitably spill across borders, creating the perfect conditions for a global health crisis to spiral.
New Donors on the Horizon?
GPEI’s endgame strategy requires $6.9 billion through 2029. While some wealthy nations are stepping back, others are stepping up: Pakistan is funding more of its own efforts through subsidized loans, Saudi Arabia pledged $500 million earlier this year, and the UAE funded a large-scale campaign after last year’s outbreak in Gaza.
But fragile states facing outbreaks today like Afghanistan, Somalia, and Yemen still lack the resources to do the same. Without sustained commitments from long-standing donors like Germany, eradication will keep slipping out of reach — giving the virus time to evolve and spread as the world stumbles at the finish line.
Near-Victory Isn’t Enough
Eradicating polio for all is still possible — but viruses thrive amid negligence. Global health depends not just on scientific breakthroughs, but also simple human choices. Whether world leaders use the tools we have at hand, or fail to, determines health outcomes for all.
Many in Germany and across the Global North have never experienced polio, making it easy to dismiss its gravity. But the stakes are generational. As Dr. Huseynov emphasized, “With prioritization of health security, Germany has a unique chance to regain a leadership role in the fight against polio and in safeguarding the health of Europe.”
The finish line is in sight. Now is the time to double down, not pull back. Memories may be short — but the consequences of failing to act could last lifetimes.
