The independent Africa Regional Certification Commission (ARCC) for Polio Eradication certified Africa free from the disease, on August 25, 2020. Relentless efforts by governments, donors, frontline health-care workers, and communities saved up to 1·8 million children from polio's crippling life-long paralysis. In August, 2016, the WHO African Region recorded its last case of wild poliovirus.Dr Ndoutabe Modjirom, WHO coordinator for the Rapid Response Team for the African Region, said commitments from African governments made the eradication of wild poliovirus possible. The resolve gathered pace in Africa after the World Health Assembly endorsed the resolution to eradicate polio globally in 1988.Engaging communities and involving local leaders is key, said Modjirom, who once spent 10 days in the Malian desert looking for a single child who had been paralysed and only succeeding after a Bamako chief helped to locate the child. Partnership with the Global Polio Eradication Initiative helped to support all the strategies used to eradicate wild polio and kept pushing and motivating leaders to continue.“Operationally, in countries where routine immunisation was lower than 90%, we implemented countless polio campaigns with hundreds of thousands of volunteers”, he told The Lancet Microbe. An aggressive approach to testing, building systems to enable quick identification of suspected cases of paralysis, and a quick response upon diagnosis to isolate the virus to prevent further spread were implemented. About 220 million children are vaccinated multiple times every year through the efforts of 2 million volunteer vaccinators.“We've learned a lot of lessons with polio eradication that are applicable for other health programmes, mainly for routine immunisation and outbreak response”, said Modjirom. The programme has built huge infrastructure and developed skills in immunisation campaigns, disease surveillance, data management, social mobilisation, and outbreak response. Over the years, this infrastructure and the lessons learned have been used to increase immunisation coverage but also control outbreaks of other diseases, such as measles, tetanus, and yellow fever. “When polio eradication started in earnest in the late 1990s, it seemed like a dream, there were high numbers of wild polio viruses at the time and sanitation in many places was very poor”, said Modjirom.Now, five of six WHO regions are free of wild poliovirus, with Afghanistan and Pakistan being the only two countries where wild polio remains endemic. “This is the lowest in history, and we are closer than ever to eradicating wild polio worldwide”, said Oliver Rosenbauer, WHO spokesperson.This achievement is also a huge stepping stone towards eliminating the long term risk of vaccine-derived polio strains, Rosenbauer said, since eradicating wild poliovirus will mean ending the use of the oral polio vaccine. “Our ultimate goal is to free the world of all polioviruses, but this needs to be done sequentially: first stopping wild poliovirus with the oral polio vaccine, then stopping the oral polio vaccine to eliminate vaccine-derived polio among under-immunised populations.”Africa's success adds to the experiences and expertise of the WHO Eastern Mediterranean Region. Dr Syed Hamid Jafari, WHO Director for Polio Eradication Initiative said the region faced challenges unique to the local context. For example, their programme in Afghanistan has been interrupted a couple of times, including when operations had to be suspended for a month because of the COVID-19 pandemic.“Afghanistan's main challenge is access; we are working to ensure that vaccines are part of overall humanitarian assistance”, Jafari told The Lancet Microbe. The team also battles misinformation through social media. Pakistan is more complex because in some communities people are displaced by conflict and there are no health services. Involving these communities is a challenge, but they must be part of the solution. “Eradication is a constant process of refinement, who are we missing in communities, tackle access… we have to overcome that”, Jafari said.Melinda Suchard, head of the Centre for Vaccines and Immunology (National Institute for Communicable Diseases, South Africa) told The Lancet Microbe that ARCC's declaration of wild polio eradication in Africa is a landmark achievement that gives hope that polio can indeed be eradicated globally. Eradication is feasible for other diseases, she said. Many hope that measles will be the next virus targeted for eradication, but there will be challenges. Measles is caused by an airborne virus and is highly infectious, so its eradication calls for vaccine coverage even higher than used to eradicate wild polio, she added.Although the number of cases caused by circulating vaccine-derived poliovirus (cVDPV) is much lower than the numbers that wild poliovirus used to cause, cVDPV could pose a hurdle to worldwide polio eradication, Suchard said.“Interestingly, a new polio vaccine is in development, even at this late stage of the global polio eradication initiative. The vaccine, termed the novel oral polio vaccine, has been engineered to be a genetically stable live attenuated polio vaccine”, she said, adding that research on the impact of the novel oral polio vaccine to stop wild poliovirus and cVDPV will be a key initiative in the near future.