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A child receives a drop of polio vaccine at the United Nations High Commissioner for Refugees supported Jalozai camp on the outskirts of Peshawar, Pakistan on Sept. 25, 2012.

Fayaz Aziz/Reuters

Saying a decisive moment has arrived in the quest to eradicate polio, world leaders vowed Thursday to embrace a new approach that includes long-term funding commitments, greater accountability and a specific focus on the three countries where the crippling disease remains endemic.

Spurred by philanthropist Bill Gates, luminaries gathered at the United Nations in New York to give their public backing to a six-year Global Polio Eradication Initiative that calls for the injection of an additional $1-billion (U.S.) a year and a more business-like approach to the vaccination campaign, including a switch from oral polio vaccine to a more effective injectable version.

"Getting polio done is one of the smartest allocations of resources the world can make," Mr. Gates, co-chair of the Bill and Melinda Gates Foundation, told the gathering.

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He also put his money where his mouth is: The foundation has invested more than $1-billion in polio eradication and will spend another $1-billion or more to finish the job.

"We're doing that because there's a real chance of success," Mr. Gates said in an interview with The Globe and Mail.

Prime Minister Stephen Harper opted not to attend the high-profile event at the UN even though Canada has been a key donor. It was the first country to make a donation when the polio eradication project was launched in 1988 and has contributed $387-million since then.

Canada was represented at Thursday's meeting by Julian Fantino, Minister of International Co-operation. He announced a modest plan to match funds raised by Rotary International in Canada up to $1-million, while other countries like the U.S., Britain and Australia made far more significant long-term pledges.

Others made much more significant commitments, most notably the Islamic Development Bank, which pledged $227-million but also promised to assist on the ground.

When worldwide eradication efforts began 24 years ago, some 350,000 people annually contracted polio, most of them children, and millions were living with disabilities as a result. The goal was to eliminate "the Great Crippler" by the year 2000.

That goal was pushed back repeatedly as the disease clung stubbornly in some countries. Last year there were 650 cases, including 351 in the endemic countries Nigeria, Pakistan and Afghanistan and 309 cases in the rest of the world. So far in 2012 there have been only 150 cases.

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"This decisive moment is a matter of health and justice," said UN Secretary-General Ban Ki-moon. "Every child should have the right to start life with equal protection from this disease."

Mr. Gates said that, in the past, the polio campaign was too dependent on wishful thinking and made unrealistic promises. This time around, he said, there is a "new sense of realism" and there will be a focus on mapping and targeting problem areas, just as was done in India's successful campaign. India, long the epicentre of the polio epidemic, has eliminated the disease. But as long as polio still exists in the wild – that is, as long as one person is still infected – it will be necessary to vaccinate about 400 million children annually.

An uncomfortable reality is that polio eradication has been stalled largely because of opposition to vaccination by Muslim clerics and the fundamentalist Taliban.

One of the priorities of the Gates Foundation has been finding ways to overcome skepticism – fuelled by anti-Americanism – about the polio vaccine. Significant donations from the Islamic Development Bank and the Crown Prince of Abu Dhabi to the polio eradication fund have helped break down barriers. There have also been outreach efforts that have resulted, for example, in the Taliban guaranteeing safe passage to vaccinators in Afghanistan, and Muslim clerics in Nigeria – who were in the past the most vociferous opponents – urging followers to get their children vaccinated.

"This isn't something imposed by the West. It's the whole world working together to eradicate polio," Mr. Gates said.

Wilf Wilkinson, the Canadian who is chairman of Rotary International, announced an injection of another $75-million over the next three years. The service club has raised an astonishing $1.2-billion for the polio campaign and its members are active in vaccination campaigns around the world.

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Mr. Wilkinson said he was excited by the new approach and the implication of Mr. Gates in particular and confident that the 2018 target date for eradication will be met.

"You can really see the influence of the Gates Foundation in the six-year plan. It's much more business-like," he said in an interview. "I really think this is the beginning of the end. I'm keeping my fingers crossed."

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