In this BMJ Group blogs post, Richard Smith, editor of the BMJ until 2004 and director of the United Health Group’s chronic disease initiative, examines whether efforts to eradicate polio can be successful, writing, “Despite the problems of geography, war, insurgency, politics, communication, finance, and people management, there are optimistic signs, said … Sir Liam Donaldson, former chief medical officer in England and now chair of the International Monitoring Board for the Global Polio Eradication Programme.” He continues, “This is, [Donaldson] concluded, a ‘unique moment in public health’: with one last heave the disease could be eradicated, but if it isn’t financial backing will disappear, health workers will not be paid, systems will break down, and cases of polio will rise back into the tens or hundreds of thousands” (3/22).