In a rare victory for global health this year, the WHO declared the absence of indigenous wild polio virus from its 47-nation African Region. Africa saw its last endemic case in 2016 in the state of Borno in northeastern Nigeria. Pakistan and Afghanistan are the last two endemic countries; both are experiencing spiking transmission. The outlook for polio eradication is complicated by explosive outbreaks of vaccine-derived poliovirus. These outbreaks have spilled into 22 countries and continue to climb, exacerbated by the WHO’s decision to suspend polio vaccination campaigns in 28 countries because of COVID-19.