HEALTH: With Adequate Funds, Polio’s Days Would Be Numbered

By Gustavo Capdevila Reprint | | Print |

Gustavo Capdevila

GENEVA, Sep 6 2002 (IPS) - The international campaigns launched two years ago to completely wipe out poliomyelitis did not achieve their goal, but they did reduce the number of new cases of the disease reported each year from nearly 3,000 to just a few hundred.

The global health community now proposes to halt all contagion of the poliovirus and to certify by the end of 2005 that all regions of the world are free of this paralysing disease, but an estimate one billion dollars is needed to do so.

The World Health Organisation (WHO) admits that it did not meet the objective of eradicating the disease from the planet by 2000, as the health ministers from the agency’s then-166 member states had proposed at the 41st World Health Assembly in 1988.

But polio, which at that time was endemic on all continents, has been confined now to just 10 countries in Africa and Asia, says Fadela Chaib, WHO spokeswoman.

“The number of cases has fallen by 99.8 percent, from an estimated 350,000 cases in 1988 to 483 in 2001,” according to Chaib.

The ten countries where new poliomyelitis cases are reported can be divided into two categories: areas with high-intensity and areas with low-intensity transmission.

In the first group are India, Pakistan, Afghanistan, Nigeria and Niger.

These five countries hold 85 percent of the 483 cases identified in 2001. “They are characterised by having areas with large populations and low routine immunisation coverage, sub- optimal sanitation and relatively wide geographical distribution of the wild poliovirus,” states the United Nations health agency.

The other group, with low-intensity transmission, consists of Somalia, Sudan, Ethiopia, Angola and Egypt. “Together, these areas accounted for less than 15 percent of the new polio caseload in 2001.” They also have lower-density populations and the areas poliovirus transmission tend to be concentrated.

The main victims of poliomyelitis are children under age five. It is a highly infectious disease that is caused by a virus. It attacks the nervous system and potentially can cause total paralysis within a few hours.

The poliovirus enters the body through the mouth and multiplies in the intestine, producing symptoms are fever, fatigue, headache, vomiting, stiff neck and soreness of the limbs, according to WHO information.

Irreversible paralysis occurs in one of every 200 infections and usually affects the legs. The risk of mortality among those affected by paralysis is five to 10 percent, and occurs when the individual’s breathing muscles become immobilised.

The eradication campaign launched in 1988 achieved a dramatic 99.8-percent reduction in 14 years to fewer than 500 new polio cases in 2001.

In 1994, the WHO-designated region of the Americas, which covers 36 countries, including the Caribbean, was certified polio- free. The WHO Western Pacific region, which covers 37 countries, including China, was certified polio-free in 2000.

The WHO European region, covering 51 countries “has been free of polio for over three years and is on track for polio-free certification in 2002.”

Progress in polio-eradication efforts from 2000 to 2001 includes “a reduction in polio-endemic countries from 20 to 10, and an 80 percent drop in new cases from 2,979 to 483.”

In that period, the disease disappeared from two “traditional poliovirus reservoirs”, Bangladesh and the Democratic Republic of the Congo (DRC).

The two countries demonstrate the efficacy of the polio eradication strategies “even in highly populated or conflict- affected countries”, like the DRC, says the WHO.

The UN agency’s policy for wiping out the disease entails efforts to “close the funding gap”. An estimated one billion dollars of financial support is needed to meet the global certification goal by the end of 2005.

Of that sum, 725 million dollars have been pledged or projected in the plans of donor nations.

The WHO is now seeking the remaining 275 million dollars needed to purchase oral polio vaccine (OPV), carry out national immunisation days and “mop-up” campaigns, and cover monitoring and laboratory costs.

The agency warns, however, that if “wild poliovirus transmission continues into 2003 in all remaining endemic areas, the total programme costs could increase by as much as 150 million dollars.”

A goal of the WHO is to vaccinate all children under age five in every corner of the world, including those living in densely populated areas or in remote regions, and children who may be difficult to reach because they live in areas of conflict.

Also essential is the political commitment of the governments in the countries where the disease persists and of polio-free countries alike, stated Chaib.

The WHO spokeswoman warned that the poliovirus “can easily be imported into a polio-free country and spread rapidly among non- immunised populations.”

“As long as a single child remains infected with poliovirus, children in all countries are at risk of contracting the disease.”