Development & Aid, Global, Global Geopolitics, Headlines, Health

DEVELOPMENT: Polio on the Brink of Elimination

Stephen Leahy

BROOKLIN, Canada, Mar 26 2004 (IPS) - A final assault to eradicate polio, an infectious disease that paralyses children, is underway with the goal of halting transmission of the disease by the end of 2004.

The Global Polio Eradication Initiative, a massive 16-year effort involving governments, international agencies, humanitarian organisations and the private sector, now has the disease cornered in small regions in Nigeria, India, Pakistan and Egypt.

Those countries have committed to complete a series of mass immunisations before the end of this year.

Smallpox is the only disease that has been eliminated worldwide. Polio would be the second.

But in the last two years vaccination programmes in parts of northern Nigeria were hampered by rumours that the oral polio vaccine (OPV) was unsafe.

As a direct result, eight neighbouring countries that had been polio-free for two years had small outbreaks of the disease last year. To halt the spread, a 10-million-dollar emergency vaccination of children in those nations was launched by the World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF).

Unless at least 90 percent of Nigeria’s children under age five can be vaccinated against polio – ideally three times so the vaccine is guaranteed to be effective – the campaign will fail.

With strong support from the Nigerian government, 36 of 37 northern states have completed their first round of vaccinations this week, says Claire Hajaj, a spokesperson for UNICEF.

"The virus is cornered and there’s no reason why it can’t be stopped. This is our best chance yet," Hajaj told IPS.

The pursuit of polio eradication has been one of the largest public-health efforts in history, involving 20 million volunteers and costing more than three billion dollars. The number of children paralysed by the disease has fallen dramatically, from more than 350,000 in 1988 to 1,900 in 2003, according to the WHO.

The end game for polio has been a long time coming. A cheap, effective oral vaccine (OPV) was developed in 1961 by Albert Sabin. Administered as drops directly into a child’s mouth, OPV is ideal for widespread immunisation efforts in the developing world.

But no one at that time imagined the enormous logistical challenge of putting those drops into the mouths of 90 percent of the world’s children.

"There are roughly 275 million children in India alone. The vaccinators have to go house to house. It’s a huge undertaking," says Hajaj.

And yet the vast majority of the world’s children have been immunised. Even in destitute, war-torn Somalia, children have received their vaccinations. Without a central government, local Somali community and religious leaders strongly supported the international effort.

WHO and UNICEF staff and equipment were protected by local warlords, Hajaj says. "The local people showed tremendous will in making it happen."

Polio is no longer endemic in Somali, but to prevent importation from elsewhere in Africa another round of vaccinations will begin at the end of March.

"If polio can be stopped in Somali, it can be done anywhere," according to Hajaj.

Community involvement and political will are two key ingredients in the success of the polio eradication effort. The third, not surprisingly, is funding. But despite the programme’s enormous success and nearness to its final goal, it is once again short of funds.

About 130 million dollars is needed through 2005 to help create a polio-free world, says Oliver Rosenbauer, a spokesperson for the WHO in Geneva, Switzerland.

After that, another 380 million dollars will be needed to continue some vaccinations, using injectable vaccines rather than the OPV, which in rare cases can produce the disease. Global polio monitoring will also be needed. With luck, by 2008 it might be possible to declare the world polio free.

A good deal of credit for the fight against polio ought to go to Rotary International, a worldwide humanitarian organisation of business and professional leaders. Rotary is the second largest donor to the Polio Initiative, contributing more than 500 million dollars.

And when polio is gone, what disease will be next?

Despite the enormous effort involved in vaccinating children, polio is considered one of the easier diseases to eliminate because, among other factors, there are no animal reservoirs for the disease. Malaria, HIV and many others will be more difficult, says Hajaj.

Over the last few years, the Polio Initiative has also been delivering other health services, such as vitamin A supplementation and health education. The polio partnership will increase these broader efforts, tailoring them to local needs, Rosenbauer told IPS.

The initiative’s tremendous expertise, infrastructure and institutional arrangements will be used for other childhood vaccination efforts against the long list of infectious diseases, such as measles.

"We still have a long way to go to reduce child mortality," says Hajaj, referring to the 2015 U.N. Millennium Development Goal of reducing under-five child mortality by two-thirds.

"The job is never done."