Polio Eradication in Afghanistan, Pakistan and Nigeria - The Final Three
Poliomyelitis, often called polio or infantile paralysis is an infectious disease caused by the poliovirus. It is a devastating disease that primarily impacts children and it can survive in the wild, but not for long without a human host. There is no cure, therefore, immunization is the foundation for eradication efforts. Today, polio is almost entirely eradicated from the planet.

Global immunization campaigns have made terrific progress in decreasing wild poliovirus (WPV) cases by over 99 percent in the past 30 years, down from an estimated 350,000 cases in 1988 to 29 reported cases in 2018. While more work needs to be done, the world is closing in on the virus and all eyes are on polio eradication in Afghanistan, Pakistan and Nigeria– the three final endemic countries. In the text below, the status of polio in these three countries is presented.

Polio Eradication in Afghanistan

Between the three countries listed above, in 2018 the most global polio cases were reported in Afghanistan. However, Afghanistan is the only endemic country not currently battling vaccine-derived polio, a form that can paralyze, in addition to WPV, which is a victory. The Global Polio Eradication Initiative (GPEI), in conjunction with Afghanistan’s Emergency Operation Centres, has dedicated continuing high-priority surveillance and instituted an aggressive immunization campaign to eradicate WPV in order to protect those most affected.

In November 2018, the country concluded an immunization campaign that targeted over five million children in the highest-risk provinces. These accomplishments are impressive, but at the same time fragile, because every single child must be vaccinated in this rapidly growing country. The Emergency Operation Centres are continuing to work under a National Emergency Action Plan and with local communities to ensure that all children are consistently reached now and in the future.

Polio Eradication in Pakistan

Polio could be eliminated from Pakistan this year, with continued strategic implementation. A vaccination campaign in December reached nearly 40 million children and the number of reported cases in the country is the lowest it has ever been. The race to the finish line requires continued focus on immunity gaps in high-risk and mobile communities, especially those that are close to the places where the virus is still indigenous, as well as continued accountability and high childhood vaccination rates.

Additionally, several of the endemic polio regions remain on the border with Afghanistan, which will require the two countries to continue addressing these WPV strongholds together. This region highlights the continued global threat of a virus that transcends geopolitical boundaries.

Polio Eradication in Nigeria

While WPV has never stopped circulating in Nigeria, there have not been any WPV cases since 2016. This is a terrific start towards wild polio eradication, but Nigeria has seen years without a WPV outbreak in the past only to see it return. The country is also managing continued vaccine-derived outbreaks. While immunization is paramount to eradication, some forms of the vaccine can infect patients and cause an outbreak. Though this adds a complex level to eradication strategies, immunization remains the most viable solution.

Currently, a variety of innovative solutions are underway to reach children in high-risk areas, including international immunization campaigns in the Lake Chad Basin whenever security permits, market vaccinations and seeking out nomadic communities. Similar to Afghanistan and Pakistan, continued efforts remain focused on closing immunity gaps, vaccinating all children and working with the country’s neighbors, but additional support for political and financial commitment is needed in Nigeria.

Going Forward

Wild polio eradication in Afghanistan, Pakistan and Nigeria is almost complete, but there are several challenges facing major vaccination efforts. In order to achieve elimination, every single child needs to be immunized. Even one unvaccinated child leaves the entire world at risk of infection.

There are, however, real challenges to this seemingly straightforward goal. Barriers like reaching children in mobile populations or in active conflict zones require international political coordination and more resources for mobile and stationary vaccination teams. Another major barrier is vaccine-derived polio cases, which threaten populations that don’t currently see polio in the wild. Research into the implications of adjusting the vaccine are underway and seek to address eliminating the spread of vaccine-derived infection.

It will not be possible to eradicate every disease with vaccination. Polio is one of the ones that can be. As global health efforts target polio eradication in Afghanistan, Pakistan and Nigeria, the world will likely be able to list polio next to smallpox and rinderpest on the coveted list of globally eradicated diseases.

– Sarah Fodero

Photo: Flickr

Australia Pledges $10 Million to Fight Polio in Papua New Guinea
Recently, the Australian government pledged $10 million to fight polio in Papua New Guinea. Australia’s contribution will go towards preventing the spread of infectious diseases and expanding the reach of vaccination campaigns. Earlier this year, the first case of polio since 2000 arose in Papua New Guinea. The government has declared the polio outbreak a national public health emergency. Since Australia is Papua New Guinea’s closest neighbor, the polio outbreak is a health threat to both countries. This shared interest spurred Australia’s decision to help contain Papua New Guinea’s polio outbreak.

Polio Around the World

Poliomyelitis, or more commonly known as polio, primarily targets children under the age of five. Polio is caused by a virus, which spreads primarily through contact between people. Though the first symptoms are relatively mild, as the infection spreads through the nervous system, it can lead to paralysis, which is the case in one out of every 200 infections. While there is no cure for polio, the disease is entirely preventable. If children receive the polio vaccine for the recommended amount of times, they can become immune to the virus.

Though the global incidences of polio have fallen by more than 99 percent since 1988, polio is still a public health threat to children around the world. According to The World Health Organization, if even one child still has polio, children in every country are at risk for contracting it. Unless polio is completely eradicated, there could be nearly 200,000 new cases of polio worldwide each year over the next 10 years. Because of polio’s highly infectious nature and the great health risks it brings, the international community must focus on vaccinating children worldwide.

An Outbreak of Polio in Papua New Guinea

For the past 18 years, Papua New Guinea was polio-free. Unfortunately, in April 2018, a young boy in Papua New Guinea’s northern region surfaced with symptoms consistent with polio, including lower limb paralysis. The following month, doctors diagnosed the boy with a vaccine-derived poliovirus type one. The single case worsened shortly afterward when stool samples from two children in the same neighborhood displayed the same strain of polio. The National Department of Health of Papua New Guinea and The World Health Organization both confirmed the diagnosis and Papua New Guinea’s polio outbreak.

In the Morobe province, where the first case emerged, only 60 percent of the children had received the approved three-dose polio vaccination cycle. Lack of proper sanitation and clean water also increased the risk of polio contagion in the area since the virus can spread through contaminated food or water. Immediately following the outbreak’s announcement, The National Department of Health, along with the World Health Organization and the Global Polio Eradication, introduced a large-scale immunization campaign.

Papua New Guinea’s Health Secretary, Pascoe Kase, underlined the importance of this vaccination campaign, saying the “immediate priority is to respond and prevent more children from being infected.” Moving forward, Papua New Guinea will work in conjunction with The World Health Organization to continue investigating the outbreak and enhancing the response efforts.

Fighting Polio in Papua New Guinea

Alongside other donors, such as The U.S., Canada and Papua New Guinea’s government, the Australian government hopes its $10 million donation will curb the current polio outbreak as well as prevent future infectious diseases. All these donations will benefit the country’s emergency vaccination campaign, totaling $21 million. The campaign hopes to vaccinate more than 3.3 million children in the country, with a special focus on children in densely populated areas.

With the donations from Australia, as well as other countries and organizations, the government of Papua New Guinea has enough funding to cover nearly all of the vaccination expenses. Dr. Mills in Euga province, who is also the president of The Society of Rural and Remote Health, remains hopeful that vaccination efforts will eradicate polio in Papua New Guinea once again.

In recent years, funding for immunizations had dropped, leaving many children vulnerable to polio. As he put it, “let’s hope [the outbreak] provides the impetus to refocus our attention on these basic things,” such as consistent vaccinations programs. He emphasizes that to prevent future polio outbreaks, methods of prevention and intervention must be a priority for Papua New Guinea.

– Morgan Harden
Photo: Flickr

Polio in Papua New Guinea
A polio outbreak was reported in Papua New Guinea. This is the first time polio has been seen in the country in nearly two decades, and an especially poignant occurrence as polio is extremely close to eradication around the world.

What is Polio?

Polio is a dangerous virus spread through food, water and contact with infected people. Those who do not have access to adequate sanitation are especially vulnerable to the virus.

Polio multiplies in the intestines but can move to other parts of the body through the bloodstream and affect the nervous system. This can lead to paralysis. The poliovirus has no cure once contracted, so the only route to the end of polio is through vaccination and other methods of prevention.

How Do You Treat Polio?

There are two forms of vaccination against the polio virus, but oral poliovirus vaccines (OPVs) are the vaccine predominantly used across the world today. OPVs are inexpensive, at a maximum of $0.18 for countries supplied by UNICEF in 2016.

They also are easy-to-use as they are administered orally. Such facility means that the vaccine does not need trained healthcare personnel or sanitized syringes for application.

Polio in Papua New Guinea

The strain of polio in Papua New Guinea is known as vaccine-derived poliovirus type 1. This form of poliovirus is caused by a mutation of the weakened version of the polio virus used in the oral vaccine. The weakened version of the virus stays inside the person who has received the vaccine for several weeks. During this period of time, the body excretes the virus.

In areas with poor sanitation, the vaccine virus can be transferred from person-to-person and can also pass on a passive immunization to others in the community. However, if there is low immunization in a region, the virus can continue transferring for an extended period of time. This spread can lead to mutations in the virus and, in extremely rare cases, the virus can become neurovirulent again in what is called a vaccine-derived poliovirus.

Morobe Province and Prevention Methods

Within the Morobe Province — the region of Papua New Guinea where the virus outbreak was found — only 61 percent of the children had received the three doses of the oral polio vaccine recommended by the World Health Organization (WHO). This lack of immunization in conjunction with the lack of adequate sanitation increases the spread of the virus and the danger of the outbreak.

WHO, the National Department of Health, the Global Polio Eradication Initiative and other groups are working alongside the government of Papua New Guinea to contain the virus. Since the confirmation of an outbreak of polio in Papua New Guinea, several large-scale measures have been put into place to prevent any further spread of the disease.

These measures include extensive immunization of those in the region where the virus has been detected, especially for children under the age of 15, and increasing surveillance measures in order to detect any new cases of polio. Plans have also been established to employ more immunization campaigns in the coming weeks.

International Aid

Global efforts to eradicate the polio virus were launched in 1988. Since that time, polio incidence has dropped by 99 percent across the world. The wild poliovirus only remains endemic in three countries: Afghanistan, Pakistan and Nigeria. In 2017, there were 22 cases of wild poliovirus and 96 cases of vaccine-derived poliovirus.

This dangerous disease is close to global eradication; however, the outbreak of polio in Papua New Guinea shows that the virus remains a danger in areas with insufficient sanitation and lack of adequate vaccinations. Organizations across the world continue to fight to keep everyone safe and to end the poliovirus once and for all.

– Lindabeth Doby
Photo: Google

Polio in Nigeria
This year, the Bill and Melinda Gates Foundation will start paying off Nigeria’s $76 million debt over the course of the next 20 years. The money was originally borrowed from Japan by Nigeria to fight the polio epidemic in the country.

In 2017, Nigeria had no new cases of polio, which is a significant improvement compared to 2012, when Nigeria accounted for half of all cases worldwide. The Gates Foundation decided to repay the debt on the premise that Nigeria would ramp up its polio vaccination efforts.

The Importance of Polio Eradication

Polio cripples and can potentially kill those who suffer from it. The disease damages spinal nerve cells, causing temporary and sometimes permanent paralysis. Paralysis can sometimes occur within a matter of hours. It is often spread through contaminated food and water. Up to 10 percent of those who become paralyzed die.

Thankfully, there is a vaccine that has contributed to the almost total eradication of polio worldwide. The main problem is getting the vaccine to the children who need it. In order for Nigeria to receive the money from the Gates Foundation, it has to provide vaccine access to at least 80 percent of the country.

The key to eradicating polio in Nigeria is to send health workers across the country to provide the vaccine. Children and families are unable to travel to receive the vaccine, so Nigeria has begun a campaign to bring the vaccine straight to people’s homes, with the support of the Gates Foundation.

Fighting Polio in Nigeria a Priority of the Gates Foundation

Polio in Nigeria was by far the biggest issue in the overall epidemic, which is why Bill and Melinda Gates honed in on the country after announcing that the eradication of polio was their highest priority. In addition to beginning to repay Nigeria’s loan, the Gates Foundation donated $3 billion in 2017 to polio eradication.

The change these donations have made in the epidemic of polio in Nigeria is tangible, since there are currently no known cases in the country. Worldwide, there are only 22 known cases, down from 350,000 cases 30 years ago.

Children today are walking that would have been paralyzed were it not for the generosity of the Gates Foundation and organizations like it. Volunteers on the ground are also the unsung heroes.

On his blog Gates Notes, Bill Gates wrote, “The heroes who have made this progress possible are the millions of vaccinators who have gone door to door to immunize more than 2.5 billion children. Thanks to their work, 16 million people who would have been paralyzed are walking today.” The efforts of these workers should not go unnoticed, as the progress made would not have been possible without people like them.

The progress towards mitigating polio in Nigeria has been phenomenal, with the disease now entirely eradicated from the country. It only takes one child or one traveler for polio to begin to spread again, so it is essential for the countries with a history of the disease to continue their efforts to fight it. Continual vaccinations and immunizations are necessary to maintain the current polio-free Nigeria.

– Amelia Merchant
Photo: Flickr

Vaccinations in Egypt
Vaccinations have been proven to be the most powerful and most cost-effective health intervention that can be provided to a population. Vaccinations have been proven to reduce disease, disabilities and deaths, especially in children under the age of five. The majority of unvaccinated children reside in low to middle-income countries where health systems are compromised, such as Egypt. Vaccinations in Egypt have proven incredibly successful, but the country still has a ways to go.

There are three main organizations that supply vaccinations to low-income countries. These are UNICEF, the Pan American Health Organization and the Gavi, the Vaccine Alliance. These organizations understand the impact vaccinations have on the eradication of disease.

Vaccinations in Egypt Have a Track Record of Success

Vaccinations have had a large impact on the health of children in Egypt. The vaccinations in Egypt that have been the most successful are poliomyelitis and neonatal tetanus. These vaccinations are responsible for nearly eradicating these diseases. The last case of polio was recorded in 2004, and by 2005, only 25 cases of neonatal tetanus were recorded.

Egypt established the National Immunization Program in the 1950s, and the first vaccinations introduced to the population were tuberculosis and diphtheria. Pertussis and tetanus vaccinations in Egypt became available in the 1960s. In 1977, the measles vaccination was introduced, followed by the measles, mumps, and rubella (MMR) combination in 1999.

However, better access to vaccinations in Egypt is critical. Measles and rubella were the most common diseases prior to vaccination programs in 1977, and even though it has been estimated that as of 1999, 95 percent of children were vaccinated with MMR, there were still major outbreaks of measles and rubella in Egypt between 2005 and 2007. Measles was considered endemic until 2008, when measles cases were estimated at less than one per every 100,000 people.

International Efforts to Increase Access to Vaccines in Egypt

Egypt has developed a strategy to increase access to vaccinations for the general population. The main organizations that coordinated and funded this plan are the Ministry of Health and Population, UNICEF and the World Health Organization. The plan is to increase access to vaccinations in Egypt in these ways:

  • Target 36 million children between the ages of two and 19
  • Maintain coverage of the vaccinations already supplied
  • Strengthen and increase school immunization programs
  • Obtain stronger disease surveillance
  • Improve social mobilization
  • Establish the Interagency Coordinating Committee

Egypt has put forth great effort to provide vaccinations to all of its children. However, there is still a substantial need for more vaccinations in Egypt.

There are nonprofit organizations that are working to improve this situation for Egypt and other countries in need. The Access to Medicine Foundation is motivating the pharmaceutical industry to aid low to middle-income countries such as Egypt. In 2008, the Access to Medicine Foundation published the first Access to Vaccines Index. This index acknowledges the pharmaceutical companies that are responding to the need for vaccination in low-income countries and highlights each company’s progress. There are many positive actions that are improving access to vaccinations in Egypt and other low-income countries. However, the need is still present and crucial.

– Kristen Hibbett
Photo: Flickr

India’s fight against Polio
Polio, or poliomyelitis, is an infectious disease spread through poliovirus. Since the early twentieth century, polio has been widespread in many countries, causing paralysis in thousands of children every year. With the help of various nonprofit organizations and the Global Polio Eradication initiative, the disease is now narrowed down to a handful of nations.

In 2014, India was certified as a polio-free country, leaving Pakistan, Nigeria and Afghanistan on the list for polio eradication programs. India’s fight against polio is a remarkable achievement because of the various challenges the country faced. Nicole Deutsch, the head of polio operations for UNICEF in India, called it a “monumental milestone.”

Polio: Cause and Prevention

Poliovirus is highly contagious, infecting only humans and residing in the throat and intestine of the infected person. It spreads through feces and can contaminate food and water in unsanitary conditions.

The virus affects the brain and spinal cord of the infected person, causing paralysis which cannot be cured. Immunization through inactivated poliovirus vaccine and oral poliovirus vaccine are the only possible methods to fight against the virus. In the case of India, it was the second option which was administered.

India’s Fight Against Polio: the Challenges Faced

India’s fight against polio faced unique challenges, such as its huge population density and an increased birth rate. The number of people living in impoverished conditions with poor sanitation is huge, making them vulnerable to the polio disease.

Lack of education and prejudice among certain sects of the population also hindered the immunization process. Other challenges faced were the unstable healthcare system, which does not support people from all levels of society, and the geographically-dispersed inaccessible terrain, which made the immunization process difficult.

Overcoming these Challenges

Overcoming the challenges of polio eradication was possible due to the combined help provided by UNICEF, WHO, Rotary Club, the Indian government and millions of frontline workers. They took micro-planning strategies to address the challenges faced by the socially, economically, culturally and linguistically diverse country that is India.

India began its oral polio vaccine program in 1978 but it did not gain momentum until 1994, when the local government of New Delhi successfully conducted a mass immunization program for children in the region. From the year 1995, the government of India began organizing National Immunization Day, and in 1997, the first National Polio Surveillance Project was established.

Other initiatives taken include:

  • Involving almost 7,000 trained community mobilizers who went door-to-door, educating people in highly resistant regions.
  • Engaging 2.3 million vaccine administrators who immunized almost 172 million children.
  • The government running advertisements on print media, television and radio.
  • Enlisting famous Bollywood and sports celebrities to create awareness among common people.
  • Involving religious and community leaders in encouraging parents to vaccinate their children.

Inspiration for Other Countries

In 2009, almost 741 polio cases were reported in India, which dropped down to 42 in 2010, until the last case was reported in 2011 in the eastern state of West Bengal. This unprecedented success is an inspiration for countries like Pakistan, Afghanistan and Nigeria, where the disease is still looming at large.

India’s fight against polio has set an example in the world that the country can be proud of, but the fight is not over yet. Although India has been declared polio-free by the WHO, it is of the utmost importance that the nation continue to assist other nations still facing the polio epidemic.

– Mahua Mitra

Photo: Flickr

The Fight Against Measles and Polio in Yemen
After two-and-a-half years of war, Yemen is left in ruins and struggling to overcome health, social and economic problems within the country. Demolished hospitals, crippled bridges, bombed industries, and poor sanitation and nutrition contribute to the devastating situation imparted by the war on the country and its citizens.

A Failing Healthcare System in Yemen

The health status of the population in Yemen is currently described as “catastrophic.” Damage from the war has transformed the nation into a fertile environment for cholera due to the highly contaminated water, which amplified the proliferation of fecal bacterial infections.

Since sewage systems have failed and garbage has piled up to cover entire neighborhoods and regions of the country, more Yemenis rely on polluted water sources for drinking and cooking. Alongside cholera, a quarter of all health facilities in Yemen are no longer operating or have already closed down; this situation escalated rates of morbidity and mortality among citizens, particularly those needing surgery or emergency care such as patients with chronic kidney failure who are dependent on life-saving support.

The shortage of qualified health professionals and physicians created a gap in primary healthcare — especially among children — as lower immunization rates led to a significant rise in the number of polio and measles cases reported.

To create a temporary and effective solution, the World Health Organization (WHO) trained more than 50 mobile medical teams and 20 fixed emergency care teams to provide people with increased access to primary health care services, and to support the operation of 72 health facilities as a way to prevent their closure.

The Fight Against Measles and Polio in Yemen

On August 15, 2017, WHO launched the fight against measles and polio in Yemen through its nationwide vaccination campaign. More than 3.9 million children under 5 years go age were vaccinated against polio and around 860,000 children aged 6 months to 15 years were immunized against measles in high-risk areas.

UNICEF also joined efforts toward the fight against measles and polio in Yemen by collaborating with WHO to ensure effective vaccination interventions for vulnerable populations, such as children and pregnant women. Julien Harneis, UNICEF Representative in Yemen, asserted that UNICEF’s mobile teams and staffs sacrifice their lives and endanger their health during their daily outreach activities within the community due to the hazardous conditions present in the country.

The medical and public health professionals work to overcome all obstacles in preventing additional deaths and morbidities associated with preventable diseases such as polio and measles.

Dr. Gamila Hibatulla, Nutrition and Health Officer for UNICEF in Aden-Yemen, explained that mobile teams rely on public sites, such as mosques, to deliver necessary health services. Vaccination is a central goal to both international agencies of WHO & UNICEF so as to prevent and manage any infectious diseases that could create an additional burden for the government and a crumbling healthcare system. Ms. Hibatulla praised the parents of young children for collaborating with the agency’s work by ensuring that their kids get immunized against serious diseases.

Challenges & Setbacks

Despite the national campaign’s accomplishments in the fight against measles and polio in Yemen, Dr. Ahmed Shadoul, the WHO Representative from Yemen, stated that the positive results generated from the campaign were only “the tip of the iceberg” in terms of the international organization’s response. According to Dr. Shadoul, only a portion of the population was reached by these efforts, as a result of limited funding and failure to reach people residing in war zone areas.

Future plans are being developed to render vaccination and primary prevention efforts more effective, and through continuous coordination, cooperation and collaboration between international agencies and the Yemeni community at large, such a goal can be obtained.

– Lea Sacca

Photo: Flickr

important and impactful vaccinationsVaccines are small doses of a disease or virus that prepare the body’s immune system for any future encounters with that disease. After exposure to the disease through vaccination, the body builds up resistance to that specific disease. The development of these important and impactful vaccinations has led to the eradication or near eradication of several diseases that brought death and disability to thousands.

Polio Vaccine

Polio is a disease caused by the poliovirus that can degrade an individual’s spinal cord and musculature. In extreme cases, polio leads to muscle paralysis and death if the paralysis invades muscles used for breathing. In 1952, Jonas Salk developed the first effective polio vaccine. After the development of the vaccine, mass immunization campaigns took place throughout the United States.

Governments then distributed polio vaccines throughout the world. By 1989, polio was eradicated in the Americas, and as of 2017 only Afghanistan, Pakistan and Nigeria had recorded cases of polio. Overall, the polio vaccination campaign is considered one of the most important and impactful global health campaigns in human history.

Smallpox Vaccine

Smallpox is an infectious disease most commonly known by the distinct progressive skin rash it causes that spreads across the body. The disease also gives individuals a fever and severely weakens the body. Approximately three out of 10 individuals that have smallpox die. Smallpox is believed to have dated back to the Egyptian era and caused many deaths throughout global civilization.

A vaccination for smallpox was formally discovered and published in 1798 by Edward Jenner. Throughout the 19th century, smaller scale vaccination campaigns attempted to eliminate the disease’s prevalence. It was not until 1967 that the World Health Organization coordinated a massive vaccination campaign to eradicate the disease globally. In 1977, the last epidemic of smallpox occurred in Somalia.

In 1980, the World Health Assembly officially declared the world rid of the disease thanks to the distribution of these important and impactful vaccinations. Today, the Centers for Disease Control and the World Health Organization describe smallpox eradication as the biggest achievement in public health history.

Yellow Fever Vaccine

Yellow fever is a mosquito-borne disease that affects countries in equatorial climates. Yellow fever causes serious bleeding of the internal organs and in many cases results in death. The illness derives its name from the jaundice symptoms, or yellow discoloration of the skin, that usually result from infection. In 1937, while conducting research at the Rockefeller Foundation in Ecuador, microbiologist Max Theiler developed an effective vaccination strain.

Later, the global health community distributed the vaccine to the countries most affected by the illness. In 1952, Theiler received a Nobel Prize for his efforts in disease eradication. Today, yellow fever outbreaks are common, but these important and impactful vaccinations continue to save millions of lives.

Furthermore, countries with disease prevalence are taking massive steps to eliminate yellow fever. For instance, as of January 2018, the Nigerian government has set a goal to vaccinate 25 million individuals in hopes of meeting a global effort to end all yellow fever epidemics by 2026.

Vaccinations are one way that foreign aid and global health work hand in hand to genuinely help humanity. While there are more diseases that need to be researched and certainly more vaccinations to distribute, it is important to take stock of historical public health achievements and incorporate their successes into future efforts.

– Daniel Levy

Photo: Wikimedia Commons

the effort to eradicate polio2018 marks the 30-year anniversary of the first international effort to eradicate polio. Polio has been one of the most-feared illnesses throughout history and has recurred in epidemics since the beginning of recorded medicinal history. Over time, the effort to eradicate polio has become exponentially more effective, with a total of only 14 confirmed cases in 2017. But that effort did not begin until 1988, and the vaccine for the virus was created only 30 years earlier in 1954.

Polio epidemics became extremely visible when President Franklin Roosevelt contracted the virus in 1921, while he was still working as the vice president of a bonding company. He created the Warm Springs Foundation, a polio rehabilitation center, in 1927 and spurred further efforts for rehabilitation.

Now iconic and obsolete, the iron lung was the next major rehabilitation tool created in 1929. Because polio causes muscle paralysis, many sufferers of the virus became unable to breathe due to respiratory paralysis. The iron lung provided breathing assistance to those whose illness had progressed far enough to need it.

However, it was not until after Roosevelt died in 1945 that a polio research project was founded. Dr. Jonas Salk was the head of the research project in 1947, which yielded the very first successful polio vaccine six years later in 1953.

After two years of field trials, the vaccine was declared a success. Between 1955 and 1957 alone, the incidence rate of polio dropped by 85 percent. It continued to drop further once Salk’s vaccine was replaced by a more cost-effective and easily-distributed vaccine.

In 1985, the Rotary Fund initiated the PolioPlus program, a movement to immunize all children worldwide against polio. Three years later, in 1988, the WHO, CDC, UNICEF and Pan American Health Organization banded together with the Rotary Fund to launch an international immunization campaign and the official effort to eradicate polio.

When the immunization campaign was launched in 1988, there was an estimated total of 350,000 cases of polio. By 1994, the Americas were declared polio-free, and by the year 2000 the incidence rate of polio was down 99 percent, and the western Pacific was also declared polio-free.

As of 2017, only three countries in the world continue to experience endemic polio infections: Afghanistan, Pakistan and Nigeria. Children under the age of five have the highest risk of contracting the illness because many are too young to receive the full course of vaccinations. According to the WHO, “as long as a single child remains infected with poliovirus, children in all countries are at risk of contracting the disease.” Because these three countries have lower rates of immunization throughout their populations, they are at higher risk of spreading the disease and letting it cross their borders

The Rotary Foundation’s effort to eradicate polio has become 99 percent effective, but the remaining 1 percent poses a risk to the entire world. Through education, mobilization and donation, the effort to eradicate polio becomes stronger every day.

– Anna Sheps

Photo: Flickr

Polio EradicationAround 30 years ago, 350,000 people annually were disabled by polio. Since then, the disease has been reduced globally by 99.9 percent. Only eight new cases were reported this year. Afghanistan, Nigeria and Pakistan are the three remaining countries where polio exists. Nonetheless, governments and non-profits continue to work toward polio eradication, with some experts believing the disease could be eradicated as soon as 2020.

In June 2017, at Rotary International’s annual convention, the Bill & Melinda Gates Foundation and Rotary International jointly announced their pledge of $450 million toward polio eradication. At the same time, world governments and other donors pledged a total of $1.2 billion to the Global Polio Eradication Initiative (GPEI).

GPEI is a collaborative effort among Rotary International, Bill & Melinda Gates Foundation, U.S. Centers for Disease Control and Prevention, the World Health Organization and UNICEF to combat polio.

The good news continued in August of this year when the United Kingdom announced that they would be pledging £100 million to the fight against polio. This funding will provide immunizations to 45 million children per year until 2020.

Though prior to this summer there was a funding gap of $1.5 billion for polio eradication, that shortfall has now been reduced to $170 million due to the contributions of Rotary International, the Bill & Melinda Gates Foundation and the United Kingdom as well as others.

While the focus now is on the three countries where polio still exists, the GPEI and its partner organizations still monitor polio in other at-risk countries.

Although the United Nations declared Somalia polio free, President Farmaajo stated that vaccination campaigns remain crucial. He noted that Somalia is still vulnerable and that polio eradication in Somalia “…was [a] collective effort and commitment by many young men and women who sacrificed their lives.”

The infrastructure built to combat polio in Somalia continues to be used to respond to other outbreaks including measles and cholera. Polio also tends to infect regions marred in conflict. In 2013, there were polio outbreaks in Central Africa, the Horn of Africa and the Middle East. The GPEI managed to end the outbreaks less than a year later.

Nigeria, one of the three countries on the endemic list, was taken off the list at one point after two years with no reported cases. Soon after, four children were paralyzed by polio in northern Nigeria. In response, the GPEI strengthened its polio surveillance operations.

It takes three years with no reported cases of a disease for it to be declared eradicated. Smallpox is the only eradicated disease in history. The United Kingdom International Development Secretary, Priti Patel, stated that, “The world is closer than it has ever been to eradicating polio, but as long as just one case exists in the world, children everywhere are still at risk.”

Due to the contributions of multiple governmental and non-governmental organizations, polio eradication is an achievable goal for the international community.

Sean Newhouse

Photo: Flickr