Thirty years ago, the world joined a bold promise: a future free of polio. For decades, organizations from all over…
Thirty years ago, the world joined a bold promise: a future free of polio.
For decades, organizations from all over the world have worked with committed governments and healthcare professionals to succeed with that promise. In addition to the development of improved access to clean water, vaccination efforts such as those led by the Global Polio Eradication initiative resulted in an incredible reduction of wild poliovirus cases: from 1000 to day 1988, to 22 in 2017. If we finish work, polio becomes just the other human disease, after smallpox, dried from the face of the earth.
But the path to extinction has been longer and more difficult than expected. While last year saw a record number of wild polio cases, we have failed to completely stop the disease. A child who has suffered is too many, and so far this year there have been 20 children paralyzed by wild poliovirus.
There have also been outbreaks of vaccine-leading polio, which occur rarely when the weakened virus in the oral vaccine mutates to virulence and can easily spread in large unvaccinated populations. These outbreaks have occurred in high-risk countries like the Democratic Republic of Congo, Papua New Guinea, Somalia and Niger, indicating that we fail to reach enough children.
Regardless of the setting or virus strain, these challenges share a common cause: obstacles to reaching every child. In Afghanistan, for example, nomadic populations, cross-border movement, insecurity and difficult terrain mean that many vulnerable communities remain inaccessible to polio vaccines.
Even though we have access, the impact has been profound. In Pakistan and Nigeria ̵
1; which together with Afghanistan make up the world’s three last polioendemic countries, from 125 countries in 1988 – we are increasing more children and the number of polio cases decreases, indicating what is possible when we get new ground.
For the affected children and families, contractual accidents are a tragedy. For us, each new case is also a lesson – pointing out where we need to intensify our efforts and remind us how fast polio can jump back if we are not alert.
For every paralyzed child, there are approximately 200 others who carry the virus without any symptoms. That’s why, although the world only sees a handful of cases, we must reach millions of children each year to prevent a massive revival of polio. If these vaccination efforts ceased, the consequences would be catastrophic. Within 10 years, polio can be back on every family’s door and lame as many as 200,000 children each year.
We understand that it is no easy task to deliver vaccines. Polio has taken refuge in some of the most complex and dynamic environments in the world. But over time, we have learned how we deliver healthcare services to extreme adversity, even in areas with almost no infrastructure.
We showed this in 2016 when the virus resumed in Nigeria after two years without a fall. A critical front in the answer was Lake Chad, a massive water source bordering Nigeria, Chad, Cameroon and Niger. Health workers carefully surveyed the many islands that dotted the lake and traveled for hours by canoe and reached hundreds of settlements for the first time. Solar-powered refrigerators that they brought along kept the vaccines cool.
Today there are still parts of Nigeria where we can not reach children or properly track the virus due to a combination of insufficient infrastructure, population movements and uncertainty. But while we are careful, we have not yet seen another fall of wild polio since the outbreak in 2016.
Our partnership has also demonstrated its ability to function strategically despite uncertainty. Last year in Syria, the conflict led to blockades that prevented health professionals from reaching cities, and we responded quickly and efficiently to an outbreak of vaccine-derived polio. We vaccinated refugee children in transit centers and camps and we collaborated with local authorities to quickly administer vaccines under safety routines – strategies we have used in conflict zones worldwide. As a result, Syria has seen one year without another child paralyzed.
We have also worked globally to strengthen local health systems and respond to society needs in addition to polio vaccination. In Karachi, for example, Rotary International works with local partners to install water filtration systems in risky communities. Similar projects – including bed linen, dietary supplements and measles, meningitis and tetanus vaccines – continue every day, anywhere we fight for polio. And this infrastructure will not disappear with the latest poliovirus but can be restored to combat other diseases and accelerate progress towards ambitious global goals such as universal health coverage long after polio was eradicated.
These examples illustrate the accuracy of this coalition, which – thanks to committed vaccinators, donors and advocates around the world – has come so far since promising 1988 to liberate the polar world. We are so close to keeping that promise. We have seen how easy the virus can push back. but we are more committed than ever before.
There will be a lifestream for Rotary’s 2018 World Polio Day Event on October 24th at endpolio.org.