In February of 2012, a team of 27 journeyed to Uttar Pradesh, India in a large-scale effort to eradicate Polio in the area. The team described the scene in the village; open sewers on roadways, jammed roads of vehicles and livestock, and smoke wafting from tent camps where migrant labourers’ graves have been dug.
The team’s immediate mission was to deliver vaccines to those under 5. The long-term goal is to eradicate polio globally – and the goal isn’t far off: there were 350,000 new cases in 1988, and only 650 new cases in 2011.
2012, however, saw a change in fortunes for those fighting the disease: funding for anti-polio efforts dropped and the political drive to get vaccines to polio-stricken regions also fell. “We’re at a tipping point,” says Carol Pandak, the program manager PolioPlus vaccination program. Thanks to the progress made throughout 2012, global eradication is in reach, by Pandak warns of the obstacles yet to be overcome.
Polio is an extremely dangerous virus. Usually spread through feces, the virus often enters through the mouth. There, it attacks the brain stem, spinal cord and can wreck havoc, paralyzing the arms, the legs and ultimately the muscles needed to speak, swallow and breath. Since the anti-polio effort began in the late 1980’s, the number of countries where polio is considered an epidemic has fallen from over 125 to just 3: Nigeria, Pakistan, and Afghanistan.
The Global Polio Eradication Initiative has set a target to get that number to zero by the end of 2013.
The initiative is funded through a group of foundations including Rotary International, the Bill & Melinda Gates Foundation, the World Health Organization (WHO), Unicef, and the U.S. Center for Disease Control and Prevention, as well as many national governments. To date, health-care providers has been able to immunize 2.5 billion children, at a cost of more than $8 billion, since 1988. The World Health Organization has estimated that, as a result, over 10 million children have been spared the effects of the virus. In India, where polio was once considered to have a permanent foothold, there have been no new cases since January 2011.
Between January and October of 2012, Afghanistan had 27 cases compared with 47 during the same period of 2011, while Pakistan had 48 compared with 136. Nigeria, on the other hand, saw a uptick, from 42 to 101.
“Until it’s completely eradicated, it can flare up again,” says John Sever, vice chairman of Rotary International’s PolioPlus Committee and an infectious-disease specialist. “If this spreads into populations that are not well immunized, it could cross borders and reinfect areas that are currently polio-free.”
Most of the obstacles still standing in the way of global eradication are abstract: political willpower, reductions in funding, conflicts preventing boots on the group, and unfounded concern over the vaccine. Nigeria’s head sultan has been one of the vaccine’s strongest supporters, however rumours have continued to circulated that the polio vaccine is a western plot to sterilize the population. The social resistance to the vaccine was so strong that in 2003, the eradication campaign was halted all year, leading to re-infection in 20 other African countries. Pakistan’s Ministry of Health runs the anti-polio program, but in Waziristan region, a area bordering Afghanistan, rumours have spread that the CIA is using the vaccine drive to gather information for strikes in the region. This rumour persisted in part due to revelations that a doctor who helped US Special Forces find Osama bin Laden has learned his intelligence by setting up a fake vaccination clinic. In June of 2012, the Taliban government pressured it’s own citizens to stop vaccinating their children, ending the program that could have immunized over 200,000 children.
The Global Polio Eradication Initiative has also been faced with diminishing funding for it’s program, heightening the issue. The projected budget for the 2012/2013 was set at $2 billion, but fell short by $700 million, mostly due to the recession and weakened global economy. With countries and governments focusing on their own domestic issues, richer nations that have long been polio-free may that freedom for granted. The immediate lack of funds for the program has already put anti-polio efforts in jeopardy: in August, an article in The Lancet warned that 68 polio campaigns in some 33 countries have already been cancelled.
“We need to finish the job,” Pandak says. “If reduced funding continues, children will be susceptible and the virus will return and spread. We’ll be right back where we started.”