On the Brink of Eradication: The Polio Epidemic

Polio is a highly infectious and crippling disease that primarily infects children. The poliovirus attacks the brain and spinal cord, causing paralysis within hours. Perhaps the most devastating nature of the disease is that it is completely preventable, yet twenty-five years after the polio vaccine was assembled, only seventy-five percent of the world has access to it.

"RI President Ron Burton sounded the call to the audience and global viewers on line to help make history by eradicating polio." Courtesy of rotary.org. Photo Credit: © Rotary International/Tim Walters

“RI President Ron Burton sounded the call to the audience and global viewers on line to help make history by eradicating polio.” Courtesy of rotary.org. Photo Credit: © Rotary International/Tim Walters

In 1988, when a startling 350,000 cases of polio were reported worldwide, the World Health Assembly, along with UNICEF, U.S Centers for Disease Control and Prevention, and Rotary, resolved to eradicate the poliovirus and launched the Global Polio Eradication Initiative. Although the global eradication plan has reduced the number of cases of polio from hundreds of thousands to just hundreds, the final reservoirs of resistance in Nigeria, Afghanistan, and Pakistan, where the virus is still endemic, have provided the greatest hardships for public health authorities.

On the evening of October 24, Rotary, in collaboration with Northwestern University’s Center for Global Health, held a special program entitled “World Polio Day: Making History” to highlight the advancements in the global effort to end polio, to stress remaining challenges, and to emphasize the importance of securing a polio-free world.

Rotary International, also known as Rotary Club, is a global network of volunteer leaders combating the world’s most pressing humanitarian challenges. Rotary’s 1.2 million members are a group of business and professional leaders from over two hundred countries whose mission is to create positive, lasting change in local and global communities. The event was streamed live to a global audience and about two-hundred invited guests attended.

Dr. Robert Murphy, director of Center for Global Health – Institute for Public Health and Medicine at Northwestern University Feinberg School of Medicine, spoke about the implications of polio eradication on the global health platform. Dr. Murphy noted that polio eradication will “rank amongst the greatest global health accomplishments in history,” however; the last 1% of cases will be the hardest to prevent. Dr. Murphy also commented that polio eradication will demonstrate that even regions teeming with slums and unceasing conflict can be navigated and reached with vaccines and essential healthcare services.

Dr. Bruce Aylward, assistant Director-General for Polio, Emergencies and Country Collaboration, noted that unlike other devastating, painful diseases, polio is different because it is completely curable with two drops of the polio vaccine. The fate of many lives depends on the accessibility of a mere two drops.

India, which was declared polio-free in February 2012, was considered one of the most difficult countries to end polio due to its poor sanitation, high population density, and migrant communities. Dr. Alyward noted that some global health specialists increasingly and boldly claimed that it was impossible to eradicate polio in India for aforementioned reasons. However, India’s success serves as an example of how robust tactics could be successful in even the most aggressive reservoirs of polio. India used a combination of innovative, micro-scaled techniques, including dispatching small teams of polio workers, marking children’s fingers with enduring ink to assist in locating missed children in larger public venues, and chalking houses to indicate unvaccinated children. In addition, when parents declined vaccines for their children, a second team of polio workers and highly respected local villagers were dispatched to convince the parents that the vaccine would protect their children. Since the poliovirus lurked and moved with the mobile Indian population, India turned to public transportation sites and assigned volunteers to halt busses and trains to distribute vaccines to unprotected children. Over the course of several days, many volunteers vaccinated 170 million children in India.

"Dennis Ogbe, polio survivor, Paralympian, and ambassador for the United Nations Foundation’s Shot@Life campaign, urged everyone to help remove the threat of polio to children’s lives."Photo Credit: © Rotary International/Tim Walters

“Dennis Ogbe, polio survivor, Paralympian, and ambassador for the United Nations Foundation’s Shot@Life campaign, urged everyone to help remove the threat of polio to children’s lives.”
Photo Credit: © Rotary International/Tim Walters

Recently, ending polio was declared an emergency for global health. The final reservoirs of polio are Nigeria, Afghanistan, and Pakistan. In these countries, polio persists at the margins of society where critical health services are lacking or even nonexistent. As a result, the greatest challenge for workers has been to vaccinate enough children to drive immunity levels above a threshold percentage, whereby herd immunity is achieved. Healthcare officials have trouble accessing the geographically isolated and terrorist-controlled areas that are native to Pakistan and Afghanistan. Making frequent trips to these remote, mountainous communities is labor-intensive, dangerous, and requires proper maintenance of vaccines during long trips. In order to face the challenges, police officers have been stationed to allow health care officials to safely access children in need of vaccines. In addition, the leaders of the Muslim world have come together to form the Islamic Advisory Group (IAG). In light of recent rumors that the vaccines were a part of an American plot to sterilize children, the IAG exists to educate Muslim parents about the importance of having their children vaccinated.

Allegiances have been built; strategies have been established. Type 2 polio has been eradicated and as of November 2013, type 3 may be vanquished forever. If this is the case, targeted vaccines can be developed to fight the final remaining Type 1 strain. As of today, we have the tools, we have the tactics, and we even have the political backup to complete eradication in the final three endemic countries. Type 1 polio continues to challenge our stamina to eradicate polio, however, hundreds of lives are dependent on two drops of this vaccine, and together, we can distribute them successfully. With record low cases of polio and the world health community behind this newly released, methodical, data-driven, and adequately funded campaign, polio, the disease that has crippled millions, stands on the brink of being eradicated forever. If successful, a new generation of children will be saved from the clutches of the fatal and debilitating poliovirus.

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