“We have the power to eradicate polio – we have the vaccine. There’s still a funding gap so it’s a question of money, but it can be done.”
That’s the message from Rotary International, a voluntary non-profit organisation which has donated $1 billion to the global polio eradication effort.
Carl-Wilhelm Stenhammar, who served as chairman of the trustees of Rotary International until last month, said he believes that the scourge of polio can be wiped out but a global alliance of NGOs, international agencies and governments must make the final push to finish the job.
“We have always been confident that it can be achieved, but the final leg of the journey has proven difficult. 99% of the work has been done. It’s like a marathon – the final mile is the hardest,” he said.
Speaking to Vaccines Today from his office in Sweden, Stenhammar said Rotary and its international collaborators are focused on the last four countries where polio remains stubbornly endemic – Nigeria, Afghanistan, Pakistan, and India.
Cause for optimism
The war on polio was at risk of being derailed last year after outbreaks in central Asia cast doubt on the target to eradicate the disease by 2012. Questions still remain about whether that target is realistic but this year has brought cause for optimism.
“We’ve seen tremendous success in India. There has been just one case there so far this year to date. Of course we are discouraged by any outbreaks, like the one in Tajikstan in 2010, but this is why it’s so important to finish our work in the four endemic countries. All outbreaks can be traced to these four countries,” he said.
The Tajikstan outbreak, which spread to several of its neighbours but has now been contained, originated in India. Recent ‘polio reinfections’ in Angola and Chad can be traced by to northern Nigeria. This, according to Rotary International, the WHO, and others, justifies the strategy of pushing for total eradication rather than settling for “containment”.
A ‘challenging but rewarding’ effort
Rotary International first became involved with the drive to eradicate polio in 1988 and its army of volunteers is on the ground working in some of the toughest conditions imaginable.
“It’s very difficult to work in some of these countries because there is no infrastructure and it can be difficult to find the children. But we’re improving all the time. We work hard to get local authorities to support out effort. We have commitment from top leadership in a number of countries and that helps secure local support,” Stenhammar said.
Working with the WHO, UNICEF, and the US Centre for Disease Control, Rotary has helped to spearhead a global alliance against polio. Now with the financial and public relations might of the Bill & Melinda Gates Foundation on board, the foundation is looking to prioritise polio as the 2012 eradication deadline approaches.
“We are prioritising polio because it is a disease that can be eradicated. We have the vaccine and we have the power to do it. We still have a funding gap so it’s a question of money. Polio can be eradicated whereas I would be less sure about eradicating some other diseases. For example, I’m not sure malaria can be done,” Stenhammar said.
He said immunisation campaigns are at the heart of Rotary’s efforts, with trained volunteers administering the vaccine to children in the worst-affected areas. “Vaccination is the main thing we are doing. It’s an oral vaccine which means an amateur like me can do it – even though I’m not a doctor – by administering a couple of drops.”
Stenhammar, himself a retired businessman who spent a lifetime working in the food importing business, said the work is “challenging but very rewarding”. He said investing in eradication could spare tens of millions of people from polio, saving between $40 billion and $50 billion by 2035.
While campaigners have grown wary of predicting the precise date when polio could be formally declared defeated, Rotary is working towards 2012 in the hope of wiping out the disease in two of the four endemic countries this year, and then adding the other two by next year. It would then take three more polio-free years before the WHO could official say that polio has been beaten.
Looking back on two decades of progress, Stenhammar is confident that polio can become the second disease ever (after smallpox) to be eradicated. “When we started this in 1988 there were 350,000 cases in 125 endemic countries. Last year there were 1,300 cases in four endemic countries. Huge progress has been made so we are ready for the last big push.”
Tell us what you think: Can polio be beaten by 2012?
New England Journal of Medicine: The Polio Endgame