Eradicating Polio

Microsoft founder Bill Gates made this announcement last week:

As of today, India has gone three years without a single case of wild poliovirus, which means it’s now officially “polio-free.” India’s achievement is one of the most impressive accomplishments in global health, ever.

Gates says many thought achieving a polio-free India was not possible:

Five years ago, India was home to nearly half of the world’s new polio cases. At the time, if you asked any health expert, they would have said India would be the last place on earth to end polio. India’s population density and high birth rate (27 million new children are born each year), combined with poor sanitation, was like a petri dish for polio.

But the government of India, with help from the organizations that make up the Global Polio Eradication Initiative including Rotary International launched an all-out effort to stop the disease. The country deployed 2 million vaccinators to reach children who had never before been reached with polio vaccines or any other health services—children who live in flooded regions or hard-to-find rural towns, or are regularly in-transit with their families. One of the most powerful images I’ve seen during my visits to India is that of parents proudly holding vaccination cards showing that their children were protected from deadly diseases for the first time.

The Wall Street Journal reports that Indian health officials understand their population is still at risk of imported cases of polio:

By 2009, there were only 741 polio cases in India, and the figure dropped to 42 the following year. The last case—a girl called Rukhsar Khatoon who was paralyzed by polio—was reported Jan. 13, 2011. There is still the danger that a new polio case may get imported from neighboring Pakistan or Afghanistan; India plans to keep vaccinating children to ensure no new cases crop up.

The goal of global eradication of polio now has some momentum:

The Gates Foundation has contributed $1.2 billion toward polio eradication since 2009, and has committed a further $1.8 billion through 2018. In all, some $4 billion has been pledged by various groups to eradicate the disease.

The effort is led by the Global Polio Eradication Initiative, which includes various governments, the WHO, Rotary International, the U.S. Centers for Disease Control and Prevention and Unicef. The initiative estimates that polio eradication could deliver total net benefits of up to $50 billion by 2035 from reduced treatment costs and gains in productivity.

But stamping out an ancient and debilitating disease promises much more. “The benefits of eradication accrue for eternity,” said Dr. Jafari of WHO.

Joshua Keating explains why we should keep the champagne on hold:

Globally, there’s a strong link between polio and political instability. The disease has recently made a comeback in both the Horn of Africa and Syria, where years of brutal fighting have broken down national vaccination campaigns.

There’s also a striking contrast between India, where 170 million children are immunized annually as part of a nationwide campaign involving hundreds of thousands of volunteers begun in the 1990s, and neighboring Pakistan, where a similarly aggressive campaign has been hampered by extremist attacks on volunteers.

At least a dozen government vaccinators, whose efforts are portrayed by the Taliban as a Western conspiracy, have been killed or wounded in northwest Pakistan, in the past three months. Eighty-three new cases of the disease were reported in the country last year, making it one of only three in the world—along with Afghanistan and Nigeria—where polio remains endemic.