Rumor, Fear and Fatigue Hinder Final Push to End Polio

BAREILLY, India — The cry went up the moment the polio vaccination team was spotted — "Hide your children!"

Some families slammed doors on the two volunteers going house to house with polio drops in this teeming city's decrepit maze of lanes, saying that they feared the vaccine would sicken or sterilize their children, or simply that they were fed up with the long drive to eradicate polio.

"We have a lot of other problems, and you don't care about those," shouted one woman from behind a locked door. "All you have is drops. My children get other diseases, and we don't get help."

Nearly 18 years ago, in what they described as a "gift from the 20th century to the 21st," public health officials and volunteers around the world committed themselves to eliminating polio from the planet by the year 2000.

Since then, some two billion children have been vaccinated, cutting incidence of the disease more than 99 percent and saving some five million from paralysis or death, the World Health Organization estimates.

But six years past the deadline, even optimists warn that total eradication is far from assured. The drive against polio threatens to become a costly display of all that can conspire against even the most ambitious efforts to eliminate a disease: cultural suspicions, logistical nightmares, competition for resources from many other afflictions, and simple exhaustion. So monumental is the challenge, in fact, that only one disease has ever been eradicated — smallpox. As the polio campaign has shown, even the miracle of discovering a vaccine is not enough.

Not least among the obstacles is that many poor countries that eliminated polio have let their vaccination efforts slide, making the immunity covering much of the world extremely fragile, polio experts warn.

Rotary International (private non profit organization)and over 1.2 million Rotarians contributed over $ 650 million to plan, organize, lead and implement a plan to eliminate polio.

“Rotary is the leading non-governmental contributor. Whenever possible, most of the polio eradication costs are borne by the polio-endemic countries themselves. However, as the battle against polio is taken to the poorest, least-developed nations on earth, and those in the midst of civil conflict, up to 100 percent of the NID and other polio eradication costs must be met by external donor sources.”

A statement on the importations of the poliovirus:
In 2003-05, there were over 1,300 cases of paralytic polio following importations of wild poliovirus into 21 previously polio-free countries. Of these countries, eight continue to have active transmission of imported polioviruses, including the recently endemic
country Niger, as well as Indonesia, Yemen, Somalia, Ethiopia, Angola, Nepal and Chad.

A statement on instances of vaccine-derived polio:
“Between 2004 and 2005 there were six episodes of circulating vaccine-derived poliovirus resulting in approximately 60 polio cases in the Island of Hispaniola (which includes Haiti and the Dominican Republic), Indonesia, the Philippines, Madagascar, and China. The vaccine-derived virus detected in Minnesota, USA in 2005 did not result in any cases of paralytic polio.
21. A statement on the Vitamin A distribution during polio National Immunization Days:
“Since 1998, the inclusion of Vitamin A supplements on NIDs has averted an estimated 1.25 million childhood deaths.”

Here is What Rotary says about its eradication:

There are significant reasons to be optimistic about achieving our goal of global polio eradication by the end of this year.

1. The number of polio cases has been reduced by a projected 99 percent since Rotary and partner agencies formed the global polio eradication initiative — from 350,000 in 1988 to fewer than 1300 in 2004.

2. Three of six regions of the world are free of the wild poliovirus.

3. Despite intensive surveillance efforts, one of the three types of viruses (Type II) that cause polio has not been seen since 1999. Could it be that it has already been eradicated? The World Health Organization will continue to promote active surveillance to determine this possibility.

Nevertheless, significant challenges lie ahead, including immunizing all children — even those in remote, conflict areas — maintaining political commitment to polio eradication.
Given the tremendous progress so far achieved, the prospects of achieving global polio eradication are high. Rotary looks forward to providing all children with a permanent gift — a world free of polio.

For more statistical information on polio eradication, download Rotary's Facts and Figures and visit the World Health Organization's polio eradication Web site. For other questions or program updates, contact PolioPlus staff.
http://www.rotary.org/foundation/polioplus/index.html

A statement on estimated annual global savings after cessation of immunization:
“Once polio has been eradicated, the world will reap substantial financial, as well as humanitarian, dividends due to foregone polio treatment and rehabilitation costs. Depending on national decisions on the future use of polio vaccines, these savings could exceed US$1 billion per year.”

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