Spring 2003 Issue
The Challenges of Eradicating Polio
How You Can Become a Polio Campaign Partner
Eradicating a disease in an imperfect world requires flexibility to accommodate ever-changing circumstances and an inordinate level of commitment to overcome many barriers. The organizers and volunteers of the polio eradication campaign have demonstrated these qualities time and time again as they work towards their goal. The CDC Foundation administers two funds dedicated to assist them in their efforts.
The Endowment for Global Health Priorities provides flexible funding targeted to a global health initiative or program outside of the United States. The first five years of the Endowment is dedicated to the polio eradication effort. The Endowment has paid for much needed services and equipment, such as bullet-proof vests for workers in high-risk areas and satellite images of remote areas to identify locations of herders and other populations that have been previously unreachable.
The Polio Eradication Heroes Fund recognizes health workers and volunteers who have incurred serious injury or lost their lives as a direct consequence of their participation in polio eradication activities. The families of the workers, who have been the victims of automobile crashes, military conflicts and other life-threatening events, receive a certificate recognizing the victim’s heroic commitment to polio eradication, and a cash tribute. So far, 30 victims have been recognized through this fund.
You can partner with the CDC Foundation to help support the efforts of the polio eradication campaign workers. Note on the form which fund you would like to support. For more information about these funds, please contact Linda Kane at 404-653-0790.
For people who live in industrialized countries, polio is a disease of the past – bringing to mind images of children fitted with leg braces or immobilized within iron lung machines. But even today, as global teams of volunteers work tirelessly to eradicate polio, it remains a real threat in a few countries in Asia and Africa.
“The polio eradication campaign has been enormously successful in mobilizing and uniting governments and individuals around the world for this common purpose,” says Robert Keegan, deputy director of the Global Immunization Division in CDC’s National Immunization Program. “Today, three regions including the Americas, Europe and the Western Pacific – 134 countries and 3 billion people – are certified polio-free. Because polio can spread quickly, the challenge is making sure these areas remain free of polio outbreaks until the last stubborn pockets can be dealt with.”
Polio is a highly infectious disease caused by a virus that can invade the nervous system and cause paralysis or death. Throughout history, polio has paralyzed millions of people – most of them young children. Less than one percent of polio infections ever result in paralysis, but for those who become paralyzed, there is no cure.
Motivated by the successes of several countries in eliminating polio from their borders through wide-reaching immunization efforts, in 1988 the World Health Assembly adopted a resolution calling for the global eradication of the disease by the year 2000. Although a variety of political and logistical obstacles have pushed the target back to 2005, the results of the campaign so far have been dramatic. Since the resolution, the number of cases of polio worldwide has decreased by 99 percent – from an estimated 350,000 cases in 1988 to about 2000 cases in 2002. In the same time period, the number of polio-infected countries has decreased from 125 to 7.
Polio eradication campaign organizers and volunteers have achieved this success using four core strategies:
- routine infant immunization specially designated National Immunization Days
- surveillance for acute paralysis to identify the cases caused specifically by polio
- door-to-door vaccination campaigns in high-risk areas
The effectiveness of these strategies, particularly the National Immunization Days, was most evident in 1993, when China immunized 82 million children on a single day. Soon after, transmission of polio in China was ended. In addition, over 250 million children were immunized in 1996 in a coordinated campaign in Bangladesh, Bhutan, China, India, Myanmar, Nepal, Pakistan, Thailand, and Viet Nam. In 2002, approximately 575 million children received polio vaccinations.
The Challenges of Immunization
The goal of globally immunizing all children under the age of five is an ambitious one, experts acknowledge. The challenges of reaching children in remote and rugged areas, often beset with political instability and civil war, and the difficulties of maintaining the polio vaccine at cold temperatures, have complicated immunization efforts in many areas.
Additionally, organizers and volunteers have had to negotiate numerous cease-fires in order to conduct National Immunization Days in war-torn areas. “Cease fires for the purpose of immunization are the hallmark of the polio eradication campaign,” says Keegan. “There have been more than 100 cease fires for the purpose of immunization in countries such as Democratic Republic of Congo, Sudan, Somalia and many others.”
Today, polio remains in seven countries including India, Pakistan, Afghanistan, Egypt, Niger, Nigeria, and Somalia. India, Pakistan and Nigeria accounted for 99 percent of the new polio cases in 2002. The poorest children, usually members of minority groups, are more likely to get polio than other groups. Political, financial and operational barriers present a formidable challenge to reaching these children.
Building a Legacy
Spearheaded by the World Health Organization, UNICEF, Rotary International, and the Centers for Disease Control and Prevention (CDC), the polio eradication campaign has brought together many governments and individuals for a common purpose.
A critical ingredient for any eradication effort, this spirit of cooperation among CDC and other partner agencies has helped to overcome a variety of obstacles. The partnership has worked effectively to ensure that parents and vaccinators can reach common ground to protect children, despite religious, cultural and political differences. The polio eradication campaign has also helped create enthusiasm for a strong culture of immunization to protect children around the world, paving the way for future public health initiatives and the delivery of additional health services.
Looking forward, public health officials hope the methodologies, systems and strategies, and networks of volunteers for polio eradication will be leveraged for the delivery of future global health services. While the humanitarian benefits of the global polio eradication campaign will be immeasurable, it has created a lasting legacy of improved health infrastructure – especially in developing countries where it is needed most.
- Karen McDonald