Editor’s note: This commentary is by Martin Cohn, a past president of Brattleboro Rotary Club who, along with Brattleboro Sunrise Rotarian Kevin Yager, hosts an award-winning monthly show on Brattleboro Community Television, “Rotary Cares.”
[R]ecently, there have been reports of a “polio-like” illness, acute flaccid myelitis, leaving children in numerous states paralyzed. The rare disease causes an “inflammation of spinal cord” that resembles cases of polio from the 20th century.
Polio-like? Polio has been eradicated in the United States and is almost eradicated worldwide. Should we be concerned?
As long as indigenous wild poliovirus transmission continues anywhere in the world, the risk of international spread of poliovirus remains. Particularly vulnerable are high-risk countries, i.e., those bordering endemic areas, those with close socio-cultural-economic ties to endemic areas and those with low routine immunization levels. In 2013 and 2014, new outbreaks occurred in Cameroon, the Horn of Africa (centered on Somalia), and the Middle East (with cases confirmed in Syria). While aggressive outbreak response activities rapidly stopped these outbreaks, they underscore the danger ongoing transmission continues to pose to polio-free countries everywhere.
Wild poliovirus transmission is at the lowest levels ever, with fewer cases reported from fewer areas of fewer countries than ever before. In 2017, 22 cases of wild poliovirus were reported from Nigeria, Pakistan and Afghanistan compared to 74 cases in 2015. Nigeria had not reported a case of wild poliovirus since July 2014 and was subsequently removed from the list of endemic countries in September 2015. However, in August 2016, four new cases were confirmed in Borno state in the northeast. Confirmation of these cases underscores the risk continued low-level undetected transmission poses to children and countries everywhere.
Vermont Rotary members are among millions reaching out on World Polio Day, Oct. 24, to raise awareness, funds and support to end polio – a vaccine preventable disease that still threatens children in parts of the world today.
Since Rotary and its partners launched the Global Polio Eradication Initiative 30 years ago, the incidence of polio has plummeted by more than 99.9 percent, from about 350,000 cases a year to just 22 cases in 2017. To sustain this progress, and protect all children from polio, Rotary has committed to raising $50 million per year in support of global polio eradication efforts. The Bill & Melinda Gates Foundation will match Rotary’s commitment two to one. Without full funding and political commitment, this paralyzing disease could return to previously polio-free countries, putting children everywhere at risk.
The goal of the Rotary PolioPlus program is the global certification of polio eradication. By eradication, the World Health Organization (WHO), the Global Commission on Certification and Rotary mean the interruption of the transmission of all polioviruses.
By the time the world is certified polio-free, Rotary’s contributions to the global polio eradication effort will exceed $2.2 billion, including $985 million in matching funds from the Bill & Melinda Gates Foundation. An independent commission will consider global certification when no wild poliovirus has been detected for at least three years, in the presence of certification-standard surveillance, and all poliovirus stocks have been appropriately contained. There are three types of wild poliovirus. Type 2 wild poliovirus last occurred in October 1999 and was certified eradicated in September 2015. Type 3 wild poliovirus has not been found since November 2012, suggesting that only Type 1 wild poliovirus continues to circulate.
Rotary’s contribution to the Global Polio Eradication Initiative since 1988 accounts for nearly 14 percent of all contributions through June 2017 and represents approximately 42 percent of private sector contributions. Rotary is the leading non-governmental voluntary organization contributor to the GPEI. Rotary has mobilized a legion of volunteers who are providing support during vaccination campaigns, mobilizing their communities for polio eradication activities, raising funds and awareness for polio eradication, and advocating for the cause with government officials. More than one million Rotarians worldwide have contributed toward the success of the polio eradication effort.
To date, 122 countries around the world have benefited from PolioPlus grants. From the launch of the Global Polio Eradication Initiative in 1988, more than 17.4 million people, mainly in the developing world, who would otherwise have been paralyzed, are walking because they have been immunized against polio. More than 650,000 paralytic cases of polio are now prevented every year.
If polio is not eradicated, within 10 years, as many as 200,000 children could be paralyzed by it each year. A polio-free world will be a safer world for children everywhere. Since 1988, more than 2.5 billion children have received oral polio vaccine. In 2017, more than 430 million children were vaccinated in 39 countries using almost two billion doses of oral polio vaccine.
It costs an average of $3 to fully protect a child against polio, including the cost of the vaccine and activities required to deliver the vaccine such as transportation costs, vaccinator stipends, vaccine carriers, chalk to mark houses after each visit, and dye to paint children’s fingers purple to indicate they have been vaccinated. A child must receive multiple doses of polio vaccine to be fully protected and therefore must be reached multiple times.
So far vaccines, saving approximately 5 million lives annually, have eradicated only one disease, smallpox. Polio could be next.
Visit endpolio.org for more about Rotary and its efforts to eradicate polio.
