The Final Battle Against Polio?

The poliovirus is tantalizingly close to being eradicated, but Pakistani extremists are standing in the way

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Diego Ibarra Sánchez / TIME

A child is vaccinated against polio at Toll Plaza, on the outskirts of Karachi.

There’s no one place a virus goes to die — but that doesn’t make its demise any less a public health victory. Throughout human history, viral diseases have had their way with us, and for just as long, we have hunted them down and done our best to wipe them out. In the developed world, vaccines have made once-common scourges such as measles, rubella, mumps and whooping cough rare to the point of near-extinction. Only once, however, has any virus been flushed from its last redoubts in both the body and the wild and effectively vaccinated out of existence. That virus was smallpox, which ceased to exist outside high-security labs in 1977. Since that day, humanity has been free to put the vaccines against the disease — and the terror its periodic outbreaks would cause — on the shelf forever.

Now we are tantalizingly close to another such epic moment. This time the disease in the medical cross hairs is polio, and there’s no minimizing the progress made against it. Just 25 years ago, polio was endemic to 125 countries and would paralyze or kill up to 350,000 people — the overwhelming majority of them children —  each year. Now the disease has been run to ground in just three countries: Afghanistan, Pakistan and Nigeria, and in 2012, it struck only 215 people worldwide. Thanks to aggressive global vaccination programs led by Rotary International, UNICEF, the World Health Organization, the U.S. Centers for Disease Control, and, most recently, the Bill and Melinda Gates Foundation, the year just beginning could be the disease’s last.

(TIME: Read the magazine story on polio, available to subscribers here)

But polio still has strong-armed friends. On January 1, as the rest of the world celebrated the New Year, gunmen in Pakistan shot and killed seven medical aid workers — six of them women or girls — who had been part of the anti-polio drive. Those killings followed nine others in December, as well as the shooting of a Ghanaian doctor, also conducting polio-vaccination work in Pakistan, in July. The month before that, the Pakistani Taliban blocked the planned vaccination of 161,000 children until U.S. drone strikes in the country were halted.

Polio is a notoriously slippery disease, one that relies on — indeed its very survival depends on — just the kind of holes such sabotage efforts open in the vaccine safety net. In 2003, polio was similarly near its end when clerics in Northern Nigeria halted inoculations — claiming that the vaccine contained HIV and was designed to sterilize children. Within two years, cases of polio linked to the Nigerian strain were raging across 16 countries. And since once case of paralysis can result for every 200 cases of polio infection, that means there may be 199 other carriers silently and unknowingly spreading the virus.

(MORE: At the U.N., a Vow to Eradicate Polio by 2015)

Using children as viral suicide bombers this way is a new — and grotesque — form of bioterrorism, and the world, for now at least, is not standing idly by. After the December killings, Pakistani officials pledged to continue with the country’s plans to deploy 250,ooo health care workers to vaccinate 35 million children this year. The governments of Nigeria and Afghanistan have similarly vowed to see the eradication drive through to its end, as have the U.N. and the other institutions involved in the battle. The Islamic Development Bank has put fresh money behind the  push, donating $227 million to the vaccine program in Pakistan in particular. This is on top of the billions already provided by Rotary and the Gates Foundation alone.

All of that money could turn out to be very very well spent. One billion dollars per year over the next few years could save $50 billion  over the next 20 years in the costs of continuing to chase the disease around the globe and treat the children who are felled by it. And there is no way, of course, of putting a price tag on the suffering of those stricken children — or the importance of sparing other victims the same fate. The war with the poliovirus and its human defenders has been joined — and 2013 could be the year in which the climactic battles are fought.

MORE: How a Ban on Polio Vaccination in Parts of Pakistan Puts the Entire World at Risk

MORE: The War Over Polio

9 comments
RichardBruno
RichardBruno

No, the poliovirus is NOT close to being eradicated. This is like saying that the polio vaccine "cured" polio. Cases of wild polio infection are being reduced, but this was true BEFORE Bill Gates' billions arrived just a few years ago. The article is right: "There’s no one place a virus goes to die." The polioviruses are not the smallpox virus. Polioviruses can live for a decade in soil contaminated with infected feces. 

“Bill Gates’s obsession with polio is distorting priorities in other critical..areas," said Richard Horton, editor of the British medical journal, The Lancet. "Global health does not depend on polio eradication.” (1)

However, FOUR MILLION adults and children die each year from contaminated water, which equates to one dead infant every 20 seconds, according to the United Nations Environment Programme. (2) 



> Estimated deaths among the 218 REPORTED polio cases in 2012: 21

> Actual deaths of polio vaccinators in Pakistan in 2012: 9



Despite a price tag of $9 billion to date, and an additional $1 billion more spent each year, universal polio vaccination -- where war, corruption and religious extremism rule -- and poliovirus eradication are not possible. 

Arthur L. Caplan, director of the University of Pennsylvania’s bioethics center, who himself spent nine months in a hospital with polio as a child, said, “We ought to admit that the best we can achieve is control.” (2) 

Bill Gates will not be crowned "Eradicator of Polio." 

The only rational course? The UN must focus on clean water, eliminating open sewers and adopt the CDC's control strategy that will be applied to the coming US polio outbreak: Isolate those infected and move en masse to vaccinate the community.

What is more, there are 20 MILLION survivors of polio who are experiencing Post-Polio Sequelae (PPS), the unexpected and often disabling symptoms -- overwhelming fatigue, muscle weakness, muscle and joint pain, sleep disorders, heightened sensitivity to anesthesia, cold intolerance, and difficulty swallowing and breathing -- that occur in 75% of paralytic and 40% of non-paralytic polio survivors about 35 years after the poliovirus attack.  Not a penny of Bill Gates money has gone toward helping those millions unlucky enough NOT to have been vaccinated.

Dr. Richard L. Bruno
Chairperson
International Post-Polio Task Force
and
Director
The Post-Polio Institute
and
International Centre for Polio Education

http://www.postpolioinfo.com

1) http://www.nytimes.com/2011/02/01/health/01polio.html?ref=science&_r=0

2) http://www.csmonitor.com/World/Africa/2010/0322/World-Water-Day-Dirty-water-kills-more-people-than-violence-says-UN


ProudAmerican
ProudAmerican

As a 1954 survivor who now deals with PPS, I applaud Time for this article and for bringing awareness to others that there are many survivors in this world who have been forgotten. Polio didn't end when we were released from the hospital, it has followed us all our lives as we dealt with the "aftermath" and the problems we deal with now as the remaining good muscles, overworked for years to do the job of the muscles that atrophied, are wearing out. The pain and exhaustion we deal with is astronomical at times but WE were SURVIVORS then and we ARE Survivors now. God bless all who deal with PPS as you find new ways to gather strength for each day

KurtSipolski
KurtSipolski

As a survivor and an author I applaud Time for helping put one more nail in the polio coffin!  This has been a long, hard 60-year struggle and every fighter should break his/her arm patting him/herself on the back.

AriColatti
AriColatti

When talking about the end of Polio should also write about Post Polio Syndrome which affects about 60% or more of polio survivors. It is a degenerative disease recognized by OMS  and  CID  G 14 in 2010. Billions are spent on polio eradication but nothing was destined to survivors and the media is silent. We are but 20 million survivors of polio and the press pretends we do not exist. But we're still here!

ricotin10
ricotin10

Yes, get the vaccine out there, and into children cute or not.  And who exactly are the Taliban?

Itinerant
Itinerant

This isn't "Islamist" any more than abortion clinic bombings are "Christian." A specific group of sub-human scumbags is subjugating the poorest, most vulnerable part of a population incapable of mustering a defense. Islam is not to blame. The Taliban is to blame.

I'd wish polio on them, but I'd rather see it (and malaria) extinguished.

AlexFeltham
AlexFeltham like.author.displayName 1 Like

The Islamists perverse objection to eliminating Polio brings to mind a similarly perverse environmentalist objection to DDT which prevented the extinction of malaria or at the very least caused millions of needless deaths.

More on this theme in: "Modern Heroes: Rachel Carson" at:

http://john-moloney.blogspot.com/


CharlesJones265
CharlesJones265 like.author.displayName 1 Like

@AlexFeltham There is a  very big difference between a human vaccine which saves lives and a potent environmental chemical with research-proven harmful effects on a wide range of organisms.