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Thirty years ago, the world was united under the sign of a bold promise: a future without polio.
For decades, organizations around the world have worked alongside dedicated governments and health workers to make this promise a reality. In addition to progress such as improved access to safe drinking water, vaccination efforts such as those carried out by the Global Polio Eradication Initiative have resulted in a an incredible drop in the number of cases of wild poliovirus: from 1,000 per day in 1988 to 22 in 2017. If we finish the job, polio will be only the second human disease, after smallpox, to disappear from the surface of the earth .
But the road to eradication has been longer and more difficult than expected. While last year we had a record number of wild polio cases, we were unable to completely stop the disease. An affected child is too numerous and so far this year, 20 children have been paralyzed by wild poliovirus.
At the same time, there have been outbreaks of vaccine-origin poliomyelitis, which occurs in rare cases when the weakened virus contained in the oral vaccine becomes virulence and can spread easily in large unvaccinated populations. . These outbreaks have occurred in high-risk countries such as the Democratic Republic of Congo, Papua New Guinea, Somalia and Niger and indicate that we are failing to reach enough children.
Regardless of the context or viral strain, these challenges have a common cause: barriers to the ability to reach every child. In Afghanistan, for example, nomadic populations, cross-border movements, insecurity and difficult terrain mean that many vulnerable communities remain inaccessible to polio vaccinators.
Even though we have access to it, the impact has been profound. In Pakistan and Nigeria – which together with Afghanistan are the last three countries in the world where polio is endemic, compared to 125 in 1988 – we regularly reach more children and the number of cases of poliomyelitis is decreasing. shows what is possible when gaining ground.
For affected children and families, contracting polio is a tragedy. For us, each new case is also a lesson: to indicate the areas in which we must intensify our efforts and to remind ourselves how quickly polio can appear if we are not vigilant.
It is estimated that 200 paralyzed children carry the virus without any symptoms. That's why, even as the world observes only a few cases, we must reach millions of children every year to prevent a mbadive resurgence of polio. If these vaccination efforts ceased, the consequences would be catastrophic. In 10 years, polio could return to all families and paralyze nearly 200,000 children each year.
We understand that delivering vaccines is not a simple task. Polio has taken refuge in some of the most complex and dynamic environments in the world. But over time, we have learned to provide health services under extremely difficult conditions, even in areas without infrastructure.
We proved it in 2016, when the virus resurfaced in Nigeria after two years without any case. Lake Chad, a huge body of water bordering Nigeria, Chad, Cameroon and Niger, has been a critical front in the response. Health workers carefully mapped the many islands around the lake and hiked canoe hours to reach hundreds of settlement areas for the first time. The solar-powered refrigerators they brought kept the vaccines cool.
Today, there are still parts of Nigeria where we can not touch children or monitor the virus properly, due to insufficient infrastructure, population movements and insecurity. However, even though we remain cautious, we have not seen any cases of wild polio since the 2016 outbreak.
Our partnership has also demonstrated its ability to operate strategically despite insecurity. Last year, in Syria, after the conflicts resulted in blockades preventing health workers from visiting the cities, we responded quickly and effectively to an outbreak of polio caused by vaccines. We vaccinated children who were fleeing to transit centers and camps, and we partnered with local authorities to quickly administer vaccines when implementing safety strategies in conflict areas around the world. As a result, Syria has had a year without another child being paralyzed.
We have also worked at the global level to strengthen local health systems and respond to community needs beyond polio immunization. In Karachi, for example, Rotary International is working with local partners to install water filtration systems in at-risk communities. Similar projects – including the distribution of mosquito nets, nutritional supplements and vaccines against measles, meningitis and tetanus – are taking place every day, wherever we fight polio. And this infrastructure will not disappear with the latest poliovirus, but can be reallocated to fight other diseases and accelerate the achievement of ambitious global goals, such as universal health coverage, long after eradication polio.
These examples illustrate the tenacity of this coalition which, thanks to dedicated vaccinators, donors and advocates around the world, has come here since it promised in 1988 to rid the world of polio. We are so close to keeping that promise. We have seen how easily the virus can repel. but we are more engaged than ever.
The 2018 Rotary World Polio Day will be held on October 24th on endpolio.org.
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