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Thirty years ago, the world united under a bold promise: a future free from polio.
In the decades since, organizations from across the world have worked well. Polio Eradication Initiative has yielded an incredible drop in wild poliovirus cases: from 1,000 a day in 1988, to 22 in all of 2017. If we finish the job, polio will become only the second human disease, after smallpox, to be wiped from the face of the earth.
But the road to eradication has been longer and harder than expected. While last year saw a record-low number of wild polio cases, we have fallen short of stopping the disease completely. One child affected is too many, and so far 20 years old paralyzed by wild poliovirus.
At the same time, there have been outbreaks of vaccine-derived polio, which occurs in rare instances when the virus is weakened in the oral mutations to virulence, and can spread easily in large, unvaccinated populations. These outbreaks have occurred in high-risk countries like the Democratic Republic of Congo, Papua New Guinea, Somalia and Niger, and indicate that we are failing to reach children.
No matter the setting or viral strain, these challenges share a common cause: barriers to reaching every child. In Afghanistan, for example, nomadic populations, cross-border movement, insecurity and difficult terrain mean that many vulnerable communities remain inaccessible to polio vaccinators.
Where we are gaining access, the impact has been profound. In Pakistan and Nigeria – which, along with Afghanistan, make up the world's final polio-endemic countries, down from 125 countries in 1988 – we are steadily reaching out to children and showing what is possible when we gain new ground.
For the children and families affected, contracting polio is a tragedy. For us, we always want to learn how to polio can come back to life if we are not vigilant.
For each paralyzed child, there are an estimated 200 others who carry the virus without any symptoms. This is why, it's just a handful of cases, we must reach a massive resurgence of polio. If these vaccinations work, the consequences would be catastrophic. Within 10 years, polio could be back on every family's doorstep, paralyzing as many as 200,000 children each year.
We understand that delivering vaccines is no simple task. Polio has taken refuge in some of the most complex and dynamic environments in the world. But over time we have learned how to deliver health services in the face of extreme adversity, even in areas with almost no infrastructure.
We proved this in 2016, when the virus resurfaced in Nigeria after two years without a case. A critical front in Chad Lake Chad, a massive body of water that borders Nigeria, Chad, Cameroon and Niger. Health workers can not wait, can not wait, can not wait, can not wait. Solar-powered refrigerators they brought along kept the vaccines cool.
Today, there are still parts of Nigeria where we can not reach or even the right track of the virus, due to a combination of inadequate infrastructure, population movements and insecurity. But while we remain cautious, we have yet to see another case of wild polio since the 2016 outbreak.
Our partnership has also demonstrated its ability to operate strategically, despite insecurity. Last year in Syria, we respond quickly and effectively to an outbreak of vaccine-derived polio. We vaccinated children at transit centers and camps, and we partnered with local authorities to quickly administer vaccines. As a result, Syria has seen a year without another child paralyzed.
We also worked globally to strengthen local health systems and respond to needs beyond polio vaccination. In Karachi, for example, Rotary International is working with local partners to install water-filtration systems in at-risk communities. Similar projects – including delivering bed nets, nutrition supplements and vaccines against measles, meningitis and tetanus – go on every day, wherever we fight polio. And this infrastructure will not disappear with the last poliovirus, but it can be reprioritized to fight other diseases and accelerate progress towards global goals like long-term polio is eradicated.
These examples illustrate the tenacity of this coalition, which – thanks to committed vaccinators, donors and advocates around the world – has come so far in the world of polio. We are so close to keeping that promise. We have seen how the virus can push back. but we are more committed than ever before.
There will be a livestream for Rotary's 2018 World Polio Event Day on Oct. 24, at endpolio.org.
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