the challenges of eradicating polio
story by: reg ling (End Polio Now Chief Information officer)
Forty-five Rotary presidencies have focused on polio: first in 1979 for vaccinating all the children in the Philippines, to today with the objective to eradicate polio globally.
Since Rotary began its campaign against polio 35 years ago, two of the wild polio virus types have been eradicated and five of the six World Health Organization regions have been declared polio-free.
Three billion children have been immunised and 21 million saved from paralysis. From wild polio being endemic in 125 countries, there are just two today. The numbers of cases have dropped from 1,000 a day to only some cases this year in Pakistan and Afghanistan.
Environmental surveillance has been introduced to identify any polio viruses present. Laboratories have been built to provide test facilities closer to the infections and shorter test times have been achieved. Vaccines have been developed and strategies refined to concentrate on the actions required.
Global events, national disasters, conflicts and changing priorities have adversely affected the schedules with the residual effects of Covid really stinging the campaign.
Only two years ago polio eradication was in the best position it had ever been in and 2023 was to be the year that the transmission of the polio virus would be interrupted.
The novel oral polio vaccine became more extensively used to counter mutations. Though cases became more geographically confined and numbers came down, this was not enough to meet the 2023 target.
By the end of July, with more polio cases and environmental samples marking the high transmission season, experts agreed that the timelines should be extended for wild polio virus eradication to 2027, and the variant polioviruses by 2029.
“global events, national disasters, conflicts and changing priorities have adversely affected the schedules.”
The challenges:
- For wild polio virus type 1; from reaching unvaccinated children and countering misinformation, to overcoming vaccine refusals and boycotts. An increase in the number of cases is continuing. So far this year it is 33 from two countries (only 12 in all of 2023). The presence of positive samples is higher too (356 vs. 190 last year) but the reports are genetically linked. There is political will and high public awareness. Surveillance is foremost and immunisation rounds are almost monthly, but security is another challenge. Consultative meetings with the GPEI partners have agreed the polio transmission interruption will be in 2025
- For cVDPV2; the extent of ES is uncertain with ongoing conflicts. The number of cases confirmed across 26 countries is 140 but they are 36% of the 2023 total. Only 15 countries have had cases with onset of polio in 2024. The number of cVDPV2 positive ES samples across 38 countries is 138 (40% of the 2023 total). There has been a risk of a polio outbreak in Gaza where the territory’s health systems are in a dismantled state. Most hospitals are no longer able to function and less than half of the primary healthcare facilities are operational. 70% of all sewage pumps have been destroyed and not a single wastewater treatment plant is working. These conditions are a breeding ground for polio and a source of polio outbreaks elsewhere. WHO has sent polio vaccines to Gaza for two rounds of immunisations which began in September. Israel agreed to a series of “humanitarian pauses” in Gaza to allow for the vaccination of children against polio. The campaign aimed to vaccinate around 640,000 children across the Gaza strip, rolled out in three separate stages, across the central, southern and northern parts of the strip.
- For cVDPV1: the number of cases confirmed from 2 countries is less than 5% of the number in 2023 when infections were in 3 countries, and there have been no positive ES samples collected this year.
- For cVDPV3; there have been no reports for over two years.
- The GPEI funding requirement is falling short of what will be required to eradicate polio.
While polio vaccinations continue across the globe, there remains the need to continue funding the Global Polio Eradication Initiative, to the tune of $1 billion annually.
The historic opportunity to eradicate polio remains within reach and the best way for Rotarians to continue our leadership role in the Global Polio Eradication Initiative (GPEI).
The annual financial requirement is about $1 billion and Rotary’s fundraising goal of $150 million, including the Bill & Melinda Gates Foundation’s 2:1 match, is significant.
The GPEI funding requirement is falling short of what will be required to eradicate polio. Rotary has always responded to financial challenges yet more money is required to sustain the GPEI programme.
The Rotary Foundation polio goals for 2024-2025 are for clubs to raise $1,500 each for PolioPlus, and for Districts to donate at least 20% of new District Designated Funds to PolioPlus.
The take up of personal contributions to PolioPlus has not been overwhelming. By the end of July, just three clubs had donated $1,500 or more to PolioPlus yet 92% of Rotary clubs in Great Britain & Ireland had made no contributions.
So, continue to raise awareness about Rotary’s role in polio eradication and to invite others to join in the global effort.
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