With World Immunisation Week taking place from 24th - 30th April, Reg Ling, a past End Polio Now co-ordinator and currently Chief Information Officer, takes a look at Rotary’s involvement with the polio campaign.

Following the inactivated polio vaccine (IPV) developed by Jonas Salk and the oral polio vaccine (OPV) developed by Albert Sabin, the western world had become mostly polio-free.

Then Rotary and Rotarians in 1979 focussed on the elimination of polio with the first Health, Hunger and Humanities grant to immunise all the children in the Philippines.

This was successful, Rotary moved on and in 1984 made an appeal to raise $247 million to immunise all the world’s children. This was amazingly successful when $241 million was raised. However, Rotary had little experience with global health practices so the World Health Organisation (WHO) was approached.

In May 1988, members of the World Health Assembly voted to eradicate polio. On the back of this the Global Polio Eradication Initiative (GPEI) was started in November 1988 with Rotary one of the four founding partners who included WHO, UNICEF and the US Centres of Disease Control and Prevention. Many countries and organisations also contributed.

Now it would be useful to consider how Rotary International and The Rotary Foundation relate to each other.

The Rotary Foundation is Rotary’s fund-raising arm and has three separate funds:

• The annual programme which is used mainly for grants and the operations of ​the Peace and Conflict Prevention programme. However, the three-year ​share system returns to the Districts their District Dedicated Funds that may ​be used for grant proposal matching whatever is selected.
  
• The PolioPlus programme which uses the funds after the end of each Rotary ​year to make grants to the GPEI. These grants are agreed and specified by the ​International PolioPlus Committee in consultation with the other GPEI ​partners.
  
• The Permanent Fund, a true endowment, which is invested and the interest is ​used to support whatever the donors have requested.
  

The PolioPlus programme was successfully rolled out country be country. Then in ​2007 the Bill and Melinda Gates Foundation, impressed by the progress, joined ​GPEI and issued Rotary with a matched challenge to raise $100 million.

Again, success drove success and the challenge was extended to $355 million if ​Rotary raised $200 million. Then with raising the $200 million earlier than was ​expected, the Bill and Melinda Gates Foundation donated a further $50 million.

From 2012, the Bill and Melinda Gates Foundation agreed to match Rotary’s ​contributions to GPEI by 2:1, initially for $35 million per year, then to the current ​$50 million per year - that’s up to a ceiling of Rotary’s $50 million per year. This ​agreement will run to 2026.

In 2019 the Global Alliance for Vaccines and Immunisations also joined the GPEI.

Progress was remarkably achieved. First the WHO Region of the Americas was ​declared wild polio-free in 1994, the Western Pacific Region in 2000, followed by ​the South East Asia Region in 2014 and the Africa Region in 2020 leaving just the ​Eastern Mediterranean Region to achieve this.

The wild polio virus type 3 (WPV3) was eradicated in 1999, the WPV2 was ​eradicated in 2015, leaving just the WPV1 that is still endemic in Afghanistan and ​Pakistan.

It is also useful to think just how much has been achieved since GPEI was ​formed:

• In 1988, there were over 1,000 polio cases a day from 125 countries.
  
• In 2016, there were only 37 cases in the year from 3 endemic countries.
  
• Then began a difficult time. Because the tri-valent vaccine (for poliovirus ​types 1, 2 and 3) was replaced by a bivalent vaccine (for polio virus types 1 ​and 3), it seeded circulation of vaccine-derived polio viruses (cVDPVs). These ​made an appearance at the time of the Covid pandemic. Polio immunisations ​initially stopped, then gradually became routine but community immunity ​levels had dropped because the vaccinations had not been maintained, so ​more cases were found.
  
• When international travel resumed after Covid, innocent or ‘silent’ carriers ​brought back the viruses to their communities and in 2022 there were polio ​positive environmental samples found in New York, Montreal, London, ​Jerusalem and other countries. WPV1 also was recorded in Malawi and ​Madagascar but there have been no more cases there since then.
  
• The international responses were to increase the number of environmental ​sampling sites, the adoption of the novel oral poliovirus 2 that is much less ​likely to mutate and to increase the number of epidemiological polio testing ​laboratories.
  
• In 2023, there were only 12 wild polio virus cases from the two polio endemic ​countries (30 in 2022), though there were also 493 cVDPV cases particularly in ​Africa (883 in 2022).
  

Over this period the International Polio Plus Committee established a ​Countdown to History committee to which the End Polio Now Coordinators ​report. These were first appointed in 2012 and these roles advocate support for ​the PolioPlus programme in their regions. These are far reaching roles requiring ​a broad and in-depth understanding of the eradication programme.

The Rotary PolioPlus goal is to reach $50 million each year and the End Polio Now ​Coordinator’s role is to positively influence the districts in their region to make ​cash contributions. But, for both 2021-2022 and 2022-2023,

Rotary’s polio fund-raising was impacted by the other essential support for ​natural disasters, the conflict in Ukraine and, more recently, in the conflict in ​Gaza. Fortunately, the funding gap was filled by expenses avoided during Covid ​pandemic.

Rotary International has suggested for each year that at least 20% of the District ​Designated Funds should be transferred to PolioPlus. More recently, PolioPlus ​Societies have been formed. Rotarians and non-Rotarians are encouraged to ​consider membership and donate at least $100 per year until polio has been ​eradicated.

The end of polio is within sight.