Via The Globe and Mail, a report by its brilliant health reporter André Picard: Three-decade effort to eradicate polio is in peril. After describing today's statement by WHO, Picard goes on:
The public health emergency is a thinly veiled diplomatic message that, if the world is serious about eradicating polio – and eliminating the need (and cost) to vaccinate and then revaccinate 500 million children every year – there must be a co-ordinated push, including confronting vaccination’s foes.
To date this year, the world has had 68 cases of polio – which may seem trivial on a planet with seven billion people.
But polio season – when the heavy rains come in the northern hemisphere – is fast approaching, and cases could increase exponentially. (Polio spreads primarily through contaminated water.)
Further, it is where the cases are occurring that is troubling.
When the eradication campaign began in 1988, polio was endemic in 125 countries. The initial goal was to be rid of it by 2000. We came tantalizingly close. The new target date is 2018.
Last year, only three endemic countries remained – Pakistan, Afghanistan and Nigeria. Recently, India, long the cradle of polio, was declared polio-free.
Almost simultaneously, polio began to gain a foothold in countries where it disappeared long ago, for a host of geopolitical reasons.
The WHO declaration on Monday named 10 countries where polio virus is now present: In addition to Pakistan, Afghanistan and Nigeria, they include Syria, Iraq, Cameroon, Equatorial Guinea, Ethiopia, Somalia and Israel. (Israel is an anomaly; polio virus has been detected in sewage but there have been no cases in people.)
The chief exporter of polio and impediment to eradication is Pakistan, where terrorists hunt and kill volunteers and health workers who conduct vaccination clinics. Things are not much better in Afghanistan.
(It is worth noting these hostilities began after the CIA used a sham vaccination campaign to get DNA on Osama bin-Laden’s family, which led to his discovery and killing.)
Pakistan is where 59 of the world’s 68 polio cases have occurred this year, and where vaccination rates are perilously low.
Just as troubling is the situation in Syria, a war-torn country where President Bashar al-Assad, has refused to allow polio vaccination in rebel-controlled areas, killing children with infectious diseases as well as bombs.
An estimated six million Syrians have been displaced, creating ideal conditions for polio to spread domestically and across the Middle East.
In Nigeria, radical Muslim clerics declared vaccination to be a U.S. plot to sterilize the young. In neighbouring Cameroon, the indifference of the country’s leaders has allowed vaccination rates to plummet, and created a bridge for the virus to the Horn of Africa.
In fact, if there is a lesson to take from the rogues’ gallery of polio-endemic countries, it is that disease flourishes where there is war, political unrest and poverty.
In hindsight, my own polio case in 1948 was probably part of a family cluster. My father had a mysterious back problem a few months earlier that kept him bedridden for some time. Then I came down with a clear case in November and spent two indignant weeks in a hospital crib (and me a big boy of 7!). Several years later in Mexico, a doctor looked at my middle brother's back and said he'd probably had polio too, a mild case while I was still in the hospital and the family was in quarantine. My family and I were lucky that none of us ended up in an iron lung for the rest of our lives.
North Americans and Europeans probably don't understand the sheer terror that polio provoked in their grandparents and great-parents in the first half of the 20th century. It was mysterious, invisible, incurable, and everywhere.
When the first polio vaccine arrived in the mid-1950s, everyone turned up for their sugar cube at the local school—even my father, my brother, and me. We knew that you could get polio twice.
