In India, where I grew up, I did not have access to the polio vaccine and the disease eventually paralyzed my legs. As a result, I have been through several surgeries and cannot walk without braces and crutches. My story was not unique. At that time, it was estimated that the disease paralyzed some 350,000 children worldwide every year. In 1988, when I was ten years old, the Global Polio Eradication Initiative (IMEP).
Thirty-four years later, immunization campaigns have nearly eliminated it. But unless we fund a new vaccination effort today, we risk a resurgence of the disease.
The IMEP – which coordinates the efforts of front line workers, communities, national governments and global partners to inoculate children – has played a critical role in reducing cases, and today is leading the charge to eliminate the disease altogether. Since 1988, IMEP has helped immunize three billion boys and girlsand more than 20 million people who would otherwise have been paralyzed, but who can now walk.
However, the fight is not over. Pakistan and Afghanistan, the two countries where the disease remains endemic, have reported just five cases of “wild,” or uncontrolled, poliovirus in 2021 and three cases so far in 2022. It may sound encouraging, but the presence of this disease, everywhere, is a threat to children all over the world. In addition, the coronavirus pandemic has highlighted how quickly an infectious disease can spread.
The problem is serious, as IMEP-funded polio eradication efforts were halted during the pandemic to reallocate resources to the Covid-19 response. The suspension of the immunization campaigns meant that millions of boys and girls could not receive their doses. As a result, nearly 2,000 minors have been paralyzed in the last two years by circulating vaccine-derived poliovirus (cVDPV2), a variant that can appear in poorly immunized communities in parts of Africa, Asia and Europe.
The suspension of vaccination campaigns against polio meant that millions of children could not be immunized. As a result, nearly 2,000 minors have been paralyzed in the last two years.
So even though we are close to 99% polio eradication, this final stretch to zero cases may be difficult. That is why the IMEP launched an ambitious $4.8 billion plan during the last World Immunization Week, in order to help end the infection by 2026.
The strategy consists of vaccinating 370 million boys and girls annually for the next five years, and increasing integration between the different community actors to achieve immunization. Therefore, it is necessary to collaborate with community leaders, clerics and influential people to gain the trust of the people, increase the acceptance of the vaccine, confront misinformation; and improve surveillance and community response to the occurrence of cases.
Investing in eradication also generates broader benefits, such as: strengthening health infrastructure, providing routine immunizations, and strengthening other health services targeting underserved communities. The polio program has made the world safe from many emerging diseases, detecting and responding to outbreaks of measles, yellow fever and Ebola.
IMEP and its associated entities helped develop and implement an oral vaccine of the next generation – nOPV2 – to help stop type 2 outbreaks. Most notably, IMEP’s strong surveillance network helped coordinate a public health response to coronavirus in 50 countries in Africa, the Middle East and Asia. The response included the delivery of vials, case detection and monitoring, contact tracing and awareness of the virus.
This final five-year drive to eradicate polio – estimated to cost at least $1 billion a year – must be fully funded and executed. The US Centers for Disease Control and Prevention warn that rolling back eradication efforts could lead to a global comeback of the virus, which by 2032 would paralyze up to 200,000 children each year, alarmingly increasing the cost of controlling the disease and treat survivors. Tedros Adhanom Ghebreyesusdirector general of the World Health Organization (WHO), points out that the eradication of this virus is highly profitable in terms of costs, and that it could generate more than 33 billion dollars in savings.
The world cannot afford to give up the fight to eliminate polio and squander more than three decades of progress. “It is highly crucial that all the actors involved are committed to ensuring that the new eradication strategy can be fully implemented,” said Niels Annen, parliamentary State Secretary to Svenja Schulze, the German Minister for Economic Cooperation and Development. “We can only achieve this if we make eradication a joint priority,” Annen said.
The world has a chance to end polio in the next five years, so that no child has to suffer like I did from a disease that is totally preventable. But that won’t happen without fully funding a final strategy to end it.