Polio is 5,000 years old. It is an infectious disease caused by one of three viruses, Type One being the most dangerous because it attacks the body quickly. The virus enters through the nose or mouth and the infection starts in the gut. If the virus reaches the central nervous system, it can cause muscle paralysis in any part of the body. The disease can kill or cause permanent disability.
My life with polio started when I was a toddler in the Howrah district of Kolkata, India, aged about 18 months. I survived at a time when 1 in 5 children where I lived were dying of the virus. Unfortunately I was paralyzed in my lower limbs and, because there was no money, I was taken to Mother Teresa’s orphanage, where I stayed for years until I was adopted. My memories from that period are dark, sad, and lonely.
Five years ago, India accounted for nearly half of all new polio cases; in February 2014 the World Health Organization declared India polio-free, three years after the last case of polio was reported in the country.
In the words of Dr Margaret Chan, the director-general of the WHO: ‘India’s achievement is an epic success story, proof that any country that really wants to can defeat polio.’ The whole of South East Asia is now on track to be certified polio-free.
The World Report on Disability, produced jointly by the WHO and the World Bank in 2011, suggests that more than a billion people experience disability. People with disabilities have generally poorer health, lower education achievements, fewer economic opportunities and higher rates of poverty. Those who live in a developing country are often among the poorest of the poor. As poverty leads to disability, disability also worsens poverty.
In 2008, I was invited to contribute towards the Global Polio Eradication Initiative in India with Rotary International. During my visits to India, I saw firsthand the cooperation between the United Nations, local government and village workers.
Unicef is expert at working with children, mobilizing the foot soldiers and buying the vaccines. The WHO develops strategies and a surveillance system to track each polio case as it occurs. It was India’s adoption of that gold-standard surveillance system that made the difference.
Nothing prepared me for what I found. We travelled to Moradabad, in Uttar Pradesh, a region very resistant to the polio vaccine. The entire campaign is about children and that means teaching parents living in extreme hardship to understand the importance of preventable diseases.
One parent told me that she wanted their child to get polio, as it would be useful when she begged for food and money. How awful must their life be for a parent to want their children to suffer from a crippling virus?
During my visit we went to many places where I helped to change attitudes. I was able to vaccinate children whose parents had up until then refused to allow health workers into their home, believing that the polio vaccine would harm their children. Of course, I wasn’t successful in every place.
My time spent in those villages showed me the challenges ahead for the eradication of polio from the remaining endemic countries – Nigeria, Pakistan and Afghanistan. One reason for resistance is gossip and rumour that vaccines are harmful. Armed groups in the three countries undermine health campaigns by misleading people about the benefits of vaccination. The key job is to educate parents and to stop the killing of health workers. There are many communities, however, for example in Nigeria, that would welcome the vaccination programmes but insecurity and conflict make it difficult to gain access to nearly a million children.
In October last year there was a polio outbreak in Syria, the first since 1999. According to health workers looking after Syrian refugees, there is a high demand for immunization, reflecting the increasing awareness of the risks of polio, even in such difficult conditions. More than 2 million children were immunized against polio across Syria during the first week of January 2014.
If the polio virus can come back to Syria, then it can come back anywhere. For a polio-free world, we must remain vigilant and committed. We are so close to eradicating polio, just as we eradicated smallpox. However, if we don’t stay the course, experts say that polio could rebound to 10 million cases within 40 years, negating the world’s $10 billion investment in the initiative.
The cost of the polio eradication programme to 2018 is projected to be $5.5 billion. Donor nations such as the G8 countries need to stand by their funding commitments. To date, most of the $10 billion spent since 1985 has come from donor countries, but 39 per cent has been donated by the private sector, including more than $1 billion each from the Rotarians and the Gates Foundation.
It is possible to immunize every child even in poor, high population areas or war zones. More than 210 countries, territories and areas are now believed to be polio-free (including China), and 134 of these, containing half the world’s population, have been certified polio-free by independent commissions. As a result of the Global Polio Eradication Initiative, many children have been spared, and many more will be spared, the cruel, lifelong consequences of polio that I know so well.
As Jonas Salk, the creator of the polio vaccine, put it: ‘Hope lies in dreams, in imagination and in the courage of those who dare to make dreams into reality.’