Why is there still polio in the world today?

Around this time of the year, global health experts and partners come together to reflect on the progress made on the road to polio eradication, honor those on the frontlines, and reflect on the work that still needs to be done. Two of the original partners of the Global Polio Eradication Initiative (GPEI) are UN agencies: the World Health Organization (WHO) and UNICEF. Rotary International, a founding partner of the GPEI works closely with these partners as well as the US Centers for Disease Control and Prevention (CDC), the Bill & Melinda Gates Foundation, Gavi, the Vaccine Alliance, and national governments to eradicate polio worldwide. The GPEI has been a huge success, but the job is not yet done. At first, the progress was amazing. In 1988, when the GPEI was formed, there were more than 350,000 cases of polio in 125 countries across the globe. Today, only Pakistan and Afghanistan are still endemic to the wild poliovirus with less than 50 wild polio cases in the world, including a handful of cases in Africa that are traced back to Pakistan. In 1988, there were three strains of the wild poliovirus:  Types 1, 2, and 3. Now, only Type 1 remains.

As the virus is nearing eradication, there are still challenges. While wild polio cases are few this year, there are some cases circulating in different parts of the world that are linked to the oral vaccine. In rare cases, if the weakened strain of the poliovirus contained in the oral vaccine circulates among an under-immunized population, it can revert back to a form that causes paralysis, although the GPEI’s new oral vaccine is more genetically stable and less likely to revert to a paralysis-inducing form (and it’s being used in a growing list of countries). A recent case in New York falls into this category, in which an unvaccinated person contracted a case of paralytic polio. The key is to keep vaccination rates high, in which case polio does not have any openings. As some countries have gone for many years without any polio, the vaccination rates can lapse, especially during the lockdown caused by the COVID pandemic. The key is to get all of the routine immunizations and you are protected. In countries with active conflicts like Ukraine, the Democratic Republic of Congo, and Mozambique, this takes extra effort and resources.

Polio can be eradicated very soon, but the challenges need to be met swiftly and with resources. In the wake of the massive floods and humanitarian disasters in Pakistan, Internally-Displaced People (IDPs) need to be supported by targeted immunizations. In Afghanistan, there is renewed hope as the Taliban has agreed to allow house-to-house vaccinations to resume, after several years when some regions were not accessible to vaccinators. Across the board, female vaccinators play a particularly important role because they’re able to go house-to-house to immunize children where men cannot, and during a visit to Pakistan in August, Rotary International President Jennifer Jones took part in a vaccination campaign and used the opportunity to “spotlight female health workers who are playing a critical role in protecting children from this vaccine-preventable disease” (Rotary magazine, October 2022). During the final push to eliminate polio in northern Nigeria, it was also women who led the way, working together with health officials, community and faith leaders, and the GPEI partners to get the vaccine into the mouths of children.

As we continue the march towards global eradication, we must also continue to ensure that GPEI’s eradication efforts receive the support necessary to end polio for good. Rotary – inclusive of 1.4 million members in 46, 000 clubs – is committed to raising $50 million a year, and has contributed more than $2.6 billion to fight the disease. What’s more, thanks to Rotary’s funding partnership with the Bill & Melinda Gates Foundation, Rotary commits $150 million annually to the global effort to eradicate polio.  If you would like to lend a hand, please take a look at this link for more information on how to help and how to donate: www.endpolio.org.

Joe Stahlman, North St. Paul, Rotary District 5960, Charlie Cogan, Northfield, District 5960 and Tim Mulcrone, Savage, District 5950 are leaders of the Rotary International PolioPlus Teams for the Twin Cities and surrounding areas of Minnesota and Wisconsin.