Funding the final phase of polio eradication

Growing up in India, I didn’t have access to the polio vaccine and as a result the disease paralyzed my legs when I was a child. Because of this, I had to undergo many surgeries and today I can’t walk without splints and crutches. My case is not the only one. When the Global Polio Eradication Initiative was founded in 1988 (I was ten years old at the time), the disease paralyzed approximately 350,000 children worldwide each year.

Thirty-four years later, vaccination campaigns have nearly eradicated polio. On the other hand, the risks of a flare-up of the disease are very high unless a more comprehensive vaccination campaign is funded today.

The initiative — which coordinates efforts by frontline medical workers, communities, national agencies and international partners to help vaccinate children — has played an important role in reducing polio cases and is on track to help eradicate the disease permanently. Since 1988, this initiative has vaccinated three billion children against poliomyelitis and helped more than 20 million people who would otherwise be paralyzed.

But the fight is far from over. Pakistan and Afghanistan, the two countries where polio remains endemic, have reported just five cases of wild poliovirus in 2021 and three cases since early 2022. This may sound encouraging, but the absence of polio anywhere in the world poses a threat to children everywhere else, and the Covid-19 pandemic has shown how quickly an infectious disease can spread around the world.

This issue has become particularly acute as efforts funded by the Polio Eradication Initiative have been suspended during the pandemic to transfer resources to help countries fight Covid-19. Millions of children have not been vaccinated against poliomyelitis due to the suspension of vaccination campaigns and the disruption of routine vaccination campaigns. As a result, around 2,000 two-year-olds have been paralyzed in parts of Africa, Asia and Europe by circulating vaccine-derived poliovirus (cVDPV2) – a variant that can occur in underimmunized communities – in the past.

So, even though we’ve eradicated almost 99% of polio, the final curve before there are no more cases could prove difficult to negotiate. That’s why, during the last global immunization week, the initiative launched an ambitious $4.8 billion program to help rid the world of the scourge of polio by 2026.

The strategy is to vaccinate 370 million children against poliomyelitis annually over the next five years. It plans to further integrate polio vaccination into mainstream community health services; by working with community authorities, faith-based organizations, and influencers to build community trust, increase vaccine acceptance, counteract misinformation, and improve surveillance and health interventions.

Investing in polio eradication brings greater benefits, if only by strengthening health infrastructure and regularly delivering immunization and other integrated services to underserved communities. The polio program has saved the world from many emerging disease threats by identifying and responding to outbreaks of measles, yellow fever and the Ebola virus.

The initiative and its partners have helped develop and deploy a next-generation oral polio vaccine –

nOPV2 – to contain vaccine-associated type 2 polio outbreaks. Most notably, the highly effective surveillance network has helped coordinate public health responses to Covid-19 in 50 countries across Africa, the Middle East and Asia. It included vaccine administration, case and contact detection and tracing, and virus awareness campaigns.

This final five-year polio eradication effort—at an estimated cost of less than $1 billion a year—must be fully funded and carried to completion. The US Centers for Disease Control and Prevention warns that cutbacks in eradication efforts could lead to a global resurgence of polio, which could cripple up to 200,000 children a year in 10 years, increasing the cost of controlling the disease and treating the disease survivors would increase significantly. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, points out that eradicating polio is extremely cost-effective and could result in cost savings of more than $33 billion.

The world cannot afford to give up the fight against polio, wasting more than three decades of progress. Niels Annen, Parliamentary State Secretary to Svenja Schulze, Federal Minister for Economic Cooperation and Development, said: “It is really crucial that everyone involved now works to ensure that the new eradication strategy can be fully implemented. We can only succeed if polio eradication becomes a shared priority.”

The world has the opportunity to end polio within the next five years, so that no child like me will have to suffer from a disease that is completely preventable. But that’s not possible without a well-financed exit strategy.

* Minda Dentler, 2017 Aspen Institute New Voices Fellow, is a polio survivor, global health advocate and the first wheelchair athlete to cross the finish line at the Ironman World Championships in Kona, Hawaii.

Translated from English by Pierre Castegnier.

© Project Syndicate, 2022.

Growing up in India, I didn’t have access to the polio vaccine and as a result the disease paralyzed my legs when I was a child. Because of this, I had to undergo many surgeries and today I can’t walk without splints and crutches. My case is not the only one. When the Global Initiative for…

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