Mon, Oct 24, 2016 - Page 7 News List

Polio is still a health emergency, so what is preventing its end?

By Ilona Kickbusch, Stephen Matlin and Michaela Told

Today should be a unique day in the history of polio. If all goes according to plan, it will be the last annual World Polio Day before the disease is eradicated. However, now is not the time for celebration or complacency; while we know how to eliminate polio, we have not yet finished the job.

Consider this: in August 2014, the WHO declared the Ebola crisis in West Africa a Public Health Emergency of International Concern (PHEIC); it lifted that status in March. In May 2014, the WHO declared the international spread of wild poliovirus a PHEIC as well; yet that status is still active today, leaving one to wonder if world leaders are paying sufficient attention.

They should be. The continuing polio PHEIC is endangering the success of the Global Polio Eradication Initiative (GPEI), into which the world has invested US$15 billion since it was launched in 1988, and it threatens global health generally.

For starters, the GPEI effort to interrupt poliovirus transmission could miss its latest target date; unfortunately, it would not be the first time. By the original 2000 target date, the incidence of polio had been reduced by more than 99 percent from an estimated 350,000 cases in 1988. However, since then, a long, stubborn “tail” of infection has persisted, mainly in remote, poor regions and conflict zones. The effort to tackle these lingering cases is laborious and it remains incomplete, despite PHEIC status.

To be sure, there have been some successes, such as in India, which was certified polio-free in 2014, and in Nigeria, which interrupted transmission the same year.

However, there have also been setbacks: This year, Nigeria suddenly had two new cases among children from an area that had just been liberated from the militant group Boko Haram.

The two other polio-endemic countries, Afghanistan and Pakistan, missed their last year’s eradication target and have had to extend it by another year, at a cost of US$1.5 billion. The root causes of both countries’ missed deadlines will require delicate, skilled political handling to resolve. They include internal conflicts that make children inaccessible to public-health professionals, opposition by some religious leaders, and public mistrust of national governments and international initiatives.

Eradicating polio is expensive, but it would cost tens of billions of US dollars more to fight the disease in perpetuity. Politicians and policymakers should be reminded that a polio-free world would be a global public good, that eradication is by far the best bargain, and that sustained financing and political support is necessary to ensure the GPEI’s success.

However, it is also important to ensure that valuable assets and practices built up by the GPEI over time are not squandered once polio is gone. These include cold chains to preserve vaccines during transport from factories to patients; established “immunization days” and negotiated “days of tranquility” in conflict zones, when vaccinations can be administered; trained healthcare workers; and systems for surveillance, laboratory analysis and rapid response. These assets have proved their worth in combating other diseases: Nigeria was able to stop Ebola’s spread during the West Africa outbreak owing to its efficient polio-tracking system.

However, the reality is that countries will be able to absorb GPEI assets into their health systems only if they are supported financially, logistically and politically. A major effort will be required to transfer materials to where they are needed, and to coordinate surveillance and laboratory operations. Doing so would not only boost global-health security and resilience for the next outbreak; it would also help us reach the UN Sustainable Development Goal for universal healthcare coverage.

Comments will be moderated. Keep comments relevant to the article. Remarks containing abusive and obscene language, personal attacks of any kind or promotion will be removed and the user banned. Final decision will be at the discretion of the Taipei Times.

TOP top