Jun 20, 2019

Why the last mile is so important - Michael McGovern, International PolioPlus Committee Chair

Michael McGovern, International PolioPlus Chair
Michael McGovern, International PolioPlus Chair

1. There were more cases of wild poliovirus in 2018 than in 2017. Should we be discouraged? 


No, not at all. We’ve always expected the number of cases to fluctuate somewhat as we get closer to zero. We’ve gone four straight years with fewer than 100 cases per year. That’s an indicator of great progress. With dedication from governments and Rotarians in areas still affected by polio, we’ll get there.   


2. Why is it so difficult to eradicate a disease like polio?


Remember that even in the United States, where the polio vaccine was readily available, it still took 20 years to become polio-free. And the areas we are working in now don’t have health systems that are as well-developed as in the United States.


3. What challenges are you seeing now?


We have been working intensely in the endemic countries — Afghanistan, Nigeria, and Pakistan — for a number of years, and some of the citizens in those countries are getting concerned that we are spending money on polio eradication when they have so many other needs. There’s some resistance to keep on receiving immunizations for polio, and polio alone. Our challenge is to find ways to provide other services to the citizens and children so we still have the parental support we need — to provide the “plus” in PolioPlus. 


4. What role does armed conflict play in those areas?


It makes the logistics of immunization far more difficult. The Global Polio Eradication Initiative partnership is not only dealing with governments — we’re dealing with anti-government elements as well. While we’ve worked to gain everyone’s trust and support, we’ve had areas that were inaccessible to immunization teams for months and sometimes years at a time. 


5. Do immunization teams know when they miss children? Or are there children they don’t even know about?


I think we have a good handle now on knowing when and where we’re missing children. The challenge is to keep reducing the number we miss. In Nigeria, we have done a lot of work since we were surprised by the discovery of several polio cases in Borno state in 2016, two years after the country had last seen a polio case. We now know through GPS mapping where the children are, and we are working with authorities there to make sure all children receive the polio vaccine.


6. Where are we seeing successes?


We haven’t had any cases of wild poliovirus anywhere in the world in nearly five years except in the three endemic countries. And in Nigeria, it’s been almost three years since we had any wild poliovirus cases, and those occurred in a small area of the country.


7. What’s the most important thing people should know?


I’ve been extremely impressed with the dedication and persistence of Rotarians in Afghanistan, Nigeria, and Pakistan. They are working hard to make sure polio is eradicated. It’s pretty amazing what they do in those countries.



immunization activities in India
immunization activities in India


Mar 28, 2019

5 ways Rotary is making progress to end polio

Female health workers are on the front lines
Female health workers are on the front lines

Rotary’s top global initiative is polio eradication. While there is still work to be done to finish the job, we can be proud of the incredible progress we’ve made, working with our partners in the Global Polio Eradication Initiative (GPEI). As we begin 2019, here are five ways Rotary is making progress toward our top goal.

1.    We’ve come a long, long way
In 1988, the year when Rotary led the formation of the GPEI, the world had 350,000 cases of polio in 125 countries where polio was endemic. In 2018, there were 33 cases of wild polio  in two countries, Afghanistan and Pakistan, which represents more than a 99.9 percent reduction in global polio cases. 

2.    Nigeria remains at zero
Although Nigeria is officially on the list of countries where polio is endemic, it is approaching the third anniversary of its  last reported case of wild polio. Steady scheduling of immunization days, routine surveillance, and engagement at all community levels and institutions are a few of the reasons for Nigeria’s success. 

3.    Bold strategies are widening our reach
The GPEI is using new approaches aimed at reaching more children. Some are high-tech, such as using geographic information system mapping. Others are low-tech — yet just as critical — such as deploying boats to deliver vaccines to the remote islands of the Lake Chad region. 

4.    New solutions are advancing our work in Afghanistan
Rotary is doing its part to turn obstacles into opportunities in this war-torn country. Afghan Rotarians are working side by side with the government and other GPEI   partners, often in dangerous places, to meet with local leaders who can foster  community acceptance of the vaccine. Rotary-funded permanent transit points also help reach populations on the move between Afghanistan and Pakistan.

5.    Complementary service projects are bolstering eradication efforts.
Polio is not an isolated problem. The communities where polio thrives are also affected by other health issues and lack clean water and proper sanitation. To respond to multiple health needs at the same time, Rotary is focusing on projects that complement polio eradication efforts — putting the “plus” in PolioPlus. One example: In Pakistan, Rotary clubs have partnered with The Coca-Cola Company and the United Nations Development Programme to build water filtration plants in Karachi’s highest-risk areas.

Mar 9, 2017

6 Key Numbers in the Fight to End Polio

We are close to eradicating a human disease for only the second time in history. A global public-private partnership has reduced the poliovirus caseload by 99.9% over the last 30 years, but there’s still plenty of work to do.

Even before we reach that milestone, the knowledge and infrastructure built to fight polio is being repurposed to take on other global challenges.

3 countries where polio is still endemic

Fewer than 40 children were paralysed by polio in 2016, the lowest number in history. This is a dramatic decrease from the estimated 350,000 cases per year in 125 countries that the world saw in 1985 - the year that Rotary International initiated a worldwide effort to eradicate this terrible disease.

In 1988, Rotary was joined in the effort by WHO, the U.S. Centers for Disease Control, UNICEF (and more recently the Gates Foundation) to create the Global Polio Eradication Initiative (GPEI).

Today the virus is limited to a few areas in just three countries – Pakistan, Afghanistan and Nigeria.

In response, Nigeria intensified surveillance activities to pinpoint where the virus is circulating.

In Pakistan, innovative tactics are being used to focus polio immunization drives. Health workers are trained in the use of cellphone data reporting, which allows real-time recording of immunization coverage and public health surveys of populations.

In Afghanistan, the program continues to adapt in order to reach the maximum number of children possible despite a volatile security situation.

155: the number of countries involved in largest coordinated vaccine switch in history

There are three different strains of the poliovirus. Once a strain is eliminated (type 2 was officially eradicated in September 2015), we have to match our vaccines to the remaining strains to protect children globally.

This transition is a massive undertaking, requiring significant funding and coordination to accomplish global health feats that have never been attempted.

To give you a sense of scale, the largest and fastest globally coordinated vaccine switch in history (to target poliovirus types 1 and 3) was successfully conducted over two weeks in April 2016, with 155 countries taking part.

$60 billion: the cost of infectious disease epidemics per year

The spread of infectious diseases is consistently among the world’s top 10 risks in terms of impact. The eradication of polio will mean no child will ever be paralyzed by this debilitating disease again. However, we must use the knowledge and infrastructure built up over many years by the GPEI to take on other global health threats.

Dramatic progress on improving children’s health beyond polio is already underway – resulting in a decreasing number of children dying from other preventable diseases in countries with strong polio infrastructure. Polio drops are now often delivered alongside essential services including nutrition support, primary health care and other vaccines.

By identifying the overlap between what the polio programme has to offer and country-level priorities for strengthening health systems, we can make a lasting difference to global health overall, and significantly reduce the gap in the impact of infectious diseases between middle-income and poorer countries.

20 million: the number of volunteers participating

Since the GPEI was launched in 1988, Rotary and other volunteers have raised funds, built awareness, and advocated for their national governments to support polio eradication.

 volunteer can administer the two drops of oral polio vaccine to a child, and participate in National Immunization Days, which attempt to vaccinate every child under five years of age in endemic or at-risk countries. Millions of health workers are also helping us reach children who have never before been vaccinated.

$1.5 billion: the amount needed to eradicate polio

This may sound expensive, but, in the words of Dr. Jonas Salk, who invented the first effective polio vaccine, “which is more important, the human value of the dollar, or the dollar value of the human?”

Funding has already contributed to many important successes of our programme. In 2016, Rotary funded the work of 52,676 vaccinators and 2528 supervisors in Iraq to keep up strong immunization coverage. Investments made to polio eradication are also contributing to future health goals by documenting the knowledge, lessons learned and assets of the programme.

Funds also make possible the programme’s extensive surveillance and laboratory network to tell us where polio does (and does not) exist – a painstaking task given only one in 200 cases of polio results in paralysis. This network is already instrumental for taking on public health challenges beyond polio, such as Ebola.

While we undoubtedly still have work to do and funds to raise, we are confident in the good work of our volunteers and members to get us to our goal of eradication. Read and be inspired by their stories and successes here – a world free from polio is certainly within our reach.

4: the factor by which health savings exceed the cost of polio eradication

Immunization as a public health investment is incredibly good value. Every dollar spent on vaccinations in the US saves $3 in direct healthcare costs and $10 societally. A polio-free world will reap financial savings and reduce healthcare costs by up to $50 billion through 2035. In fact, we’ve already saved $27 billion since the GPEI was launched, and low-income countries account for 85% of the savings, not to mention the immeasurable alleviation of human suffering.

Conversely, if we allow polio to spread again, it would cost upwards of $35 billionmore in treatment expenses and economic losses, so it’s a no-brainer that we have to commit all our resources to finish the job once and for all.

This article is part of the World Economic Forum Annual Meeting 2017

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