Is This the End of Polio?
Rotary Hangs in to Eradicate the Disease Once and For All
By Alice Dickow
In the United States and much of the world, polio is barely a bad memory. In one of the great successes of modern medicine, the use of vaccines developed in the 1950s virtually eliminated the crippling, sometimes deadly disease. But there are still a few countries where a handful of cases occur each year, and that means the virus has a chance to make an unwelcome comeback, not just in those few countries but worldwide.
With so few new wild polio virus cases remaining—there were just 22 in 2017—most global health funders consider the matter closed and spend their money on other problems. But a few heavy hitters, namely Rotary International and the Bill & Melinda Gates Foundation, are keeping the pressure on until polio is truly eradicated. Their persistence underscores a key strength of philanthropy: the ability to stick with a cause over years, or decades, without having to worry about the patience of voters or shareholders running thin.
Rotary International recently made another serious move to end polio, awarding nearly $100 million in grants to eradicate the disease in the countries where it remains endemic. The majority of the grant money is going to three countries: Afghanistan ($22.9 million), Pakistan ($21.7 million) and Nigeria ($16.1 million). Further funding will support efforts to keep an additional 16 vulnerable African and Asian countries polio-free.
Rotary’s Long Commitment to the Battle Against Polio
Rotary has been working to eradicate polio for over 30 years. In 1978, it expanded from local service activities and international scholarships to include national and international projects in health, hunger and humanity, or 3-H. Clem Renouf, president of Rotary International from 1978 to 1979, had read about the eradication of smallpox, which was proof that a serious disease could be wiped out. He wanted a similarly ambitious project to initiate Rotary’s new 3-H projects. Rotary selected polio, a global health problem of recognized international importance—and one for which a proven vaccine was available.
Rotary’s polio eradication efforts began in 1979 with vaccinations for 6 million children in the Philippines. In 1985, it launched the PolioPlus program, the first initiative to tackle global polio eradication through the mass vaccination of children. In 1988, Rotary became a partner in the Global Polio Eradication Initiative, a public-private partnership that includes the World Health Organization, the U.S. Centers for Disease Control and Prevention, UNICEF, the Bill & Melinda Gates Foundation, and various world governments.
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In total, Rotary has contributed more than $1.8 billion and countless volunteer hours to immunize more than 2.5 billion children in 122 countries. At least as important, Rotary’s advocacy efforts have played a role in decisions by donor governments to contribute more than $8 billion to the effort.
Pivotal to this fundraising success has been the relationship with the Gates Foundation. Presently, the Gates Foundation has pledged to match every dollar pledged by Rotary with two more, up to $50 million per year. The result: a yield of $450 million for polio eradication activities over a three-year period.
What’s at Stake?
Eliminating a disease is not like any other project. If polio is eradicated, it would be only the second time in history (after smallpox) that a disease afflicting humans has been eradicated by vaccines. Since the GPEI was launched, the incidence of wild polio virus has plummeted by more than 99.9 percent, from about 350,000 cases in 1988 to just 22 in 2017.
However small in number, those remaining polio cases are the most difficult to prevent due to factors such as geographical isolation, poor public infrastructure, armed conflict and cultural barriers. While significant strides have been made against the paralyzing disease, wild polio virus is still a threat in parts of the world, with 14 cases in Afghanistan and four cases in Pakistan this year so far.
But as long as a single child has polio, all children are at risk. In other words, until polio is truly eradicated, it can still spread, even to other countries.
Work Remains Even After Potential Polio Eradication
Rotary International has set a 2018 deadline to eradicate polio. But even if it achieves that, the work does not end there. Once the final case of polio is recorded, it will take three years of monitoring to ensure that the last case is, in fact, the final one. That means that if the final case is identified this year, these programs will require continued funding and volunteers. That’s in addition to the more than $1.8 billion Rotarians have contributed to the cause so far.
“We are so close. We’ve got a 99.9 percent reduction in polio. But we’re not there, yet,” says John Sever, a vice chair of Rotary’s International PolioPlus Committee, who has been part of the eradication effort since the beginning. “Rotarians and others have to keep working. People will naturally say, ‘Well, it seems to be basically gone, so let’s move on to other things,’ but the fact is, it isn’t gone, and if we move on and don’t complete the job, we set ourselves up for having the disease come right back.”