Until polio is eradicated, all countries remain at risk. Europe is no exception, and the sixteen deaths caused by a polio outbreak in Albania in 1996, which spread to Greece and Kosovo, are a harsh reminder of this fact, writes John Hewko.
John Hewko is General Secretary of Rotary International, a spearheading partner in the Global Polio Eradication Initiative.
Since the global polio campaign to eradicate polio was launched thirty years ago, cases have fallen 99%. With continued support for polio eradication, and appropriate levels of funding for polio vaccination campaigns and surveillance over the next four years, the EU could help bring an end to the devastating disease within the next five years.
As we mark World Immunisation Week, it’s worth reviewing the progress made since Rotary – a civil society organisation – had the audacity to take on global polio eradication thirty years ago. Three years later, the Global Polio Eradication Initiative (GPEI) was formed, a public-private partnership between Rotary International, the World Health Organisation (WHO), UNICEF, and the U.S. Centers for Disease Control.
More recently, the Bill and Melinda Gates Foundation joined the cause, and the GPEI has reduced polio cases worldwide by 99%, immunising more than 2.5 billion children.
The strategic plan of the GPEI is rapidly approaching its endgame. Last March, we reached a milestone when the entire Southeast Asia region, including India, was certified polio-free. Africa is on the brink of being declared polio-free, as there have been no recorded cases of polio on the continent since August 2014.
However, until polio is eradicated, all countries remain at risk. Europe is no exception, and the sixteen deaths caused by a polio outbreak in Albania in 1996, which spread to Greece and Kosovo, are a harsh reminder of this fact. Following outbreaks in Central Asian Republics and Central and Eastern Europe during the 1990s, flare-ups have coincided with humanitarian crises, and more than one hundred cases were reported in Syria in 2013. Wild poliovirus was found in sewage samples in Israel that same year.
This highlights the constant risk of importation, even in countries where polio has been eradicated for decades.
The European Union can counter this threat in two ways: by ensuring high routine immunisation rates, and by supporting the GPEI at this critical time.
First, high immunisation coverage (90-95% of the population) is advised by WHO in countries vulnerable to importation of the virus. In 2013, an estimated 12 million children in the EU had not been vaccinated against polio, leaving them exposed to cases entering the region from its south-eastern flank.
In Ukraine – where my family is from – the immunisation rate is only 74%. Second, we know that it is much less expensive to prevent disease than it is to treat disease. If the EU helps the GPEI across the finish line, our actions will benefit billions of lives as we reallocate the predicted $50 billion savings in health care costs over the next twenty years.
Significant challenges remain; polio is still endemic in Pakistan, Afghanistan and Nigeria. Health workers there take great risks to reach populations in remote areas in the face of armed conflict, poor public infrastructure and persistent resistance among some to vaccination, fed by extremism and misinformation. Only last month in Pakistan, two health workers were killed by militant extremists who oppose the immunisation.
The whole region will be safer, and the reality of a polio-free world will be that much closer if we support these brave health workers and stamp out the virus in Pakistan. If we don’t stay the course, experts say polio could rebound to over 200,000 cases per year in the next 10 years.
The EU is a vital partner in this fight with a cumulative investment of more than €200 million through 2014. Now is the time for continued commitment to support polio eradication and secure a permanent progression in global public health.
Investment in the GPEI is money well spent, strengthening health systems and resilience as part of its legacy. Polio eradication will further the goals of the Global Health Security Agenda, a project to which many EU member states are committed. It aims to improve the ability of countries around the world to prevent, detect, and respond to infectious disease outbreaks. The eradication campaign has a knock-on effect on other health programs, and its infrastructure reaches an unparalleled number of the world’s poorest including nomadic children who had never received basic health services in Nigeria, Sudan and Somalia.
As I write, a team of polio experts from India is on the ground in Sierra Leone to help fight Ebola. Nigeria’s successful response to the Ebola crisis last year was enabled by the cutting-edge GPEI infrastructure. The vast networks of surveillance technology, laboratories, emergency response centres and well—trained medical personnel have also helped to tackle measles, tetanus, meningitis, malaria, yellow fever and cholera. Polio staff have administered over a billion doses of Vitamin A, drastically reducing child mortality rates caused by its deficiency, freeing developing countries from a disease burden that had cost $17 billion.
Failure to act now means polio will continue to claim thousands of victims with huge human and financial costs. But renewed support will ensure no child will ever again suffer from a disease which is completely preventable.
Let’s end polio now and make history today.