A “key problem” in reaching the goal of polio elimination “may well be that organizers of the global anti-polio initiative, and of other global health programs, are not listening to the people they want to help — or to each other,” Thomas Abraham, an associate professor in the Journalism and Media Studies Center at the University of Hong Kong, writes in a New York Times opinion piece. “As a result, in many communities targeted by [polio immunization] programs, people perceive a gulf between global programs like polio eradication and more immediate local health needs,” he continues, adding, “It is cold comfort to save a child from polio if the child later succumbs to malaria or diarrhea from dirty drinking water.”
The Washington Post reports on polio eradication efforts in Pakistan, writing, “[O]verall trends in Pakistan, where nearly 30 million children have been vaccinated in recent years, are encouraging.” The newspaper writes, “Last year’s cases numbered 198 nationwide,” adding, “This year’s tally is 54.” However, “the intractability of other social ills, including insurgency, poverty, illiteracy and inadequate sanitation, have conspired to ensure that the country remains years away from meeting its goal of polio eradication by the dawn of 2013,” the newspaper notes. The Washington Post discusses a number of challenges to vaccination efforts, such as a Taliban ban on vaccinations and fear among some parents that “the drops contain religiously proscribed (‘non-halal’) ingredients or are part of a Western plot to spread infertility and limit Muslim population growth.” The newspaper adds, “One key to reducing outbreaks, U.N. health workers say, is to educate parents” (Leiby, 11/16).
“The number of polio cases worldwide reached a record low in 2012, giving experts confidence that the disease can finally be eradicated, according to presentations made at” the annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH) in Atlanta on Tuesday, Agence France-Presse reports (11/13). “The number of polio cases around the world that have been reported this year as of October dropped to 177, down from 502 cases as of October 2011,” and “for the first time ever, no new cases were reported in previously unaffected countries, meaning the geographic spread of polio has slowed,” the Los Angeles Times’ “Booster Shots” blog writes (Bardin, 11/13).
NPR’s “Shots” blog reports on an update about the polio situation in Nigeria, published Thursday in the CDC’s latest issue of Morbidity and Mortality Weekly Report (MMWR), writing, “Despite beefed-up efforts to vaccinate kids and a flood of new resources, … [t]here have been twice as many polio cases as last year, and a few communities, where kids chronically miss vaccines, are serving as ‘sanctuaries’ for the poliovirus, giving it a place to replicate and survive” (Doucleff, 11/8). “Ninety-nine new cases of polio have been reported in Nigeria in 2012 so far — more than in the rest of the world combined, according to the Global Polio Eradication Initiative,” GlobalPost notes, adding, “[W]hile the rest of the world celebrates the near-extinction of the disease, health officials warn the rise of polio in Nigeria this year could lead to a surge in other countries” (Murdock, 11/9). Although “[m]ore kids have been vaccinated this year compared to 2011, and health workers are now using modern satellite tools to track vaccinators and target kids who often get overlooked,” the “Shots” blog notes, “If the virus isn’t stopped in these communities by the middle of next year, the authors [of the MMWR update] call for ‘additional innovative vaccination strategies to interrupt all WPV (Wild Polio Virus) transmission’ in Nigeria” (11/8).
“Look in the global strategies for HIV, [tuberculosis (TB)], malaria, maternal and child health, polio eradication, [neglected tropical diseases (NTDs)], and [non-communicable disease (NCDs)] — among many others — and you’ll see Nigeria at or near the top of the ‘Must Win’ countries,” Todd Summers, a senior adviser at the Center for Strategic & International Studies’ (CSIS) Global Health Policy Center, writes in the CSIS “Smart Global Health” blog. “Home to 170 million people, many of them desperately poor, Nigeria carries a huge and disproportionate share of burden for many of the world’s most deadly diseases,” he writes, noting the country, “one of the most important countries for all three diseases, is losing more in revenues than all of the Global Fund’s annual contributions combined.” He continues, “So, somehow, the Nigerian government needs to do a better job of capturing the revenues it’s due, and channeling a greater percentage of that revenue to the urgent health needs of its citizens, but that doesn’t seem to be happening.” However, Summers concludes “there’s some good news to report” on overall governance in the country, and he provides some examples (11/8).
“Polio will never be eradicated in Pakistan until a way is found to persuade poor Pashtuns to embrace the vaccine, according to a study released by the World Health Organization” in its November bulletin, the New York Times reports. A survey of 1,017 parents of young children living in “Karachi, Pakistan’s largest city and the only big city in the world where polio persists, … found that 41 percent had never heard of polio and 11 percent refused to vaccinate their children against it,” according to the newspaper. Some parents from poor families “cited lack of permission from family elders,” Anita Zaidi, a professor at the Aga Khan University in Karachi, said, adding some wealthy parents said the vaccine was “harmful or unnecessary,” the newspaper notes. “Pashtuns account for 75 percent of Pakistan’s polio cases even though they are only 15 percent of the population,” the newspaper adds, noting poorer children are at a higher risk because they are more likely to be exposed to raw sewage, where the virus travels. According to the New York Times, “the eradication drive is recruiting Pashtuns as vaccinators and asking prominent religious leaders from various sects to make videos endorsing the vaccine” (McNeil, 11/5).
“Afghanistan is taking steps to improve its routine immunization coverage, after a drop in coverage led to a sharp increase in measles outbreaks last year, killing more than 300 children,” IRIN reports. “Experts say nearly 30 percent of the population has no or very poor access to primary health care, including immunization, and the percentage is estimated to be as high as 70 percent in areas of conflict in the south,” the news service writes, adding “decreasing vaccination coverage [is] due to rising insecurity, decreased access, difficult terrain and harsh winters,” as well as last year’s severe drought. “In the National Priority Programmes, which outline government priorities until 2015, the government admits many vaccinators lack initial training, and that budget shortages in past years prevented supervisory and monitoring visits by provincial level management teams,” IRIN states, adding that the WHO this year has implemented training programs and, along with UNICEF and the Ministry of Health, has combined the measles and polio vaccination campaigns to better utilize resources (11/1).
While there is “much to be proud of” in the progress in the fight against polio, “there’s still more work to be done,” former Canadian Prime Minister Paul Martin writes in a GlobalPost opinion piece. Martin, a polio survivor, notes that in 1988, when the Global Polio Eradication Initiative was launched, 350,000 cases in more than 125 countries were recorded annually, but “[s]o far this year, we’ve seen just 171 cases, and only Pakistan, Afghanistan and Nigeria have never stopped transmission.” He continues, “Canada has been a leader in this fight,” but “[t]he credit for this progress, of course, goes far beyond Canada” to “the work of global partners like the World Health Organization, UNICEF, Rotary International and the Bill & Melinda Gates Foundation; the frontline workers whose tireless efforts make all of this possible; and the countries that are making the political and financial commitments necessary to see the end of this disease.”
“The world is on the verge of a great success story: the eradication of polio,” John Hewko, CEO and general secretary of Rotary International, and Jeffrey Sachs, director of the Earth Institute at Columbia University and special adviser to U.N. Secretary-General Ban Ki-Moon, write in the Huffington Post’s “Global Motherhood” blog. But “[t]here is still ground to cover,” they continue. “Even though the current cases of polio transmission number less than 200 so far this year, the case for finishing the job — getting to zero — is more crucial than ever,” they write, adding, “If polio is fully eradicated, it can’t ever return. On the other hand, if even a few cases persist, and the world lets its guard down, those few cases could become the start of a new epidemic.”
In its ongoing series examining efforts to eradicate polio, NPR health editor Joe Neel and Jason Beaubien, a global health and development correspondent for the news service, on Thursday spoke with “Talk of the Nation” host Neil Conan about obstacles to stamping out polio in the three countries where the disease persists — Afghanistan, Pakistan, and Nigeria. According to the transcript, they discuss how “[o]bstacles in each country, including religious extremism, difficult terrain and transient populations, make eradication efforts difficult” (10/25).