In a marathon race, many competitors say the last part of the run is always the most difficult and many a runner has ‘Hit the Wall’ in the final stages. So it is with Polio eradication. Michael Zaffran, Head of Polio eradication at the World Health Organisation, expressed it well when he said ‘The last mile has proven to be the toughest phase of the polio eradication.’ On Saturday 13 July 2019, the Courier-Mail ran a front-page article titled ‘Polio Peril.’
The article talked about the plunging vaccination rates across southeast Queensland. It also gave statistics showing areas where vaccination rates had fallen and informed readers of the fact that Polio is just a plane ride away from Australia. It is hard to believe that, in Australia today, we still have people who decry vaccination and claim it is harmful. However, the reality is that vaccinations save many millions of lives – and lifestyles – every year. We, therefore, must educate people to realise the benefits of vaccination – especially against polio.
It was Nelson Mandela who said ‘education is the most powerful weapon which you can use to change the world.’ Polio is a highly infectious disease caused by a virus. It mainly affects children under 5. The World Health Organisation says that the ‘virus invades the nervous system, and can cause total paralysis in a matter of hours. The virus is transmitted by person to person spread mainly through the fecal-oral route or, less frequently, by a common vehicle (for example, contaminated water or food) and multiplies in the intestine.
Initial symptoms are fever, fatigue, headache, vomiting, stiffness of the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralysed, 5% to 10% die when their breathing muscles become immobilised.’ There is no cure for polio! However, it can be prevented by vaccination. Polio vaccine, given multiple times, can protect a child for life. Over the last 30 years, Rotary has made the eradication of Polio it’s Number One Priority.
By the end of 2018 over 99.9% of cases had been eradicated with only 33 cases reported that year. We were on a count down to complete eradication and a Polio free world. Unfortunately, the latest figures show that the wild poliovirus remains entrenched in Afghanistan and Pakistan, and in Africa, the vaccine itself is generating virulent strains (see ‘vaccine derived Polio’ below).
In Pakistan, polio health workers are often met with hostility and violence. In April 2019, fuelled by rumours on social media that children were being poisoned by the polio vaccinations, people rioted killing one polio worker and the two police officers guarding her. Likewise, the eradication program in Afghanistan is complicated due to the violence across much of the country and by the refusal of some communities to accept the vaccination programs. Last year’s vaccine-derived polio outbreak in Papua New Guinea is now under control following a massive vaccination program.
Vaccine-derived poliovirus (VDPV) is a mutated version of the weaker polio virus used in vaccinations. VDPVs are rare and happen in populations with very low vaccination rates. They develop when children who have not been vaccinated come into contact with the feces of vaccinated children. A massive vaccination program is the only way to stop VDPVs. Africa can bring this outbreak under control and thus finally realise Nelson Mandala’s edict of ‘kicking Polio out of Africa.’
So reports that polio is just a plane flight away from Australia, and indeed, Bribie, are not scaremongering. The reality is that low immunisation rates are a recipe for an outbreak and no place on earth is safe from polio until the disease is eradicated everywhere. Bill Gates (who contributes US$2 for every $1 Rotary raises to End Polio) puts it this way – ‘As long as polio threatens even one child anywhere in the world, all children — wherever they live — remain at risk. The stakes are that high.’
What can you do to help?
1. If you know an anti-vaxxer, show them photos of children with polio and urge them to have their children vaccinated immediately. Just because you live in Australia does not mean you are immune or that Polio won’t affect your loved ones.
2. Hold a Worlds Greatest Meal to End Polio (WGM). See: https://wgmeal.com/
3. Donate directly to Rotary https://www.rotary.org/en/donate
One crucial step in this quest is the need to Stop Complacency! Even some Rotarians are saying they have grown tired of the Polio campaign and are considering sending their funds elsewhere. Many have become desensitised to the campaign. We are so close to a Polio free world now is not the time to be complacent. So I encourage everyone to increase their efforts to End Polio.
Smallpox is the only disease that has been eradicated from the world. Let’s help Rotary and our partners to go down in history and make poliomyelitis the second. In June 2019 Rotary announced that it is giving US$100 million in grants to support the global effort to end polio. Of this Afghanistan will receive $16.3 million, Nigeria $10.2 million and Pakistan $25.2million. Additional funding will support efforts to keep vulnerable countries polio-free.
Michael McGovern, chair of Rotary’s International PolioPlus Committee, said that he was ‘optimistic that the end of polio is within our grasp, but we must remain vigilant in rallying global political and financial support as we push towards a poliofree world.’ We clearly have it in our hands to finish this marathon – and not “hit the wall”.
We can ensure that no child will ever be paralysed by any form of poliovirus – be it wild or vaccine-derived. If readers like me remember children from their childhood who had this horrid disease, or who have friends suffering post-polio syndrome, they will understand why we must ensure it never returns. Robert de Castella – the great marathon runner – perhaps said it best, ‘There are no shortcuts!’ We must vaccinate every child.