Aiming for Extinction: Polio in the Cross Hairs

With the development of a vaccine and a subsequent concerted effort starting in the 1950s, naturally occurring polio was all but eliminated in industrialized countries by the late 1960s. However, for developing countries, the elimination of polio as a public health concern has been a much longer exercise. Started in the 1970s and formalized in 1988, the efforts to eradicate polio worldwide are still under way, but the disease has been eliminated in most of the 125 countries it originally afflicted. However, pushing this disease to extinction is proving to be a much more difficult undertaking.

Polio or Poliomyelitis is a viral disease that has accompanied mankind through the ages and has the ability to infect an entire population. The disease spreads easy in areas with poor hygiene and contamination of water and food supplies. For those that develop polio, 1% will experience permanent nerve damage and paralysis that can show itself within hours. The paralysis can affect can any nerves in the body causing an inability to move particular muscles, limbs or in more severe cases preventing breathing and thus causing death. In the early 20th century, polio was dreaded for the sheer numbers of individuals that it crippled.

By 2005, polio had been eliminated in all but 4 countries: Afghanistan, India, Nigeria and Pakistan. However, between 2004 and 2006, the disease escaped several times to countries such as Indonesia, Saudi Arabia, Somalia and Yemen causing a need for emergency outbreak handling to once again drive the scourge from these reinfected countries. Now, four years later, with many more escapes of the virus, the situation has deteriorated considerably.

As of April 8th, 2009, 15 countries in Africa have been confirmed with cases of polio. Prior to this most recent outbreak, some of these countries had been polio free for more than 10 years. While the prey may have been in the cross hairs 4 years ago, the Global Polio Eradication Initiative (GPEI) of the World Health Organization (WHO) now has significant efforts ahead of it simply to avoid losing 20 years of effort in fighting the disease.

As a continuous source of polio infections in the African continent, Nigeria has never achieved a state where transmission has been halted within the country. In 2008, 82% of worldwide polio cases occurred in Nigeria. As the most populated country in Africa, with a 2005 population of 141 million people of which 48% are under the age of 15, the difficulty of eradicating polio within the country is understandable. Add to this a 2003 controversy over the safety of the oral polio vaccine and the problem becomes more difficult as many in the population still do not trust the vaccines despite Nigerian officials confirming its safety.

However, all is not lost, but massive efforts by many world governments and organizations are required to regain the ground lost against polio. One assistant in the fight is a new form of polio vaccine that is 4 times as effective as previous vaccines in preventing infection. However, this vaccine or any other will do little if it cannot be delivered to the vast majority of children susceptible to infection.

To that end, notable contributors such as software billionaire Bill Gates have contributed funding to vaccination programs largely funded by worlds governments. The Red Cross has plans to coordinate delivery of vaccines to 42 million children within Nigeria in the month of May following the 41 million intended across Africa in April. The intent of all these efforts is to once again find polio within the cross hairs to set it up for eradication.

Having once pushed the disease to the brink of extinction, we must encourage our leaders to do it again. However we must keep in mind that conflicts such as those in Darfur in Sudan make the task exceedingly difficult so helping to solve these political and social problems is important in getting a chance to eliminate the disease once and for all.

Do you think that eliminating polio is something we can foresee within 5 or 10 years? Is the WHO fooling itself thinking that the eradication is even possible? Does Africa have too many problems that will make the elimination of the disease an impossible task?

Related Links:

http://www.polioeradication.org/disease.asp

http://en.wikipedia.org/wiki/Polio

http://www.unicef.org/media/media_18981.html

http://www.medicalnewstoday.com/articles/35184.php

http://appablog.wordpress.com/2009/04/08/polio-outbreak-in-14-african-countries-prompts-ifrc-emergency-appeal/

http://www.medicalnewstoday.com/articles/147340.php

http://en.wikipedia.org/wiki/Demographics_of_Nigeria

http://www.independent.co.uk/news/science/nigerian-vaccine-scare-threatens-plan-to-eradicate-polio-733175.html

http://www.globalissues.org/news/2009/02/14/624

http://www.medicalnewstoday.com/articles/125609.php

http://www.afrol.com/articles/23338