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Polio Eradication or control?
Although cases of polio are reportedly at an all-time low worldwide, the disease remains endemic in Nigeria and there have been recent new outbreaks in a few other African countries, prompting fresh calls for an increase in efforts to help eradicate the disease once and for all. But the recent outbreaks have also reignited debate about whether a polio-free world through eradication is possible at all, or whether controlling the spread of the disease is more effective. Reports Muzondwasi Banda.
A
ccording to the Centre for Disease Control (CDC), polio remains a substantial cause of disability in polio-endemic countries, like Nigeria in Africa,
and Afghanistan, India and Pakistan in Asia. In the past three years, 14 additional countries have reported cases as a result of importations. In Africa these include Angola, Burkina Faso, Benin, Central African Republic, Chad, Côte d’Ivoire, the Democratic Republic of Congo, Ghana, Ethiopia, Mali, Niger, Sudan, and Togo. The CDC and other proponents, argue
that until polio is eradicated in every country, it remains a threat to children in polio-free countries. This view is shared by director-general
of the World Health Organisation Dr Margaret Chan. “We have a window of opportunity now, with cases at an all-time low. But if there is polio anywhere we are at risk of polio everywhere. Only eradication will ensure that polio does not re-emerge as a global threat,” she said at the January 2011 World Economic Forum (WEF) in Davos, where British Prime Minister David Cameron and the Bill and Melinda Gates Foundation (BMGF) announced new commitments to eradicating polio. “I passionately believe that we have
a once-in-a-lifetime opportunity to rid the world of the evil of polio,” stated the British premier. “We have the vaccines and the tools to
do it. All that’s missing is real and sustained political will to see this effort through to the end. We have come so far in eradicating polio. We are so close to delivering a polio- free world for all our children. Let’s finish the job. And let’s eradicate polio once-and- for-all,” he said.
70 | March 2011 New African With a polio funding gap of close to
$720m, the UK pledged it would double its support to the Global Polio Eradication Initiative (GPEI) over the next two years to £40m, to help fully vaccinate an additional 45 million children. Meanwhile Bill Gates announced that the BMGF will commit an additional $102m to help stamp out the disease. But the new funding news and the
expected mass immunisation programme in Africa scheduled to start this April are issues that have rekindled the debate over which of the two – control or eradication – will remove the burden of polio most effectively in Africa. Pro-control proponents have for
years questioned the overall goal of polio eradication, arguing that a lot of money has already been spent on elimination programmes, but the disease still remains a threat and refuses to completely disappear. In a recent New York Times (NYT)
report, Bill Gates’ efforts came under heavy attack from a number of polio-eradication sceptics, including Dr Donald Henderson, the former WHO officer who categorically believes that polio cannot be eradicated. His view was supported by Richard Horton, editor of the influential British medical journal The Lancet, who the NYT quotes as saying: “Bill Gates’ obsession with polio is
distorting priorities in other critical BMGF areas. Global health does not depend on polio eradication.” Another critic, Arthur L. Caplan,
director of the University of Pennsylvania bioethics centre, who himself spent nine months in hospital with polio as a child, told the NYT: “We ought to admit that the
Above: A child in DR Congo receives polio vaccination, which costs as little as 60 US cents
best we can achieve is control.” But responding to these criticisms,
the general secretary of Rotary International, Ed Futa, did not mince his words either: “Those who want to end the
eradication effort, in favour of controlling this crippling disease, are wrong, both morally and economically. The control approach allows an ‘acceptable’ number of children to suffer from a vaccine- preventable disease. Most of the victims will be the children of already hard-pressed families in developing countries. Who has the right to decide whose children are crippled for life and in what numbers? Eradication will also save money in the long run: more than $40bn, according to a recent study by Kid Risk, Inc. At stake is the $9bn already spent on the Global Polio Eradication Initiative.” He added: “Members of Rotary Clubs
worldwide have worked hard for more than 25 years to end polio, contributing more than $1bn and countless volunteer hours. Total eradication, not control, must remain our goal.” Those who believe polio can be
eradicated question the motive of those who oppose the idea, citing how countries like the US eliminated the disease decades ago, due to concerted efforts and mass administration of the polio vaccine. Why can’t the same happen in Africa?
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