Final push in polio battle

Africa has been declared polio-free, and thanks to valiant efforts the world may be next.

An Afghan health worker administers a polio vaccine in Kandahar. Afghanistan and Pakistan are the only two countries where polio remains endemic, crippling hundreds of children every year. Muhammed Sadiq / EPA
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The most significant thing about the awards presented to five Heroes of Polio Eradication is not that the ceremony was held in Abu Dhabi on Sunday, nor that they are backed by the world's richest man through the Bill and Melinda Gates Foundation.

It is the hope that in the near future they will never need to be awarded again.

Two years into a six-year plan to eradicate a disease that once killed and maimed children in their tens of thousands, it remains endemic in only two countries – Pakistan and Afghanistan.

Only three days ago, the World Health Organisation announced that polio was no longer endemic in Nigeria, paving the way for it to become the final African nation to be declared officially polio free in 2017.

If the same can be achieved in Pakistan and Afghanistan, then polio will join smallpox and the once deadly cattle disease rinderpest as plagues now consigned to history.

This, however, is no small task. The Heroes awards honour those in the front line of the fight against polio, a battle in which the deadliest aspect is not always the disease. In the past two years, the Taliban have killed more than 70 people engaged in vaccination programmes.

Despite these difficulties, this is a war that is being won. In its latest report, published in October, the Global Polio Eradication Initiative (GPEI)noted that: “The number of cases of polio that have occurred so far in 2015 is at its lowest point in history.”

Even with the dangers of working in regions where transmission continues the GPEI remains optimistic, noting the possibility of declaring the world officially free of polio by 2019.

Two things are needed for this to happen. One is the tireless efforts of health workers in the affected areas, journeying into remote villages and communities, often in conditions of great danger from an enemy that seeks to portray them as western spies carrying out a US conspiracy to sterilise ordinary Muslims.

Resistance to the vaccine means many parents refuse to allow it to be administered to their children.

The second essential component for success is money.

Since 2013 the eradication initiative, whose partners include the Gates Foundation and the UAE, has received pledges of US$4 billion (Dh14.69bn) to complete its work.

Since then more than 86 million vaccines have been distributed in Pakistan. In one of the worst affected areas, immunisers have gone door-to-door in 53 areas of Pakistan’s Khyber Pakhtunkhwa province dispensing vaccines to children under the age of 5.

In Afghanistan, where the disease is thankfully less prevalent, UAE-funded health workers carry out the same work.

Without their determination and courage the battle against polio would falter and could possible be lost.

Despite being completely preventable with a vaccine developed more than 60 years ago, polio has proved to be remarkably resilient. It thrives in wars and breakdowns of society witnessed in several parts of the world in recent years.

Most often spread by contaminated food and water, it is known to have existed for thousands of years but was only formally identified at the end of the 19th century.

In adults it can kill up to one in three and while the mortality rate is lower in children, its long-term effects can be devastating, leaving its victims crippled for the rest of their lives.

The turmoil of Afghanistan and parts of Pakistan has created the last breeding group.

Of the 359 cases of wild polio identified last year, 334 were found in those two countries, with the vast majority in Pakistan.

But while fewer than 20 instances were recorded elsewhere, and all a result of the disease being imported, they included countries such as Syria, Iraq and Somalia – all highly unstable places.

Last week, the WHO asked for a state of emergency to be declared in Ukraine, the scene of fighting between the government and Russian-backed separatists.

The reason for this was a diagnosis in south-west Ukraine of two cases of polio in children, which were also the first instances of the disease in Europe in five years.

If the countries where polio is still endemic are not helped properly, the WHO estimates that within a decade there could be 200,000 new cases every year, worldwide.

The situation would have been much worse without the Global Polio Eradication Initiative and the contribution of the UAE and the Gates Foundation.

Previously, says Dr Jay Wenger, who leads the foundation’s campaign, efforts to wipe out the disease “lived hand-to-mouth, year to year with funding and that crimps the ability to do important things you need to do”.

“We’re on the verge,” Dr Wenger says. “The foundation sees this as a great opportunity to finish the job and give a gift to humanity of basically forever getting rid of this thing.”

The extent of the heroism required to “finish the job” was revealed in last year’s documentary, Every Last Child, funded by Abu Dhabi’s Image Nation.

The film documented the battle against polio through the eyes of five people, including vaccinator Gulnaz Shesazi, a team leader earning just $1 a day, whose niece and sister-in-law had been killed by the Taliban.

Director Tom Roberts was moved by Ms Shesazi’s reaction.

“Her response was not to say, ‘I’m going to walk away from this’. It was to recruit other members of her family and recommit herself to the polio campaign.

“She spoke out publicly and her family were threatened. But she was determined to do this right.”

To understand that this is a war worth fighting – against ignorance and disease – all that is needed is a quick look at the statistics. In 1988, when the GPEI began its work, nearly 1,000 children were paralysed by polio every day.

Thanks to donors such as the UAE and the Gates Foundation, the number of cases each year has dwindled by 99.9 per cent.

It has been estimated that perhaps 13 million people are walking today who would otherwise be crippled.

Finishing the job and ending polio will require another $1.5bn and the continuing support of the GPEI’s benefactors – and, as yesterday’s awards demonstrate, quite a few heroes.