Tuesday, February 8, 2011

Polio Eradication—The Elusive 1%

In a recent Rotary meeting, there was a short briefing on the subject of Polio Eradication, which is one of the long-term projects of Rotary International.

In most countries of the world today, polio cases are very rarely seen. So most people don't really know a lot about the disease. But polio was one of the most dreaded childhood diseases in the 20th century. Polio epidemics have crippled thousands of people in the past.

After the development of the polio vaccines in the 1950s, the global number of polio cases had been reduced from the hundreds of thousands to about a thousand per year. Although polio has been declared officially eradicated in most countries today, the disease can very quickly spread from countries where the disease is still endemic. And because of the efficiency of transport these days, e.g. air travels, the possibility of an epidemic is not exactly very remote. That is why the only way to be sure is by total eradication of the disease via vaccination.

Unlike the HIV drug-cocktails, the polio vaccines are relatively cheap and easy to administer. The World Health Organisation, UNICEF, Rotary International and many other organisations have been working very hard to raise resources for the Polio Eradication project. Because of the availability and effectiveness of the polio vaccines, and considering that we are presently fast approaching 100% of our goal, it seems like it's just a matter of time that polio will be totally eradicated. In fact, it should happen very, very soon too!

But the reality is that polio is still present in some countries. As of 2006 polio remains endemic in four countries: Nigeria, India, Pakistan and Afghanistan, and there are good reasons to believe that polio is also endemic in nearby countries due to reestablished transmissions.

One might wonder why not simply send a whole bunch of medical professionals into these countries to administer the vaccines and eradicate polio once and for all and get it over with?

Three main reasons why the seemingly simple solution to eradicate polio is not so simple after all. Firstly, insufficient infrastructures and facilities for the delivery and administration of the vaccines to the target groups. Secondly, the ongoing wars and fightings in some countries which have prevented the vaccination campaigns. Thirdly, recent opposition to vaccination campaigns have evolved—somehow, there is fear that the vaccine might induce sterility.

Looking at the second and third reasons above, it is very tempting to just let all these people die of polio, since they're refusing help from the rest of the world anyway. But the truth of the matter is that for as long as polio is endemic in these few countries, there is always that possibility that it will spread to the rest of the world. So whether we like it or not, we will have to keep fighting the disease for as long as it takes.

It can be seen that in a perfect world, where the human race can work together to fight the disease, we can very easily beat it. But alas, it is not in our nature to work together. Polio is 99% eradicated, but it's that 1% that is keeping us all on our toes still.

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