In the fifth blog in our World Immunization Week series, Jim Calverley, Parliamentary Advocacy Officer (Child Health) at RESULTS UK discusses the prospects of eradicating polio.
Until a few short months ago, I was a solicitor, working in a busy London law firm. I knew very little about polio but I did know that I had been immunised against it as a child. That is apt because this highly infectious, viral disease mainly affects children under the age of 5. Whilst the majority of infected children do not exhibit symptoms of the disease, 1 in 200 cases leads to irreversible paralysis. Of those, about 5 to 10% will die from the disease due to their breathing muscles becoming immobilised.
I have since left the law and in the time that I have been at RESULTS UK, I have learnt a good deal more about polio. I have learnt that there is in fact good news which is this: polio can be eradicated given its inability to survive for long periods outside the human body. It is therefore feasible that polio could become only the second disease in history (after smallpox) to be eradicated from the face of the earth. On any level, that would be a staggering achievement.
The disease has been reduced by more than 99% from an estimated 350,000 cases in 1988. Nigeria, Pakistan and Afghanistan remain the last three endemic polio countries. The last reported case in Nigeria was on 24 July 2015 and there is real hope that an important landmark can be achieved with Nigeria (and by extension, Africa) remaining polio-free for a year. Against all the odds, India was certified polio-free in 2011 – an achievement which must continue to galvanise the rest of the international community to achieve global polio-free status.
Paradoxically, the frequently adopted position that ‘one final push’ is all that is required to eradicate polio actually makes it difficult for stakeholders to talk frankly about the challenges of eradication. That it is within sight should not detract from the fact that the remaining 1% will be the most difficult to achieve.
The alternative to eradication is bleak. As long as a single child remains infected with polio, children in all countries are at risk and the failure to eradicate polio could result in as many as 200,000 cases every year, within 10 years, all over the world. The human (and treatment) costs of such an outcome are such that it is more cost-effective and logical to focus on the benefits of investing in the eradication of Polio. Leaving aside for one moment the human cost, eradication makes financial sense as it is estimated that the world economy will benefit by $50 billion over 20 years from eradication. Furthermore, in reaching the poorest and most marginalized in society, the eradication of polio contributes to breaking the poverty cycle: a healthy population will progress further in school and have a reduced reliance on the health system and. It will also be more proactive and help to avert economic productivity losses as it progresses into adulthood.
Polio-funded infrastructure will also leave an essential legacy for global disease surveillance. Indeed, the polio surveillance systems in Nigeria played a significant part in what was widely considered to be a hugely successful response to Ebola. Investment in vaccinations are universally accepted as being a highly cost-efficient way of tackling Polio (and many other life-threatening and debilitating diseases) and that investment makes all the more sense when one considers that the costs of responding to a global Polio epidemic may well be akin to the costs of responding to Ebola.
Britain is a global leader in polio eradication efforts and has already helped vaccinate 200 million children since 2009. I am proud that the UK is going to fund the vaccination of up to 360 million children against polio between 2013 and 2018. The suffering that will be averted by ensuring all children receive polio vaccines is barely imaginable and I hope that the example set by the UK Government will encourage the UK’s international counterparts to prioritise making polio a disease of the past.