Financing the last tranche of polio eradication

Growing up in India, I did not have access to the polio vaccine and because of this, the disease paralyzed my legs when I was just a child. That’s why I had to undergo many surgeries and today I can’t walk without splints and crutches. My case is not the only one. When the Global Polio Eradication Initiative was established in 1988 (I was ten years old at the time), the disease paralyzed an estimated 350,000 children worldwide each year.

Thirty-four years later, immunization campaigns have nearly eradicated polio. On the other hand, unless a more extensive vaccination campaign is financed today, the risks of a resurgence of the disease are very high.

The initiative, which coordinates the efforts of frontline medical workers, communities, national authorities and international partners to help vaccinate children, has played a major role in reducing polio cases and is well on its way. to eradicate the disease forever. Since 1988, this initiative has immunized three billion children against polio and more than 20 million people who would otherwise be paralyzed can walk.

But the fight is far from over. Pakistan and Afghanistan, the two countries where polio remains endemic, have reported only five cases of wild poliovirus in 2021 and three cases since the beginning of 2022. This may sound encouraging, but the presence of polio anywhere in the world is a threat. . to children around the world and the Covid-19 pandemic has shown how quickly an infectious disease can spread around the world.

This problem has become particularly acute as efforts funded by the Polio Eradication Initiative ceased during the pandemic to transfer resources to help countries combat Covid-19. Millions of children have not been vaccinated against polio due to the suspension of vaccination campaigns and the interruption of routine immunization campaigns. As a result, around 2,000 two-year-olds have been paralyzed in the past by circulating vaccine-derived poliovirus (cVDPV2), a variant that can arise in underimmunized communities, in parts of Africa, Asia and Europe.

So while we are close to 99% polio eradication, the last curve before there are no more cases could be difficult to negotiate. That’s why the initiative launched an ambitious $4.8 billion program last World Immunization Week to help rid the world of the scourge of polio by 2026.

The strategy is dedicated to vaccinating 370 million children annually against polio over the next five years. It plans to further integrate polio immunization into general health services in communities; working with community authorities, faith-based organizations, and influencers to build trust with populations, increase vaccine uptake, counter misinformation, and improve surveillance and health interventions.

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Investing in polio eradication yields greater returns, if only through strengthening health infrastructure and regular delivery of immunizations and other integrated services in underserved communities. The polio program has saved the world from many emerging disease threats by detecting and responding to outbreaks of measles, yellow fever, and Ebola viruses.

The initiative and its partners have helped develop and deploy a next-generation oral polio vaccine, nOPV2, to help stop vaccine-derived type 2 polio outbreaks. Most notably, the highly effective surveillance network has helped coordinate public health responses to Covid-19 in 50 countries across Africa, the Middle East, and Asia. It included the administration of vaccines, the detection and follow-up of cases and contacts, as well as information campaigns about the virus.

This final five-year effort to eradicate polio, at an estimated cost of less than a billion dollars a year, must be fully funded and run to completion. The US Centers for Disease Control and Prevention warn that cutbacks in eradication efforts could cause a global polio resurgence that in 10 years could paralyze up to 200,000 children a year, thus greatly increasing the cost to defeat the disease and treat survivors. Tedros Adhanom Ghebreyesus, director general of the World Health Organization, points out that polio eradication is extremely cost-effective and could produce more than $33 billion in cost savings.

The world cannot afford to give up the fight to eliminate polio and waste more than three decades of progress. According to Niels Annen, Parliamentary State Secretary to Svenja Schulze, Germany’s Minister for Economic Cooperation and Development, “It is really crucial that all stakeholders now commit to ensuring that the new eradication strategy can be fully implemented. We can only have success if polio eradication becomes a common priority.

The world has a chance to end polio within the next five years so that no child has to suffer like I did from a disease that is totally preventable. But that won’t happen without a well-funded exit strategy.

* Minda Dentler, 2017 Aspen Institute New Voices Fellow, is a polio survivor, global health advocate, and the first female wheelchair athlete to cross the finish line at the Ironman World Championships in Kona, Hawaii.

Translated from the English by Pierre Castegnier.

© Project Syndicate, 2022.