The laser focus by health authorities around the world on COVID-19, coupled with the vaccine hesitancy rising during the pandemic, is clouding the outlook to finish the long-overdue task of polio eradication around the world.
More than 100 Rotarians and guests from six countries joined a Midtown Atlanta Rotary Club Zoom call Tuesday, two days after World Polio Day Oct. 24, to hear experts from the Decatur-based Task Force for Global Health discuss last-mile efforts to eliminate globally the paralytic virus that was last recorded in the U.S. in 1979.
For all the progress over the six decades since the disease was filling entire American hospital wards with patients fitted in iron-lung machines, the experts emphasized a refrain that has become familiar during the COVID-19 pandemic: no one is completely safe until everyone in the world is inoculated.
But vaccination has become a sticking point in countries where the virus remains a threat, partially because almost all of the active polio cases in 35 countries globally are vaccine-derived.
Only two cases of “wild” polio have been recorded all this year — one each in Afghanistan and Pakistan — while other cases from Iran to Ethiopia to Senegal happen when the weakened live virus in an oral vaccine reverts back to its paralytic state in children whose immune system doesn’t mount a sufficient response.
The risk of such vaccine-derived polio is small when weighed against the benefits of saving an estimated 1.5 million lives and untold suffering since a global push for eradication began in 1988, a time when 350,000 wild cases and 35,000 deaths annually in 125 countries.
But even odds of one spillover case in 4-5 million doses have inspired efforts toward an even safer oral vaccine that is unable to revert. The Task Force’s polio initiative is supporting that effort, as well as helping develop and distribute antivirals to those with weakened immune systems who threaten to spread vaccine-derived polio. Rotary International has a long-held commitment to working with nonprofits like The Task Force toward eradicating polio.
On the ground in Senegal, veteran polio fighter Fabien Diomande said anti-vaccination misinformation around COVID-19 has been affecting people’s willingness to take up other life-saving vaccines. The focus on the highly transmissible respiratory virus is also crowding out other public health priorities like polio, which is on the back burner at the moment.
“The countries are facing so many public health priorities, and on top of them there is COVID-19. The governments cannot neglect that, so COVID-19 is drawing all the attention first — funds and human resources,” said Dr. Diomande, Task Force polio surge capacity team director, who has seen inoculation campaigns succeed in places like Nigeria even in the face of vehement anti-vaccine sentiment.
The seeming disappearance of polio, as viewed from the Western world, threatens to lead to complacency, said Dave Ross, president and CEO at the Task Force, which has been working on polio eradication for 20 years, overseeing responsible containment of viral samples. as well as lending surge capacity to countries in need of outbreak response. Teams are now deployed in eight African countries.
“When public health is maximally effective you don’t see a problem, and it makes it very hard for people to invest in something they don’t see,” Dr. Ross said, calling on Rotarians to use their influence in business to remind leaders how terrible the disease is and how important it is to stamp out that remaining 0.4 percent of cases.
Walter Orenstein, a professor at the Emory University School of Medicine, similarly asked those on the call to help build the political will needed to invest in a problem that might seem far-off to Americans, many of whom may not even know polio still exists.
He appealed to American self-interest, noting that an outbreak is one unvaccinated child away.
“This will resurge if we don’t finish the job,” Dr. Orenstein said.
One remaining factor complicating the work is the security challenge of working in the areas of Afghanistan and Pakistan where the virus is still endemic.
Having taken over Afghanistan amid the U.S. withdrawal after 20 years of war, the ruling Taliban agreed days ago to allow the United Nations to resume its door-to-door polio vaccination campaign for kids under 5 for the first time since 2018.
Learn more about Rotary International’s longstanding commitment and contributions to ending polio here.
Learn how the Decatur-based Task Force for Global Health combats the disease at https://taskforce.org/polio.