Polio eradication shifts into emergency mode

Although this child in Chad has been immunized against polio, others in the central African nation -- and those everywhere -- remain vulnerable to the disease until it is eradicated worldwide. Photo by Jean-Marc Giboux
Despite the dramatic drop in polio cases in the last year, the threat of continued transmission due to funding and immunization gaps has driven the Global Polio Eradication Initiative (GPEI) to launch the Global Polio Emergency Action Plan 2012-13.

The plan aims to boost vaccination coverage in the three remaining polio-endemic countries -- Nigeria, Pakistan, and Afghanistan -- to levels needed to stop polio transmission. Health ministers meeting at the World Health Assembly in Geneva adopted a resolution on 25 May that declared “the completion of polio eradication to be a programmatic emergency for global public health.”
Polio eradication activities have resulted in several landmark successes since 2010. India, long regarded as the nation facing the greatest challenges to eradication, was removed from the list of polio-endemic countries by the World Health Organization (WHO) in February. Outbreaks in previously polio-free countries were nearly all stopped.

During that same time span, however, polio outbreaks in China and West Africa due to importation from Pakistan and Nigeria, respectively, have highlighted the continued threat of resurgence. Failure to eradicate the disease could lead within a decade to paralysis of as many as 200,000 children per year worldwide.
“Polio eradication is at a tipping point between success and failure,” says Dr. Margaret Chan, director-general of WHO. “We are in emergency mode to tip it towards success -- working faster and better, focusing on the areas where children are most vulnerable.”

Eradicating polio would generate net benefits of US$40-50 billion globally by 2035, with the bulk of savings in the poorest countries, based on investments made since the GPEI was formed, savings from reduced treatment costs, and gains in productivity.

“We know polio can be eradicated, and our success in India proves it,” says Rotary International President Kalyan Banerjee. “It is now a question of political and societal will. Do we choose to deliver a polio-free world to future generations, or do we choose to allow 55 cases this year to turn into 200,000 children paralyzed for life, every single year?”

Global emergency action plan
The GPEI’s emergency action plan was developed in coordination with new national emergency plans. The plan builds on India’s success and outlines a range of new strategies and initiatives to better support polio eradication efforts, including:
• Intensified focus on the worst-performing areas of Nigeria, Pakistan, and Afghanistan to increase vaccination coverage by the end of 2012 to levels needed to stop transmission
• New approaches tailored to each country to tackle persistent challenges and improve polio vaccination campaign performance
• Heightened accountability, coordination, and oversight to ensure success at every level of government and within every partner agency and organization
• A surge of technical assistance and social mobilization capacity

Full funding of new plan critical
Already, funding shortages have forced the GPEI to cancel or scale back critical immunization activities in 24 high-risk countries, leaving more children vulnerable to the disease and polio-free countries exposed to the risk of reintroduced transmission.
“All our efforts are at risk until all children are fully immunized against polio -- and that means fully funding the global eradication effort and reaching the children we have not yet reached,” says UNICEF Executive Director Anthony Lake. “We have come so far in the battle against this crippling disease. We can now make history -- or later be condemned by history for failing.”
Full implementation of the emergency action plan is hindered by a funding gap of nearly $1 billion through 2013.
“We are all responsible for creating a polio-free world while we still can,” says Chris Elias, president of global development at the Bill & Melinda Gates Foundation. “Achieving this goal is a critical step in protecting all children from vaccine-preventable diseases.”

Working in emergency mode
Since the start of 2012, the GPEI has moved its operations into emergency mode. The U.S. Centers for Disease Control and Prevention (CDC) has activated its Emergency Operations Center, UNICEF has officially activated an Interdivisional Emergency Coordinating Committee operating directly under the deputy executive director, and WHO has moved its polio operations to its Strategic Health Operations Centre.
Such measures are reserved for responding to global health emergencies, such as the H1N1 pandemic and the 2004 Indian Ocean tsunami -- and will generate a massive surge in technical capacity, real-time tracking of program performance, and immediate implementation of corrective action plans as necessary. In March, The Rotary Foundation Trustees reaffirmed that polio eradication is the Foundation’s urgent priority. In addition, Rotary senior leaders have launched a series of one-on-one meetings with the heads of state of the polio-endemic countries.

“We need everyone’s commitment and hard work to eradicate polio and cross the finish line,” says Dr. Thomas Frieden, director of CDC. “It won’t be easy, but together we can eradicate polio forever and for everyone.”

Philanthropist commits another US$1 million to Rotary’s push to end polio

R ajashree Birla, of the Aditya Birla Group, has committed an additional US$1 million to The Rotary Foundation for polio eradication efforts.

Rajashree Birla, of India’s Aditya Birla Group industrial conglomerate, has committed an additional US$1 million to The Rotary Foundation for polio eradication efforts. Birla announced the donation on 8 May at the Arch C. Klumph Society dinner during the 2012 RI Convention in Bangkok, Thailand. Birla’s contributions to the Foundation’s campaign now total more than $6.2 million.

Birla, of Mumbai, announced the donation on 8 May at the Arch C. Klumph Society dinner during the 2012 RI Convention in Bangkok, Thailand. Birla’s contributions to the Foundation’s campaign to eradicate polio, including this commitment, total more than $6.2 million.

Birla’s late husband, Aditya, made the Aditya Birla Group into a Fortune 500 company and one of the largest in India. Today, her son, Kumar Mangalam, is chairman of the board, and she serves as a director.
“Mrs. Birla’s presence at the convention, not just for her program segment but all four days, showed the regard she has for Rotary. She is magnanimity, dignity, compassion, humility and tranquility personified,” said RI President Kalyan Banerjee. “It is not just the additional one million dollars she gave for Polio eradication but the grace and absolute commitment she reflects we admire and respect her for.”

Past RI President Rajendra K. Saboo added that Birla's actions are the embodiment of goodness. “She is not just a generous philanthropist but seeks financial support from others and hands-on serves to get the drops in the mouths of children,” Saboo said. “That is what makes her a 'Hero of Humanity.’ ”

“Aditya Birla was one of India’s foremost industrialists and an active philanthropist,” said Rotary Foundation Trustee Chair William B. Boyd in introducing Rajashree Birla at the convention. “His widow has continued this work through the family’s foundation, introducing education and health care initiatives that improve the lives of underserved populations in rural India. The Birla family is a staunch supporter of the End Polio Now campaign and has contributed generously to [Rotary’s] US$200 Million Challenge fund.”
Birla’s contribution to the Foundation comes during India’s breakthrough year in its fight to be polio-free. The

World Health Organization (WHO) removed India from the list of polio-endemic countries in February, after the country hadn’t reported a case of polio since January 2011. To be certified polio-free, India must go until February 2014 without another case of the disease. Continued support is needed to ensure that India and other countries remain polio-free and to stop transmission of the disease in the three remaining polio-endemic countries, Afghanistan, Nigeria, and Pakistan.

Birla, addressing the convention on 7 May, said, “Based on the success of Rotary International’s initiatives in India — coupled, of course, with the admirable backing of the government’s health departments and institutions like WHO, UNICEF , CDC , and the Gates Foundation — the day is not far off for us to envisage the elimination of polio in the other three countries where unfortunately its traces remain.”
She added, “We owe it to ourselves and to humanity at large to ensure that in these three countries as well, polio becomes an affliction of the past.”

An honorary member of the Rotary clubs of Bombay and Mulund, Birla also stressed the need for business accountability and community service. Her Giving to Living campaign encourages corporations to “embed giving into their DNA.” “When a corporation pushes its energies and helps resolve social sector issues through its engagement, it indirectly stimulates its own business development,” Birla said. “There is much to be gained when business leaders take giving to heart, and set the mandate of making a difference by caring for people in their community.”

Polio eradication milestones celebrated

A laser light show dazzled Rotarians at RI’s 2012 Convention in Bangkok, Thailand, in May, in celebration of two recent milestones in the decades-long fight to eradicate polio worldwide: India's removal from the list of polio-endemic countries and surpassing the goal in Rotary's fundraising challenge. Read more.

RISING TO THE CHALLENGE
Rotary's US$200 Million Challenge totals*
US$223.4M
*As of 25 June 2012
Polio Facts & Figures
Area Number of cases in 2012
Afghanistan 8
Nigeria 45
Pakistan 22
Non-endemic countries 3
Total worldwide 78
(Data as of 20 June/World Health Organization)