A valuable goal scored against polio

The Bill and Melinda Gates Foundation recently marked up a valuable goal in the fight against polio by obtaining the support of the FC Barcelona Club and its foundation in the final battle to eradicate polio from the face of the Earth. We know very well that the objective is achievable, since we succeeded in reaching it in the Americas in 1991. I had the great pleasure of being present in Washington, D.C., along with the Deputy Director of our Organization, Jon Andrus, to witness the formal commitment of Bill Gates, Josep Guardiola, and Andrés Iniesta, as well as my compatriot Lionel Messi and many others, to this struggle. As I have pointed out repeatedly, public health requires and generates a grand partnership among myriad actors from all fields. This partnership to fight polio is exciting, since the Barcelona players can no doubt be immensely helpful in raising awareness and promoting the commitment needed for the home stretch in eradicating polio.

A great deal of progress has been made in two decades, from victory in the Americas in 1991 to success in most of the world’s countries today.

[ This little Peruvian boy (pictured above) is Luis Fermín Tenoria. Luis was the last child in the Americas to be paralysed by indigenous wild poliovirus, first showing symptoms of the disease on 5 September 1991. ]

This year, polio has cropped up only in 14 countries, and there are but four in which it has never been possible to halt transmission of the disease: Pakistan, Afghanistan, India, and Nigeria. Thanks to unflagging vaccination campaigns, the number of cases has been reduced by 99%. But the presence of polio, even with so few cases, continues to be a risk for all, since as long as the disease persists in some enclaves, it can spread to other countries. Hence, the final phase in the fight against polio is not only a difficult challenge that, when successfully met, will prevent unnecessary suffering, but a public health action with global benefits. Therefore, we particularly value the commitment of the FC Barcelona Club, the Gates Foundation, and the many other stakeholders involved, such as Rotary International, to working alongside organizations such as ours, whose efforts are devoted to international health.

In the worldwide eradication of a disease, the final phase is vitally important and beneficial to all. That is why I have repeatedly—and most recently in a letter to Mr. Gates, following the announcement that I am now commenting on—stressed the commitment of the Pan American Health Organization to providing technical support to several African countries in this decisive phase of the fight against polio. The innovative strategies that led to success in the Americas, and the lessons learned in the course of that effort, have been, and continue to be, highly useful in the fight against polio.

Some of the lessons learned during polio eradication in the Americas are worth mentioning:

• The effort was an initiative of, by, and among the countries, whose progress toward the goal aroused passion and commitment. They knew that the goal only made epidemiological sense if reached simultaneously in all the countries. A risk to any was a risk to all. The countries supported each other and shared their human and financial resources, creativity, and frustrations, and 20 years after reaching the goal, are proud to continue polio-free.

• An entire generation of workers committed itself to the effort and grew with it. Epidemiologists, pediatricians, journalists, nurses, politicians, community workers, mayors, people from the private sector, workers’ cooperatives, rural dwellers and farmers, lay midwives, public transportation companies, and nongovernmental organizations were among those participating. Little by little, the community adopted a culture of prevention.

• The contribution of communities and the work of volunteers made the difference in reaching remote and hard-to-reach populations. Community leaders brought scattered populations together on the day vaccination teams arrived. Rotary Club members provided vehicles, served as drivers for vaccination brigades, and also took the responsibility of ensuring that there would be food for the work day. The effort was an example of social mobilization unprecedented in the recent history of public health in the Hemisphere.

• The commitment of all of society made the difference in confronting challenges that seemed extremely difficult to overcome, such as access to populations touched by armed conflict. Days of calm in the midst of civil wars, negotiated in high political circles, were agreed to and observed by combatants, their families, and the communities that supported the parties in conflict. Battles were suspended to make way for vaccination, and vaccinators were on many occasions guided and protected as they travelled over roads planted with mines.

• Progress such as that seen today in India show that obstacles that only six months ago seemed insurmountable can be overcome and that doors can be opened to a new way of thinking aimed at consolidating and maintaining achievements.

• The Interagency Coordinating Committees operated in each country and at the regional level. Thus, interagency cooperation mobilized resources and adjusted their allocation in response to periodic meetings held by the Ministries of Health.

• In the effort to eradicate polio, the countries made maps or sketches of each of their municipalities, ascertained how many children were born annually in their national territories, learned to program visits to communities to provide vaccination as well as oral rehydration solution, vitamins, antiparasitics, medical consultations, and drugs, in addition to conducting health education in the communities visited. In other words, there were wide-ranging public health benefits, reaching well beyond the original goal.

[ Meeting of the Commission for Polio Containment Certification. 04-05 March, 2010. © Office of the Director/PAHO ]

Polio eradication in the Americas also is a reminder of the critical role of vaccination for the well-being of our societies.

Their low cost in comparison with providing an entire lifetime of major individual and social benefits (a single dose of oral polio vaccine costs only US$0.13) makes them one of the most beneficial investments. We are also proud to see the enormous success of Vaccination Week in the Americas, which it is about to celebrate its tenth year, and hope that 2012 will see it become World Vaccination Week—but that is a subject for another blog. For now, suffice it to say that the contribution of the FC Barcelona players and coach will also help raise awareness about vaccination’s key role in preserving the health of all.

There can be no doubt that by joining the fight against polio, FC Barcelona and the Gates Foundation have scored a valuable goal on the field of public health—one for which all of us, regardless of what team we root for, must cheer!

More information:

• 20 Years without Polio in the Americas
• Immunization Newsletter April 2010: Americas Successfully Complete Phase 1 of Polio Containment
• PAHO Poliomyelitis WebPage