Global Polio Eradication Initiative needs more innovation and funding to wipe out the disease, experts say
p> LONDON (AlertNet) - American polio survivor Ann Lee Hussey caught the vaccination bug on a trip to India nearly 11 years ago. In the capital New Delhi she saw polio-paralysed children and adults begging in the street, some on all fours, dragging their twisted legs behind them with the aid of sandals fitted on their hands.It was the smile of a nine-year-old girl she met at a polio rehabilitation centre, with a brace on her wasted right leg, that inspired Hussey to devote much of her time to helping children in developing countries avoid the crippling disease.
"It was quite traumatic to see how people live and function," she said of India’s polio sufferers. "I asked myself ‘why do we allow this to continue?’"
She has now joined 18 vaccination trips for Rotary International – a global volunteering organisation for business people – to India, Nigeria, Egypt, Mali, Niger and Bangladesh. In late November she will travel to Chad, which has seen polio cases surge this year to 114, around a quarter of all cases worldwide in 2011.
Poliomyelitis – known commonly as polio – is a highly infectious disease caused by a virus that invades the nervous system and transmitted via the faecal-oral route. It can cause irreversible paralysis in hours, mainly affecting children under five. There is no cure, but vaccination can prevent it.
Hussey, now 57, contracted polio when she was 17 months old, in Maine, during one of the largest-ever epidemics on the U.S. east coast. After being temporarily paralysed from the waist down, damaged nerves and weakened muscles left her with a shorter and smaller right leg, which remains a physical challenge.
"What keeps me going is knowing that every child that gets immunised is one child closer to the world not having this disease anymore," the veterinary technician told AlertNet in an interview ahead of World Polio Day, marked each year on October 24.
ERADICATION TARGET OFF-TRACK
Rotary International is the top private-sector contributor to a global partnership dedicated to eradicating polio – which aims to wipe out polio globally by the end of 2012.
In the late 1980s, polio was endemic in more than 125 countries, with some 350,000 cases recorded each year
Since its 1988 launch, the Global Polio Eradication Initiative (GPEI) – which also includes the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC), the Bill & Melinda Gates Foundation and the U.N. Children's Fund (UNICEF) – has reduced polio incidences by 99 percent. But the remaining 1 percent is proving tough to stamp out.
In mid-October, an independent board that monitors the GPEI's progress warned in its latest quarterly report that unless the programme addresses "fundamental problems", there is a "substantial risk" that stopping polio transmission will not be achieved by end-2012.
"Important changes in style, commitment and accountability are essential," the panel of international health experts said.
Afghanistan, India, Nigeria and Pakistan are still classified as "polio-endemic," meaning transmission has never been interrupted there. And in Angola, Chad and Democratic Republic of Congo, transmission has become re-established for 12 months or more.
Except for Angola and India, each of these countries has had more cases to date in 2011 than it had by the same time last year, according to the report, and Chad, Afghanistan and Nigeria have already exceeded their entire 2010 total.
Pakistan and Chad alone account for around half of 2011 cases globally. Polio outbreaks have also occurred in six other African nations and China this year.
India, on the other hand, is making "great progress", the report said, despite poor sanitation in urban areas and high levels of migration. The South Asian nation is judged to be on track to stop transmission by the end of 2011, thanks to strong surveillance and impressive vaccination coverage.
India undertakes well-advertised "National Immunisation Days", during which the oral vaccine reaches more than 170 million children under five over a three-day period.
But in Pakistan, the polio eradication programme is “failing" despite an emergency action plan launched by the government nine months ago, the monitoring report said.
The problem is attributed to patchy commitment among health workers and district-level leaders. Flooding and violence in parts of the country have also prevented vaccinators reaching communities.
In northern Nigeria elections have sapped momentum after good 2010 progress. And the report picked out the Horn of Africa as a potential risk area, because of cross-border polio transmission in Kenya and Uganda over the past two years and the negative ramifications of famine and violence for vaccination operations in Somalia.
FUNDING SHORTFALL
Given these obstacles, the GPEI has warned that insufficient funding at this stage would jeopardise the entire eradication effort. There are already signs tight public finances are denting donors' enthusiasm.
The initiative puts the cost of its activities for this year and next at $2.23 billion, and faces a funding gap of $535 million, according to its website.
Private philanthropic organisations, including the Gates Foundation and Rotary International, account for the largest share of funding, at close to 30 percent.
The GPEI monitoring report also criticised what it described as the global programme's cautious approach to innovative methods and vaccination technology.
The GPEI has made insufficient efforts to deal with weak leadership and poor performance, and hasn’t tried hard enough to understand why immunisation coverage is low in some places, the report said. The programme should curb its over-optimism, and start trialling new practices that could lead to breakthroughs, it added.
The chair of Rotary's International PolioPlus Committee, Robert Scott, said Rotary "concurs" with the call for more emphasis on innovation in the planning process, and its committee will meet soon to explore how it can help implement the suggestion.
Vaccinator Hussey recommends involving more survivors of the disease as ambassadors for the polio-eradication drive.
"If you have had (polio), you can give a better explanation of what the disease is, and why we need to get rid of it," she said.
(Editing by Rebekah Curtis)
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