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Ambassadors Abdul Wahab, permanent OIC observer to the United Nations, and Frederick Barton, U.S. representative to the Economic & Social Council of the U. N., speak during a panel on polio at UNICEF headquarters in New York

NEW YORK — 2 December, 2009. In a major step forward in the fight to rid the world of polio, the U.S. government and the Organization of the Islamic Conference (OIC) announced that they will be strengthening their collaboration toward eradicating the disease. Panelists speaking at UNICEF headquarters in New York City on 2 December stressed that the battle against polio may be won or lost depending on how well all sectors of society can work together, including governmental and nongovernmental agencies, and religious organizations. In the areas where polio maintains its last strongholds, misinformation and conflict continue to impede workers’ ability to vaccinate children.

The panel was organized after U.S. President Barack Obama issued a statement in June announcing "a new global effort" with the OIC to eradicate polio. Dr. Bruce Aylward, director of the Global Polio Eradication Initiative at the World Health Organization, said eradication is possible through some very simple methods, if the political will is there. “The OIC is central to the global efforts” of polio eradication, agreed Ann M. Veneman, UNICEF’s executive director.

Ambassador Abdul Wahab, permanent observer of the OIC to the United Nations, said that vaccinating children against polio is consistent with teachings in the Quran to make every possible effort to take care of children. The OIC has been on the forefront of the fight to eradicate the disease in many Muslim countries. Wahab also reported that the OIC secretary-general has helped secure funding for polio eradication and contacted the presidents of Afghanistan, Nigeria, and Pakistan to encourage them to strengthen their efforts in support of eradicating the disease. The International Islamic Fiqh Academy has issued an edict, or fatwa , about the importance of parents getting their children vaccinated against polio.

Though the disease is 99 percent eradicated, reaching children who live in areas torn apart by conflict or political upheaval has been a major hurdle. “The toughest cases always come at the end,” said Ambassador Frederick D. Barton, U.S. representative to the Economic and Social Council of the United Nations. He said that addressing the challenges of ending the disease requires trust in the Global Polio Eradication Initiative partners and confidence in the solutions offered. Barton noted that phenomenal progress has been made in the battle against polio. “[What] Rotary has done with the US$200 Million Challenge and the leadership it has shown for the past decades is remarkable,” he said.

Past RI President James L. Lacy, chair of Rotary International’s Polio Eradication Task Force for the United States, said Rotarians who remember what it was like to fear polio will do whatever it takes to end it. “We have to keep pressing ahead. And it takes every one of us to do what we can.” The panel’s moderator, Dr. William Foege, senior fellow of the Bill & Melinda Gates Foundation’s Global Health Program, said Rotary's work will be remembered in history, but the job needs to be finished. “They won’t thank us at all for starting it, but they will thank us for ending it,” he said. “No one should suffer from a disease that’s completely preventable for a few pennies of vaccine,” said Lacy. Polio eradication will be “our everlasting gift to the world. It’s a promise Rotary intends to keep.”

Afghanistan-Pakistan shelters boost end-polio effort

15 December, 2009, Kabul - A new vaccine against polio will be used for the first time today in polio immunization campaigns in Afghanistan. The bivalent oral polio vaccine (bOPV), recommended by the Advisory Committee on Poliomyelitis Eradication, the global technical advisory body of the Global Polio Eradication Initiative as a critical tool to eradicate polio, can provide the optimal concurrent protection needed by young children against both surviving serotypes (types 1 and 3) of the paralysing virus. This will vastly simplify the logistics of vaccination in the conflict-affected parts of this country. This sub-national immunization campaign, from 15-17 December, will deliver bOPV to 2.8 million children under five in the Southern, South-Eastern and Eastern Regions of Afghanistan.

Of the three wild polioviruses (known as types 1, 2 and 3), type 2 has not been seen anywhere in the world since 1999. This achievement led to the development of monovalent vaccines, which provide protection against a single type with greater efficacy than the traditional trivalent vaccine. To determine whether a bivalent vaccine could effectively protect children living in areas where both types circulate, a clinical field trial completed in June 2009 compared bOPV with the existing vaccines. For both types 1 and 3 polio, bOPV was found to be at least 30% more effective than the trivalent vaccine and almost as good as the monovalent vaccines, yet in a package that could deliver both at once. The bOPV allows countries to simplify vaccine logistics and to optimize protection using a mix of the available polio vaccines according to local needs. In southern Afghanistan, where access to children can be limited depending on the security situation, using bOPV helps maximise the impact of each contact with a child.

Most of Afghanistan is polio-free: 28 out of the 31 children paralysed by polio this year come from 13 highly insecure districts (of 329 districts in the country). In 2009, polio eradication efforts in Afghanistan have focused on improving operations and creating a safe environment for vaccination teams. Nongovernmental agencies have been contracted and local leaders involved to ensure that parties in conflict are approached, safe passage for vaccinators assured and children reached. Due to such preparations and strengthened supervision and staffing, the proportion of the nearly 1.2 million children under five years old in the Southern Region who could not be reached was reduced from more than 20% in early 2009, down to 5% during the July and September 2009 campaigns. The availability of bOPV multiplies the effect of such improvements. However, in the 13 highest-risk districts of Kandahar and Helmand provinces in the Southern Region, the proportion of children who are still unimmunized is well above 20% - and more than 60% in some areas.

Four countries in the world have never stopped polio transmission - Afghanistan, India, Nigeria and Pakistan. Types 1 and 3 polio circulate in limited parts of all these countries, and the others will follow Afghanistan's lead in using bOPV during the coming months, marking the adoption of a major new tool in the international effort to eradicate polio. While the Global Polio Eradication Initiative, a public-private partnership leading the effort, has reduced the incidence of polio by more than 99% (from an estimated 1000 children affected daily in 1988 to 1483 children in all of 2009 to date) polio still has a foothold in the four endemic countries. The consequences are severe beyond those areas: 16 previously polio-free countries are currently suffering outbreaks following importations of the virus; in four of these, polio transmission has lasted more than a year.

The availability of bOPV is part of a range of new and area-specific tactics in 2009 to reach eradication more quickly. The swift production of the vaccine was the result of extraordinary collaboration between the World Health Organization, UNICEF, vaccine manufacturers and regulatory agencies. The vaccination campaign in Afghanistan is financed by the Government of Canada, the second-highest per capita donor to the Global Polio Eradication Initiative with US$260 million in contributions. Canada, which assumes presidency of the G8 in 2010, first placed polio on the group's agenda when it last held the presidency in 2002. The G8 is the single-largest donor bloc to polio eradication.
The Global Polio Eradication Initiative is spearheaded by the World Health Organization, Rotary International, the US Centers for Disease Control and Prevention and UNICEF. For more information on the polio eradication effort and how to support it, visit rotary.org/endpolio

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