Fear, suspicion hinder battle against polio
LONDON/PESHAWAR –When Bill Gates hears about children like Fahad Usman, a two-yearold Pakistani boy crippled by polio before he learned to walk, the billionaire philanthropist sounds frustrated and fired up.
Fear and suspicion have prevented thousands of children like Fahad from being protected against the infectious and incurable disease. Now more than ever, it’s time that stopped, Gates says.
Rumours that polio immunization campaigns are “Western plots to sterilize Muslims” or that the vaccine is “George Bush’s urine” underline the need to take politics out of the fight to eradicate polio, he says.
If Gates, the most influential of global health advocates, gets his wish — and in an interview he’s pretty sure he will — the world won’t stop at the 99 per cent reduction in cases so far, but will rid itself of polio completely by 2018.
Yet evidence from Pakistan and Afghanistan, two of only three countries where polio is still endemic, suggests a battle lies ahead to overcome Taliban opposition, vaccine refusals, security and funding gaps to beat out that last one per cent.
“We are working hard to depoliticize the whole thing,” said Gates, whose $35-billion Gates Foundation is spearheading international efforts to eradicate the disease.
“In no way should this campaign be associated with just the West,” he said. “This is the whole world working together to eradicate a disease.”
Polio attacks the central nervous system and can cause permanent paralysis within hours of infection. Two-yearold Fahad is one of 35 children struck down with it in Pakistan so far this year.
“Fahad’s left leg went completely limp, and slowly, in a day or so, his right leg was gone too,” his father says.
There is no cure for polio, but it can be prevented. A polio vaccine given in several doses can protect a child for life.
The most recent case in Pakistan was recorded on Aug. 30, and because polio spreads from person to person, the World Health Organization says as long as any child remains infected, children everywhere are at risk. Afghanistan and Nigeria have recorded 17 and 88 cases so far this year respectively, while Chad, a nonendemic country that borders Nigeria, has had five.
Gates and experts at the Global Polio Eradication Initiative insist the $2 billion a year needed now will be well worth it. They say if the campaign succeeds, the world would not only declare its second eradicated disease — smallpox was wiped out in 1979 — it would also be billions of dollars richer. A 2010 study found that if polio transmission were to be stopped by 2015, the net benefit from reduced treatment costs and productivity gains would be $40 billion to $50 billion by 2035.
Yet getting the pink drops of protective vaccine into every child — over 90 per cent coverage is needed to succeed in wiping out this highly infectious disease — is complex.
Immunization campaigns have been disrupted by fighting along the Afghan-Pakistan border where villages are home to many of the children missed so far. Senior Taliban commanders, Maulvi Raza Shah and Sirajuddin Ahmad, say they oppose polio vaccines because they don’t know what is in them and believe they are part of a plot by the West to sterilize Muslims.
“Every drug has a known formula, but polio vaccine has no formula. And then the United States and its allies are giving us this vaccine free of cost when they don’t even give free water to their own people,” said Raza Shah.
At his temporary home in Jalozai, a sea of refugee tents where the family now lives with others displaced by violence, Fahad’s father Mohammed Usman talks of the tragic consequences of such cultural and religious clashes. He says it breaks his heart every time he sees his son struggle to stand.
“It’s very painful for me to hold him, to know that he will not be able to walk. Every time his mother looks at him she has pain in her eyes,” he says.
It was fighting, not fear, that prevented Fahad from being immunized. Teams could not reach his home near the border with Afghanistan.
“We have a lot of pockets we have not reached for years,” said Elias Durry, who co-ordinates the WHO’s polio eradication drive in Pakistan.
Experts say if the eradication effort fails and polio rebounds, the virus could cause up to 10 million cases in the next 40 years. The human and economic costs of that would go way beyond the $9 billion invested so far in trying to wipe it out. At this point, though, there is an almost $1 billion shortfall in funding for the fight against polio, according to the independent monitoring board’s report.
At the United Nations General Assembly in New York this week, Gates held talks with the presidents of Pakistan, Nigeria and Afghanistan, as well as senior officials from Australia, the United States, Britain, Japan and Canada.
At the same meeting, the president of the Islamic Development Bank announced a loan agreement for $227 million to cover Pakistan’s polio eradication costs. The bank also gave a $3 million grant to Afghanistan.
Gates describes this meeting of so many key players in the bid to end polio as a “great evolution.”
“We’ve got the Islamic Development Bank coming in, we’ve got ongoing commitment from Abu Dhabi, and we’ll have people from both those donors going out to Pakistan to talk about how committed they are and how important this is,” he said.