Category Archives: End Polio

Polio – a Wake-up Call?

A Message from Keith B-J to Rotary Members in District 1200

I am sure that most of you will be aware that we now have polio epidemics in a number of countries. Fortunately the 140 wild polio cases are still confined to Afghanistan and Pakistan – partly because of the ping-pong effect of people moving backwards and forward through the Khyber Pass region between the two countries, and partly because of non-cooperation and anti-propaganda issued by the local tribal and religious leaders.

However, we also had 250 cases of vaccine-derived polio in a variety of countries because of the oral vaccine we used – nearly all type 2 virus. The oral vaccine that we have been using for years contained three live (but attenuated so that they are no longer virulent) viruses – Types 1, 2 and 3. The wild Type 2 virus has not been seen in the wild since 1999 and that is why we did the “Switch” a few years ago, changing to the bivalent vaccine – Types 1 and 3 only. However we are now reaping the results of that triple vaccine.

I met Bill Gates five years ago and his comment was “This is not about money – there is plenty available. It all depends on the political will of the leaders of the countries or communities concerned”. Wise words indeed, particularly when religious leaders tell parents that the polio vaccine causes AIDS or sterility – both guaranteed to frighten parents.

We have been saying, for over 30 years, that we are not safe until the last child has been vaccinated. When a country has roughly 85-90% coverage, the so-called herd immunity usually stops transfer of the virus. However, when immunisation level fall lower than that figure, there is an increasing risk, not only of developing polio from the wild virus, but also that the virus in the live vaccine can mutate and so cause vaccine-derived polio-. Sadly, because a number of third world countries have less than optimum immunisation levels, we now have polio epidemics in countries that have not had polio for many years. Also vaccine derived polio tends to appear in those whose general health is not as good, and who are less well nourished – again usually in the third world.

But there is perhaps a bonus because whereas we were not always believed in the past, parents and countries are now realising that, if they do fail to immunise, then they will have problems and as education improves, Mums want their children covered against polio, and other diseases. I am living in hope that it will swing back in our favour this year if people have got the message. After all, we never thought we would eradicate polio from India but the Indians were told what a disgrace it would be if they were the last country in the world with polio and they have now been clear for six years. If India can do it with its massive population and geographical challenges, then other countries can do so as well. Bill Gates was right – it is a political problem and it just needs cooperation from the top down to the grass roots level and we will rid the world of polio.

If I can help by coming to your club to talk about this, or if you have any questions, please do not hesitate to let me know.

Keith

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