A polio-free world
Feb 29,2008 00:00 by The San Diego Union-Tribune

Despite all the best intentions, all the necessary knowledge and tools and a ton of money, some things are just very hard to do. Like ridding the world of polio.

In the 53 years since Dr. Jonas Salk announced the development of a safe and effective killed-virus injectable vaccine, followed six years later by Dr. Albert Sabin's live-virus oral vaccine, the disease has essentially been eradicated in the United States. There have been no new infections of "wild virus" polio in this country since 1979. A small handful of people each year contracted the disease from the Sabin vaccine itself, but there have been none of those since the government changed policy back to the killed-virus vaccine in 2000.

For much of the rest of the world, it was a different story. Three decades after Salk's historic achievement, polio was still paralyzing more than 350,000 people in 125 countries every year - 1,000 children virtually every day.

Then, in 1988, the World Health Organization, Rotary International, the U.S. Centers for Disease Control and Prevention and UNICEF launched the Global Polio Eradication Initiative. Its goal was to eliminate polio everywhere on the planet by 2000.

The initiative became the single-largest internationally coordinated public health project the world had ever seen. And it has made enormous progress, with more than 2 billion children immunized thanks to the cooperation of some 200 countries, 20 million volunteers and more than $5 billion.

But polio is still with us.

The numbers are, mercifully, drastically reduced from those of 20 years ago. There were 1,299 confirmed new cases of wild-virus polio infection worldwide in 2007. All but 104 of those were in the four remaining endemic nations of Afghanistan, India, Nigeria and Pakistan.

The eradication effort continues. The Bill & Melinda Gates Foundation, which already gave $50 million to the cause in 1999, announced two months ago that it was contributing another $100 million. Dr. Margaret Chan, WHO's director-general, called it "precisely the catalyst we need to finish polio."

Sadly, however, other health experts are now not so sure that the elusive goal of complete eradication is even possible.

According to a Washington Post article, these experts say the continued use of the live-virus oral vaccine is resulting in about 7 percent of all polio cases worldwide. To eliminate the virus completely, it is said, will require health officials to stop all use of the oral vaccine.

Easier and more cheaply said than done. The oral vaccine costs only 15 cents per dose, compared with $2.70 per dose for the Salk vaccine, with two injections required.

Polio will be with us a while longer. Some things are just very hard to do.

Reprinted from The San Diego Union-Tribune.