Why should Australia care about ending polio?
By Ian Riseley
Every year, two to three million deaths are prevented thanks to life-saving vaccines. Childhood vaccination represents one of the best returns on investment, with net health, economic and social benefits (such as medical innovation, female empowerment, and improved health infrastructure) worth a staggering 44 times the cost of vaccination in low- and middle-income countries. On October 24th, we celebrate World Polio Day and look at polio eradication efforts, which have already reaped $27 billion of savings and spared more than 15 million people from disability. We are “this close” to making history by making polio the second human disease to be eradicated.
World Polio Day offers an opportunity to reflect on the enormous progress made toward the elimination of polio and what that progress represents for broader global public health initiatives. Australian leadership has been critical to bringing us close to the brink of polio eradication – and we have a vital role in the fight to stop it forever.
In the early twentieth century, the word ‘polio’ caused fear and panic among Australians. Thousands of children became infected with this disease each year, and many faced hospitalization, paralysis and death. Before there was a vaccine to prevent polio, the infamous iron lung was the only treatment available for people with polio-induced breathing difficulties, which are commonly associated with the early stages of the virus.
In the 1950’s, in a groundbreaking discovery, Dr Jonas Salk developed the first-ever polio vaccine. Most industrialized countries quickly implemented mass immunization campaigns, saving hundreds of thousands of lives around the world – but polio still wreaked havoc in developing countries with weak health systems and insufficient resources to buy vaccines.
That was until the then President of Rotary International, a Queensland accountant called Sir Clem Renouf, mobilized Rotary members in 1979 to support a project to immunize six million children in the Philippines against polio, and polio was ultimately eradicated in that country. Later, Rotary members raised US$247 million, and vaccinated 12 million people in Mexico and in 27 countries across South America, focusing on communities that previously did not have access to the vaccine.
One of Australia’s best-kept secrets, Sir Clem Renouf’s early leadership inspired the creation of the Global Polio Eradication Initiative (GPEI) in 1988 – combining the strengths of Rotary, UNICEF, the World Health Organization (WHO), the US Centers for Disease Control and later the Bill & Melinda Gates Foundation, with the ambitious mission to eradicate polio.
At that point, polio was endemic in 125 countries and more than 350,000 people — primarily children under the age of five — were affected by polio each year. Today, polio is 99.9% eradicated and only three countries remain polio-endemic: Nigeria, Pakistan and Afghanistan. This means 15 million people are walking today who would have otherwise been paralyzed for life. These achievements are unprecedented, marking the single biggest internationally coordinated public health project the world has ever known.
Over the years, Australia has partnered with Rotary International and the private sector to match contributions to polio eradication, and Australia’s advocacy efforts and political leadership on the global stage to end the disease have been critical.
Australia led the way at a Commonwealth Heads of Government Meeting held in Perth in 2011, pledging $50 million to the GPEI. Inspired by Australia’s example, other Commonwealth members Canada, the United Kingdom, Nigeria and Pakistan, joined by the Bill & Melinda Gates Foundation, pledged US$122 million in new funds to the initiative. That particular summit was labelled by the WHO as a “turning-point” in the effort to eradicate polio.
Then, in 2014, Australia committed US$100 million to polio eradication, which then-Prime Minister Tony Abbott announced in front of 20,000 Rotary members at their international convention in Sydney. This five year commitment has since been reduced but is still valuable.
Earlier this year, Australia’s investment in polio eradication contributed to a key milestone – the largest ever, globally-synchronised withdrawal of one vaccine and rollout of a second. Now that one of the three wild polio strains (type 2) has been eradicated, the switch, which saw the trivalent oral poliovirus vaccine (tOPV) replaced by the bivalent oral poliovirus vaccine (bOPV), will protect children against the remaining two strains. This is a critical component of the polio endgame strategy and one which was achieved in 155 countries in just two weeks.
Progress toward polio eradication is a great example of Australian foreign assistance at its best – a genuine example of us making a real impact on the world stage about which Rotary members and all Australians should be proud. Australia’s ongoing leadership is paramount to the success of the polio program. The outbreak of polio in northeastern Nigeria in July is a reminder that the poliovirus is opportunistic and will strike back given the chance: as many as 200,000 children risk becoming paralyzed over the next 10 years if momentum stalls.
Given the small average cost of a polio vaccine – only 13 Australian cents – and its enormous return on investment, the appropriate strategy is clear. Australia must continue to do its fair share to plug the US$1.5 billion shortfall that the GPEI currently faces or jeopardize efforts to eradicate polio for good. Ending polio now also prepares the world for future breakthroughs against infectious diseases, creating a legacy for global public health.
Australia’s commitment has supported more robust health systems with highly trained vaccinators, while also providing other essential health interventions such as maternal health education. It has supported cutting edge solutions to the most complex global public health challenges, including by helping to find new ways to reach the most vulnerable children, such as those in areas of insecurity. It has also empowered hundreds of thousands of women to play a leading role in that process as health workers, who take great risks to deliver the polio vaccine to millions of children.
With the programs, personnel and resources in place to eradicate polio, we have an opportunity to make history with continued resolve and political will, and to guarantee that no child will suffer again from this disease. Let’s aspire to such a future, where World Polio Day exists only to remind us of the best of what we can achieve as a global community.
Ian Riseley is President-elect of Rotary International.