More attacks and polio cases harm Pakistan’s eradication effort | 

Pakistani security officials and relatives of tribal police assigned to guard polio workers who were killed in bomb blasts, pray next to the bodies during their funeral, near Peshawar.
Pakistani security officials and relatives of tribal police assigned to guard polio workers who were killed in bomb blasts, pray next to the bodies during their funeral, near Peshawar.
AP Photo/Mohammad Sajjad

The year is young, but Pakistan has already endured a serious of setbacks in riding itself of polio. Two new cases were confirmed over the weekend in Peshwar. Meanwhile, a bomb attack on a polio vaccination team left 11 dead and 12 wounded.

The fight against polio has been far more literal than figurative. Since December 2012, more than 40 people working with or for polio vaccination in Pakistan have died. The increase in cases of polio from 58 in 2012 to 91 in 2013 is attributed to the poor vaccine coverage in the country. Attacks on vaccine workers has only made it harder to reach young people.

Police vehicles carrying officers meant to protect polio vaccine workers were struck by a bomb on Saturday. A second bomb went off a few minutes later, when a new convoy was sent in response to the first attack. A firefight ensued between the surviving officers and the unknown gunmen.

“An Attack on security personnel providing security to Polio Teams is an attack against Humanity,” said the Prime Minister’s Focal Person on Polio, Aysha Raza Farooq, in a Facebook post following the attacks. “Such coward attacks and conspiracies against our goal of Polio Free Pakistan will further strengthen our resolve to stamp this menace out of the country.”

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Polio is a proxy for chaos | 

polio vaccine

Sanofi Pasteur

The polio virus, as it is frustratingly inclined to do, has rebounded again despite the ongoing, determined effort aimed at worldwide eradication.

Like the game whack-a-mole, polio is popping up again in locations that we thought had gotten rid of it for good – like Israel or eastern Europe.

This happens because the virus is good at cloaking itself, sickening only about 10 percent of those infected and spreading primarily due to poor sanitation or hygiene (i.e., the highly unappetizing path of transmission known as the ‘oral-fecal’ route). But that’s the purely epidemiological, health-focused explanation.

The main driver, arguably, for the recent surge polio cases is conflict, instability and, of course, ongoing poverty. Continue reading

We must end polio – if only so Bill Gates can talk about something else | 

That sounds flip. But it’s not meant to undermine the global campaign to eradicate polio or (continue to) irritate the media folks at the Gates Foundation. It’s meant to underline the frustration I assume Bill Gates and many other advocates of this important global health goal must feel, even if they don’t say so.

News analysis (of sorts)

Today, at the United Nations, Bill Gates, heads of state from the polio-plagued countries Pakistan, Nigeria and Afghanistan, the head of the UN, the fiesty chief of the World Health Organization and other ‘global luminaries’ today repeated the call to push on with the ongoing effort to rid the world of polio.

UN Secretary-General Ban Ki-moon said that the world is at a decisive moment and that he has made polio a “top priority” for his second term.

“Failure to eradicate polio would be unforgivable…. Failure is not an option,” said Dr. Margaret Chan, Director-General of the World Health Organization. India was recently declared polio free, a major achievement for the campaign.

Gates Foundation

Bill Gates and Jeff Raikes in Nigeria for polio vaccination

“The evidence is clear: if we all do our part, we can and will end this disease. But we must act quickly and give ourselves the very best chance to succeed,” said Gates, who had earlier explained on his personal blog why he flew 3,000 miles to speak for three minutes at this somewhat predictable event. “When we defeat polio, it will motivate us to aim for other great health and development milestones.”

Yeah, yeah. Same old stuff. But that last statement by Gates is key.

Chances are, this particular dog-and-pony show among all the other UN dog-and-pony shows — despite the alleged luminaries — may get only passing notice because, well, most people don’t really care about polio. That’s why they bring out luminaries – to get you to pay attention.

(NOTE: The first news report I saw on this gathering of luminosity was an AP story in which the reporter at the polio event asked Gates what he thinks of the new Windows 8 operating system. Gates said, “Very exciting.” No word if the journalist asked about polio….) Continue reading

Endangered species: Guinea worm | 

Mike Urban,

A woman in Nigeria endures the painful extraction of Guinea worm

A flurry of reports lately have celebrated the potential end of one of the world’s most horrific human parasites, the Guinea worm. Here’s the latest such from The Guardian:

Guinea worm disease is reaching the end of its days. The parasitic infection, which has sickened millions, mostly in Asia and Africa, is on the verge of being done in not by sophisticated medicine but by aggressive public health efforts in some of the poorest and most remote parts of the world.

I’ve reported on this disease for many years and seen people afflicted by it – including the last Nigerian known to have had the parasite. You become a host to Guinea worm from drinking contaminated water, which allows it to eat its way through your body over a year’s time – as it grows to several feet in length.

It doesn’t kill you, but its painful course through your body might make you wish were dead.

Some might think this an interesting but minor accomplishment given the other health needs of the developing world, but it’s more important than it appears. The elimination of Guinea worm from poor farming communities in Africa and Asia translates into more productive communities, not to mention the broader benefit of improved water quality. And it was largely done through educating people on a shoestring budget, mostly led by the Carter Center, rather than using some new vaccine or drug.

Guinea worm looks to be the second human disease, after smallpox, to get wiped off the planet (followed soon — or perhaps preceded — by polio, many hope). This is a great accomplishment. For those who aren’t so sure, those who want to preserve the balance of nature and respect all life, here’s a place for you — Save the Guinea Worm Foundation

A(nother) polio emergency, perhaps the final one | 


Child receives polio vaccine

The world is close to eradicating polio but this infectious disease has a tendency — like the whack-a-mole game — to pop up just when you think you’ve got it put down.

The polio eradication campaign has been quite successful, getting rid of endemic polio in all but three countries: Nigeria, Afghanistan and Pakistan. But due to major increases in polio lately in these three countries, and some spill-over exportation of the disease into neighboring countries, the World Health Organization today officially declared a polio emergency. Continue reading

India marks one year without polio, inches toward eradication goal line | 


Child receives polio vaccine

India will have made it one year, as of Friday, without a reported case of polio — a milestone everyone in the global health community is celebrating.

Except for maybe all those skeptics who say, or said, polio will never be eradicated.

The goal here is a world completely without polio, of course, since if this infectious disease exists anywhere it can spread everywhere — as China recently discovered.

But this accomplishment by India, which not that long ago had the world’s lion share of polio cases, does a lot to get us closer to the day when this crippling, sometimes deadly, disease is eradicated.

I’ve seen the ravages of polio in poor countries and, back in 2003 when I was a reporter for the Seattle PI, traveled to parts of India where the polio cases were exploding and reported on the country’s difficulties trying to rid itself of this infectious disease.

It may sound a simple enough goal to vaccinate all kids against polio, but it’s not. I can attest to how complex and challenging it has been — because of the nature of this disease, the lack of health care resources in the countries most in need and the various forms of political opposition that can emerge to obstruct what might seem to many an obvious good.

India’s not out of the woods yet and the disease remains entrenched in three countries, Afghanistan, Pakistan and Nigeria. But the fact that India appears to have completely rid itself of this disease is evidence that the global campaign to eradicate polio is that much closer to reality.

Indian health officials deserve a lot of credit for reaching this milestone, but credit for getting us where we are today should go first to Rotary International — which for decades has sustained the global vaccination effort against all odds (and lots of skepticism) — and then to organizations like UNICEF, the World Health Organization and, lately, the Bill & Melinda Gates Foundation.

The Gates Foundation has thrown a lot of money at this effort over the last ten years or so. Both Bill Gates and his father Bill Sr. also have been outspoken public champions of polio eradication — even to the point of apparently finally winning over the world’s leading polio eradication skeptic D.A. Henderson.

Here’s Bill Gates’ celebrating India’s achievement on Huffington Post

Other news stories of note:

Globe and Mail: How India conquered polio

Washington Post: Polio focus leaves other diseases behind

Reuters: India’s victory fuels endgame vaccine talks

Scientific American: India on track to be declared polio free


Which four diseases face total eradication? Bill Foege predicts extension of smallpox success | 

by Tom Paulson

Bill Foege

Smallpox was, until today, the only disease that had ever been eradicated from the planet.

The United Nations today declared that rinderpest, a cattle disease that when prevalent had profound adverse impact on humanity, is now the second disease to have been eradicated.

Bill Foege, one of our local boys made good, is a big fan of disease eradication.

Foege is the world-renowned physician who figured out the strategy that succeeded in wiping out smallpox. He is featured in an interview on disease eradication on PRI’s The World today “How to Kill a KIller Disease.”

Here’s a story I did almost a year ago about Foege on the 30th anniversary of the eradication of smallpox. You may notice that PRI used the same photo — a photo I took of Bill in Colville, Eastern Washington, where he grew up.

Foege, a former chief of the U.S. Centers for Disease Control and now a senior adviser to the Bill & Melinda Gates Foundation, has written a fascinating book on the global campaign to eradicate smallpox called “House on Fire.” On PRI, he predicted that four more diseases will be eradicated soon.

“I think maybe six diseases will be eradicated before I die,” said Foege, listing the next four as polio, guinea worm, measles and onchocerciasis (river blindness). What about malaria?

“Malaria may take a little longer … but we need to try to eradicate malaria and I’m very optimistic about it,” he said.

Before Bill Gates became a polio warrior, there was Ezra and the Rotarians | 

Gates Foundation

Celebrating Rotary's commitment to polio eradication, a display on the north side of the new Gates Foundation campus

For the record, Bill Gates couldn’t have become the world’s leading advocate for polio eradication if not for people like Ezra Teshome. People who wear sprockets on their heads.


I hung out on Wednesday night with a small gang of Seattle Rotarians, including Ezra and Bill Gates Sr., who had braved the winter storm warning (of, yeah, that dusting of snow) to celebrate Rotary’s 106th anniversary and its decades of commitment to seeing polio wiped off the face of the planet. Continue reading