- Pakistani policemen stand guard as a health worker administers a polio vaccine in Karachi, Pakistan, March, 2014.
This week, the World Health Organization certified that India and Southeast Asia was ‘polio free.’
Significant progress has been made against this crippling disease, with 80 percent of the planet now free from polio thanks to an aggressive global vaccination campaign largely led for decades by WHO, UNICEF, Rotary International and more recently supported – both financially and from the bully pulpit – by the Bill & Melinda Gates Foundation.
There is indeed cause for celebration, but also alarm.
- 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.”
- A Pakistani health worker, left gives a polio vaccine to a child, who was displaced with his family from Pakistan’s tribal areas due to fighting between the Taliban and the army.
- AP Photo/Muhammed Muheisen
Consecutive days of attacks on polio vaccination workers in Pakistan renewed concerns about its eradication. At least ten people were killed during attacks on Tuesday and Wednesday, this week. Despite that, Changing public attitudes by Taliban leaders may indicate a coming decrease in attacks.
Gunmen on motorcycles opened fire on a vaccination team in the city of Karachi, killing three members and injuring two. The following day, a police van carrying guards for vaccine workers was bombed in the northwest. At least seven people were killed as a result, including one child, said local police.
The police said that it will continue to provide security support for vaccine workers in the region. While neighboring India celebrated three years polio-free, Pakistan saw polio cases nearly double in 2013 to 91 cases. The northwest of Pakistan has struggled with reported cases of polio caused, in part, by the difficult circumstances facing vaccine campaigns. The Taliban have been a strong opponent to vaccines, citing fears of spying and harming children.
UNICEF estimates that 32 polio health workers have been killed across Pakistan since the middle of 2012. Continue reading
- Dengue is spreading globally
Taken in isolation, the news reports that polio appears to have returned to Syria for the first time since the late 1990s, that dengue and yellow fever is showing up across the southern United States and that Texas has had its worst year ever for West Nile virus all seem like separate disease outbreaks.
And they are. But taken together, they should also serve as a reminder that disease, especially infectious disease, doesn’t spread independent of human behavior – and bad behavior on the other side of the planet can kill here.
- Child receives polio vaccine
If polio is confirmed in Syria, most would agree it’s legit to blame this on the disruption in public health services due to the civil war.
The rise of dengue and yellow fever in Los Angeles or Dallas is sometimes attributed to warming temperatures due to climate change, which it may be, but the spread of these ‘tropical diseases’ out of the tropics is also just as likely the result of growing global urbanization (the mosquitoes that carry these bugs seem to like cities), long-distance travel and ineffective disease control measures. Continue reading
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
Public health emergencies arise around the world on a regular basis.
Humanitarian and aid organizations need to act quickly, but they need money to get work done. An emergency appeal for millions, if not billions, of dollars can take time to fulfil.
So what if the money was already available? With the money in place, an organization can respond to an emergency immediately.
The International Finance Facility for Immunisation Company (IFFIm) does just that for the GAVI Alliance, a public-private global health organization that increases access to immunizations in poor countries by working with governments, donors and the private sector.
IFFIm sells bonds to private investors in order to raise money for GAVI’s vaccine work. When GAVI needs money a request is made to IFFIm’s board to disburse the needed funds. For vaccines, a health solution that requires early action, gaining access to needed funding quickly has a big impact on programs like the eradication of polio.
“Having predictable, long-term funding in place will help us ensure that the world’s most vulnerable children have access to healthcare, and that is a critical step in achieving the goal of ending extreme poverty by 2030,” said Jim Yong Kim, President of the World Bank.
Two more polio vaccine workers were shot dead in northwest Pakistan on Sunday. It is the latest attack on polio eradication efforts in Pakistan that extends back to a series of attacks at the end of 2012. The BBC cites 17 polio vaccine worker deaths in the past few months.
Polio is down, but not out in Pakistan. 35 cases of polio were recorded in Pakistan last year. Vaccines play a key role in eradicating polio. The lack of security in Pakistan and uncertain safety for vaccine workers means an estimated 240,000 children have missed polio vaccines, says the UN. Continue reading
A shot at life
The benefit of expanding the use of vaccines worldwide seems like a no-brainer: A cheap and easy way to stop disease dead in its tracks.
Yet polio persists despite a massive global campaign. The crippling disease is back in the Horn of Africa and new violence against vaccinators in Pakistan prompted the World Health Organization to again suspend its polio immunization work there.
The ups and downs of the polio campaign is a cause for concern to those seeking to eradicate this disease. But it isn’t just polio vaccines, or vaccinators, in poor countries that are targeted. There’s a disturbing synchronicity among vaccine opponents – whether it’s the Pakistani Taliban, Nigerian Islamists or Seattle granola heads. Seattle, in addition to being an epicenter for global health, is also known for having the lowest rate of child vaccination for any US city.
Part of the problem may be that a vaccine’s benefit is invisible on the individual level – lack of death and disease. Perhaps another reason vaccines are so frequently targeted for boycotts is the contagion of scientific illiteracy. Continue reading