Gates foundation, Rotary give anti-polio battle a $200 mn
John Donnelly, feedback@livemint.com
The nearly two-decade-old global effort to eradicate polio, now in a difficult endgame stage in trying to eliminate the last places where the virus still paralyses children, received a major financial boost on Monday with a $200 million (nearly Rs792 crore) commitment from the Bill & Melinda Gates Foundation and Rotary International.
The donation, while hailed by global health officials as a major step, still leaves a substantial funding gap over the next two years. It also comes at a time when several scientists have raised new concerns about whether the strategy to wipe out polio was the correct one.
The Gates foundation gave $100 million to Rotary, which pledged to match the grant from club member donations over the next three years. Rotary officials said on Monday that it will transfer the Gates money to the World Health Organization (WHO) and the United Nations Childrens Fund (Unicef) next year for use in polio immunization campaigns. In the last 15 years, Rotary has donated more than $600 million to fight polio, and thousands of its members have volunteered in campaigns.
Speaking to reporters, Dr Robert Scott, chairman of Rotary Foundation, said of the Gates foundations grant, $100 million (in donation) takes our breath away… The job is 99% completed. But the polio cases representing the final 1% are the most costly.
Bill Gates Sr, co-chairman of the Gates foundation, said polio eradication was an achievable goal, adding that he hoped the grant would challenge governments to make good on earlier commitments to fund the programme.
WHO officials have estimated eradication efforts will cost nearly $1.3 billion in the next two years, a staggering amount considering that the wild polio virus is transmitted in four countriesNigeria, India, Pakistan, and Afghanistanand that 735 cases have been reported this year.
The health organization said that even with the Gates grant and Rotarys commitment, the programme is challenged by a $650 million shortfall in the next two years.
The US, Germany and Russia have fulfilled pledges to fight polio and Japan was close to meeting its promise. But WHO officials said the UK, Canada and France have lagged far beyond on their pledges.
The polio eradication programme has made impressive gains recently, reducing by more than half the number of cases globally this year, compared with 2006; cutting Nigerias cases to almost a quarter of last years numbers; and knocking out polio type Ithe most virulent form of the diseasein highly populated areas of Uttar Pradesh.
The crowded urban environment in the state, coupled with high rates of childhood diarrhoea, make it such a difficult place to fight polio that if the polio virus was to pick its last stand, its Alamo, so to speak, it would head for Uttar Pradesh, said Bruce Aylward, director of WHOs polio eradication initiative.
But the campaigns switch to a vaccine that targets only polio type I has yielded strong results.
But the announcement earlier this year that roughly 75 children in Nigeria contracted polio from the oral vaccine sent a chill through many public health specialists and renewed doubts of some whether polio could ever be eradicated. Some called for the eventual switch to using the injectable polio vaccine, now used in the US and many countries in the West.
The injectable vaccine cannot transmit polio; cases of vaccine-acquired polio from the oral vaccine are extremely rare, but children who are infected this way can transmit it to others. The oral polio vaccine has one major advantage, especially in the developing worldit costs about ¢16 (about Rs6) a dose, compared with $2.75 for the injectable vaccine.
Still, said Ellie Ehrenfeld, a polio researcher at the National Institutes of Health (NIH), while the oral vaccine was just the right thing to do to bring us almost to the end, it is incompatible with the eradication of polio wild virus. We need to change the endgame strategyby switching back to to the injectable polio vaccine. Aylward disagrees. He said the current tactics will end polio and that greater use of the injectable vaccine was still a couple of years off. The issue was taken up on Tuesday and will be discussed on Wednesday in Geneva as the WHO convenes a group of polio specialists.
©2007/The Boston Globe