1. Polio: Where Are We Now… After 30 Years of Dedication and Hard Work?
Prepared for
Chester Rotary Club
November 6, 2018

2. This Is Polio A virus, not a bacterium 3 strains; only one now active
Highly infectious; affects mostly children less than 5 yrs. old
Spreads though bodily secretions and feces
Attacks nerves in the spinal cord

3. This Is Polio (con’t)
Interrupts flow of impulses, causing death or paralysis
“Iron lung”, a treatment
that saved some
But no cure. Irreversible paralysis.
Prevention the only answer

4. What Viruses Remain? Of 3 strains of the virus, only Type 1 remains
Last case of Type 2 was in 1999
Last case of Type 3 was in 2012
Only 3 countries – Afghanistan, Pakistan, Nigeria have cases of the wild polio virus
Geopolitical uncertainties prove challenging

5. Important Statistics In 1988 – 350,000 cases in 125 countries
To date in 2018 only 25 cases in 2 countries: 19 in Afghanistan; 6 in Pakistan. Nigeria not yet certified

6. The Scale of Work in 2017
Rotary and partners immunized 430 million children in 39 countries:
Afghanistan Niger Angola Indonesia Nigeria
Benin India Pakistan
Cameroun Iraq Republic of the Congo
Central African Republic Kenya Sierra Leone
Chad Laos Somalia
Cote d’Ivoire Liberia South Sudan
Democratic Republic of Congo Libya Sudan
Djibouti Madagascar Syria
Equitorial Guinea Mali Tajikistan
Ethiopia Mauritania Uganda
Gabon Mozambique Yemen
Guinea Myanmar
Guinea-Bissau Nepal

7. Challenges We Must Overcome
We’re also fighting vaccine-derived poliovirus
Oral polio vaccine contains some live weakened polio virus
Weakened virus stimulates an immune response in child
Child excretes vaccine-virus
Usually a good thing because it creates immunity in other unvaccinated children
Rarely it mutates back into a more virulent strain that can cause paralysis. Vaccine-Derived Polio Virus(VDPV)

8. Challenges in Conflict Zones
Yemen – world’s worst humanitarian crisis
Polio vaccinators cross rough terrain, brave hostile frontlines, climb mountains
Yet, in ,000 vaccinators administered drops to 5.3 M children
Families wait and welcome vaccinators who use a donkey to carry the gas cylinder that powers generator to keep vaccines cold

9. And Profound Impact in Other Conflict Zones
Nigeria – declared polio-free but new case uncovered in released Boko-Haram captives
Now need one more year without polio to be declared polio-free
Afghanistan – nomadic populations, insecurity, difficult terrain pose challenges but overcome with transit center and point of entry vaccinators

10. More Conflict
Pakistan – reduced infections by 90%; also re-purposing local health systems to fight measles, meningitis, tetanus complications.
Syria – outbreak in 2017 so vaccinators went to transit centers and camps and cities during cease-fires

11. The Best Solution
High immunization rates are best protection against wild and vaccine-derived polio viruses
Many countries use inactivated polio vaccine (dead virus) to avoid risk of VDPVs
But oral polio vaccine is the only vaccine to prevent transmission of WILD polio virus
When world is certified polio-free, only inactivated polio vaccine will be used

12. The Search Is On for the Silent Killer!
Besides the immunization work, there is more
In final stages of polio eradication, environmental surveillance is key:
Workers collect water samples near sewage treatment plants, open canals or streams

13. And More Sleuthing…….. Samples are transported to a GPEI Lab
Virologists test for polio and determine exact genetic makeup of virus if one is found
Doctors, traditional healers, clerics report paralysis cases to medical authorities

14. ………Search Continues
Stool samples are taken within 48 hours of paralysis onset
Scientists and virologists identify genetic sequences; identify and map where virus originated
This data then drives best immunization strategy for health workers

15. A Magnificent Infrastructure
GPEI has 146 labs accredited by WHO
In 92 countries
And has created health infrastructures in countries that previously had none
This infrastructure stopped Ebola outbreak in Nigeria within 3 months

16. What Does This All Mean???
17.4 M people walking today because of you; 2.5 B children immunized
>1 M Rotarians volunteered time and treasure to eradicating polio

17. Meaningful!!
PolioPlus is the largest private/public health initiative in the history of the world
Rotary – largest non-governmental contributor to polio eradication:
more than $1.7 billion.

18. The Cost/Benefit Realities
We must eradicate polio in the last three endemic countries – Afghanistan, Pakistan, Nigeria…… and
Certify polio-free after 3 years
Remember, polio is just a plane ride away
Viruses know no borders
Eradication is the most cost-effective
strategy

19. Cost/Benefit con’t
Cost of CONTROLLING vs. ERADICATING is much higher. We have no choice
Eradication translates into much lower health care costs
Economic value of a healthy person over a paralyzed polio patient is significant
If we cease vaccination efforts, >200,000 children each year will be paralyzed within 10 years
We must go forward – We’re this close!

20. What Can You Do?
PolioPlus - primary goal of The Rotary Foundation so we must continue to fund it
Support club and district fund-raisers
Every $1 donated by you is matched 2:1 by Gates Foundation and becomes $3
Share our mission with non-Rotarians

21. And Thank You, Rotarians, for Your Support

22. We Can’t Stop Now
Our promise to the children of the world in 1988: Eradicate Polio
We Must Keep Our Promise!
THANK YOU!!
Sources for more information about Polio