NMAH | Polio: Expanded Immunization

Improving World Health
In some countries, vitamin A, measles vaccine, and tetanus shots have been given during immunization days in addition to the polio vaccine.

As early as 1974, world health workers began to conceive of immunizing all the worldís children against vaccine-preventable childhood diseases: diphtheria, Haemophilus influenzae type b, polio, measles, mumps rubella, pertussis (whooping cough), hepatitis A and B, tetanus (lockjaw), and varicella (chicken pox). The campaign against polio established the model to make improvements in world health more achievable—with trained epidemiologists, a network of laboratories, volunteers, cold chains, an information system, a comprehensive surveillance system, and funding mechanisms.

If Smallpox, Why Not Polio?
World eradication of smallpox in 1980 prompted health officials to suppose that other diseases might be eliminated. The intense global campaign against polio started in 1988, after the World Health Organization, the Pan American Health Organization, Rotary International, UNICEF (the United Nations Children’s Fund), and the Centers for Disease Control and Prevention had succeeded in controlling polio in the Western Hemisphere. Poverty, politics, wars, and diseases in resource-limited nations have made it difficult to end the transmission of poliovirus.

	To eradicate smallpox, $312 million dollars were spent worldwide between 1966 and 1980. In contrast, one C-17 military transport aircraft costs $327.8 million.
	Smallpox eradication used a “ring” method, vaccinating everyone in the geographic area around the person diagnosed with the disease. The method for stopping polio transmission relies on National Immunization Days, when every child under age five in a given country is vaccinated at the same time.
	The first national immunization was held in Brazil, on June 14, 1980.

“The war against polio is nearly over. Victory has been achieved in the Western Hemisphere with eradication of the disease from the Americas. The battle has been joined in the rest of the world, and conquest of this dreaded affliction within the next decade now seems certain.”
—Drs. Frederick Robbins, Ciro de Quadros, and Thomas Daniel, 1997

Allocating Limited Resources
In Africa, the leading causes of death are HIV/AIDS and malaria, not polio. Some argue that the millions spent on stopping the transmission of poliovirus should be spent on more lethal diseases. Others point out that polio has greatly contributed to poverty, debility, and hardship, including the neglect and brutality directed at those disabled by polio—a disease, unlike HIV and malaria, that we do know how to efficiently control.

Polio and AIDS
In developing nations, the eradication of polio and attempts to control HIV/AIDS and malaria are in competition for funds and workers. India reported only eight new polio cases in 2004; Nigeria reported 257. By comparison, a total of about four million people are living with HIV/AIDS in India and Nigeria.

In 1988, there were an estimated 350,000 cases of polio in 125 countries. In 2000, 2,880 cases were reported in 20 countries. By 2004, endemic polio existed in only six countries: India, Pakistan, Afghanistan, Egypt, Nigeria, and Niger. Nations are certified as “polio free” after three years with no new cases.