Eradicating polio: Insights from another major epidemic

Published November 11, 2021, 12:05 AM

by Sonny Coloma


Sonny Coloma

How would Rotary clubs and similar service organizations do their work while an entire country is under lockdown due to a national health emergency?

This was the dilemma faced by more than 1.2 million Rotarians in more than 36,000 clubs in the world when the coronavirus pandemic broke out in early 2020. Two catch phrases provided quick answers: “Rotary connects the world” and “Rotary opens opportunities.” Connectivity was the theme of then Rotary International President Mark Daniel Maloney. “We’re made for this, don’t waste this crisis” was the call of his successor Holger Knaack.

I was truly amazed at how Filipino Rotarians immediately sprung into action to fight the contagion. An owner of a garments firm immediately went into production of PPE gowns; a restaurateur prepared packed meals for health frontliners and distributed these in hospitals; a special vinyl box was also devised to protect doctors from infection while intubating critically ill COVID patients.

Pivot was the key word. Rotary leaders tapped into the Global Polio Eradication Initiative network and urged Rotarians to organize grassroots teams to stem the spread of COVID-19 while the development of an effective vaccine was still being awaited. As the Philippines and the rest of the world cautiously moves into a period of reduced anxiety and risk, it is well to recall vital lessons learned by Rotary in the fight to eradicate the poliomyelitis epidemic that afflicted and threatened millions of children worldwide for the entire 20th century and beyond.

The Philippines was declared polio-free in 1996 a year ahead of Cambodia, the last country in the World Health Organization’s Western Pacific Region that had polio cases. Then in 2000, after a lapse of three polio-free years, WHO declared that polio had been eradicated in both the Americas and the Western Pacific, a large region consisting of 37 countries including China, Australia, Japan and Korea and the rest of East Asia. Today, there are only two countries in the world with active polio cases: Afghanistan and Pakistan.

Organized in 1988, The Global Polio Eradication Initiative was billed as the “largest public health initiative in history.” Spearheading it was the WHO that was responsible for planning, technical direction, surveillance and eradication certification. The Center for Disease Prevention and Control (CDC) deployed scientists and public health experts. UNICEF took charge of the distribution of vaccines and assisted countries in crafting communication and awareness strategies. The Bill and Melinda Gates Foundation provided a substantial portion of the funding. Rotary International was responsible for fund-raising, advocacy and volunteer recruitment.

Here’s a granular perspective from the WHO Western Pacific region on how a massive grassroots campaign was waged to decisively defeat the polio scourge:

“Making sure that all the children in the Region were protected against polio was a huge undertaking, involving a great many people in a wide range of different roles. The work ranged from contact with individuals (for instance, health workers and volunteers giving vaccine drops to children), through support for such activities (such as by transporting vaccine to health centers), to coordination of the program at a central level within each country, and beyond that, overall coordination of individual countries’ efforts at WHO Regional Offices, and ultimately at WHO Headquarters.

“All levels were vital. Without reaching the individuals, children could not be protected against polio, or diagnosed with it if they became unwell. Without support at a number of different stages, health workers and volunteers could not have carried out the vital task of giving vaccine drops to children. And without overall coordination, the final stages of reaching the last, hidden children would have been impossible. In other words, children were protected from polio one by one — but that protection was by no means random or haphazard: It was a well-planned and highly organized endeavor. Just protecting some, or even many, children against polio would not have been enough. It was necessary to reach a very high proportion — almost all — of the population to ensure that the poliovirus could be completely stamped out.”

Oscar de Venecia, one of the pioneers in the Philippines’ end-polio campaign since the late eighties, shares important lessons that could be helpful, too, in eventually fully halting the spread of COVID-19 and minimizing its harmful and deadly consequences:

“Every year, health workers and volunteers, assisted by Rotarians, worked hard to reach children for immunization in their areas, sometimes heroically. Our teams were even able to penetrate risky areas and get the support and cooperation of insurgents and rebel groups after we persuaded them of the urgent need for their children to be vaccinated. The government and rebels agreed on “Ceasefire for the Children” during National Immunization Days (NIDs).

“Among the innovations used to make sure that children in all households are covered during the NIDs were (1) the use of indelible ink on the index finger of a child upon immunization, (2) the paint marking of houses of children already immunized and (3) the on-time reporting of immunization results.

“There was an incident in which two Filipina nurse volunteers carrying polio vaccines who drowned while crossing a river to reach a remote barrio. When the bodies were recovered, they were holding on to the box containing the oral poliovirus vaccine.”