One Million Community Health Workers

As World Polio Day nears on October 24, 2013, let’s review five facts you may not have known about polio (taken from the WHO website):

1) We are 99.9% of the way to eradicating polio globally: In 1988, the WHO, UNICEF and the Rotary Foundation came together at the World Health Assembly to create the Global Polio Eradication Initiative, which has saved an estimated 10 million people from paralysis through an organized vaccination campaign. Last year, there were less than 200 confirmed cases of polio.

2) Only Afghanistan, Nigeria and Pakistan have never eradicated polio: These countries face challenges including poor sanitation and weakened health systems, and remain targets of the polio “Endgame Strategic Plan.”

3) Every child must be vaccinated to eradicate polio: Whether through the injectable polio vaccine (IPV) or the oral polio vaccine (OPV), all children, even those living in the most remote or conflict ridden areas of the planet, must be vaccinated to completely eradicate the disease.

4) The global effort to eradicate polio is the largest ever internationally coordinated public health effort in history.

5) Cheap and effective vaccines are available to prevent polio: costing as little as 10 cents, the oral polio vaccine can be administered by anyone, including Community Health Workers (CHWs).

The story of the polio vaccine is dramatic and inspiring. We know eradication of a disease is possible, as we saw with the eradication of smallpox in the 1950s through 1970s. In that campaign, a devastating illness was completely wiped from the planet in what one could argue was the first global health campaign in history. Millions of people who would otherwise be disfigured or dead now are alive and well, with no reported cases of smallpox since 1978.

So too, we have hoped, with polio. Poliomyelitis is a viral disease that causes inflammation of the spinal cord and brain, leading in about 10% of cases to paralysis and devastating respiratory compromise if the diaphragm becomes affected. Hospitals used to be filled with “iron lungs” or negative pressure ventilators that worked to mechanically assist breathing because those affected were unable to breathe on their own. The disease was indiscriminate, affecting many famous people including Francis Ford Coppola, Joni Mitchell, Neil Young, and of course Franklin D. Roosevelt.

In the 1950s, two vaccines were created by Jonas Salk and Albert Sabin, vaccines that we use today. The Salk vaccine is an injectable, inactivated vaccine typically used in high-income countries. The Sabin vaccine, which is used more commonly worldwide, is an oral vaccine which is easy to administer and very inexpensive.

CHWs and volunteers have been indispensable in the distribution and administration of the vaccine. Thanks in large part to their help, we now have almost completely eradicated the disease, with less than 200 cases worldwide. With a final push, known as the “Endgame Strategic Plan,” the world hopes to end polio forever in a year’s time. If eradication is achieved, it will be a great victory for the global health community and the entire world.