Holdouts Strain Efforts to Erase Polio Worldwide

This article discusses the ongoing pockets of resistance the Polio Eradication Initiative (PEI) is facing in the quest to eliminate this disease globally. Worldwide, the number of wild poliovirus (WPV)
cases is less than 2,000 and continues to circulate in only four remaining countries - India, Afghanistan, Pakistan and Nigeria.Stamping out the disease in these last few strongholds is proving extremely and unexpectedly difficult.



According to this article, in the north Indian city of Moradabad, where poverty and malnutrition are rampant, vaccinators are facing many challenges. Vaccines given to children in such a poor state of health are poorly absorbed, and children continue to contract polio after receiving as many as a dozen doses. In addition, the community has recognised the desperation of the polio campaigners and some individuals have started to demand cash or other services in return for vaccinating their children. Many are angered by the government's focus on polio in light of the threat of more virulent disease like tuberculosis.



Working with Rotary, United Nations Children's Fund (UNICEF), World Vision, the World Health Organization (WHO) and other bodies, Indian government officials have secured participation from Bollywood movie stars, Muslim clerics, community women and other influencers to help promote the campaign. This has proven largely successful, and from January to May of 2007 the number of families resisting vaccination in the Moradabad district fell from 653 to 469. Those families who remain resistant pose a huge concern, especially those demanding compensation in return for compliance, which could start a costly trend in families who are already accepting the polio drops.



Maintaining the PEI is expensive, with millions poured into the programme by international funders. It has been suggested that controlling the disease rather than eliminating it might be more cost-effective. A recent study by the Harvard School of Public Health, however, anticipates a drastic surge in the number of cases if the intensive vaccination campaigns are eased.



According to Dr. Kanwaljit Singh of India's National Polio Surveillance Project in Moradabad with regards to the disease "unless the whole world is done, we are not done."