Bill Gates, chairman and co-founder of Microsoft Corp., called for urgent donations to stop the spread of polio and make it the first infectious disease eradicated since smallpox was wiped from the planet in 1979.
The billionaire, who contributes about $200 million a year to the cause through the Bill & Melinda Gates Foundation, is pressing rich nations to plug a $720 million funding gap to eliminate the crippling, potentially lethal virus by 2013. Cases worldwide were reduced to 946 last year from about 3,500 in 2000, after world health leaders called for a new $2.6 billion strategic plan to finish the task.
Gates announced $102 million in extra funding in Davos, Switzerland, last week, joining the U.K. government and Sheikh Mohammed bin Zayed Al Nahyan, the crown prince of Abu Dhabi, in bolstering support for polio. Today in New York, Gates said the foundation is making eradication of polio its top priority.
“It is the thing we can do to most improve the human condition,” Gates, 55, said in a speech at Roosevelt House, the New York home where President Franklin D. Roosevelt recuperated after being stricken with polio at age 39. Roosevelt and his law partner Basil O’Conner later started the National Foundation for Infantile Paralysis, whose March of Dimes campaign mobilized the country against polio and raised millions of dollars to support the search for an effective vaccine.
Wiping out polio in the next two years would cost $2 billion.
“This is a magical several-year period,” Gates said in an interview today in what was Roosevelt’s personal library in New York. Gates said he is committed to the campaign because it provides “a chance at one of the greatest successes of mankind.”
Polio paralyzed millions of people worldwide in the 20th century before vaccines became widely available from the mid- 1950s. At the height of the most extensive polio outbreak ever in 1952, almost 60,000 cases with more than 3,000 deaths were reported in the U.S. alone.
“That’s incredible progress, but the last 1 percent remains a true danger,” Gates said in his annual letter released today. “Eradication is not guaranteed. It requires campaigns to give polio vaccine to all children under 5 in poor countries, at a cost of almost $1 billion per year.”
World health officials resolved to stop polio transmission in 1988, prompting the World Health Organization, United Nations Children’s Fund, Rotary International and the Centers for Disease Control and Prevention to form the Global Polio Eradication Initiative. Their goal was expected to be completed within 12 years, the same time it took to stop smallpox.
While cases have fallen from an estimated 350,000 in 1988 to 946 last year, some researchers say money spent solely on rooting out the last vestiges of poliovirus may be better directed at strengthening the immunization programs that aim to protect children from polio as well as measles and other communicable diseases.
“It’s very difficult to stop because we are very close to eradicating polio,” said David Heymann, a former assistant WHO director-general who headed the agency’s polio program from 2003 to 2009. Still, national vaccination campaigns targeting only polio shouldn’t take away from routine immunization, he said.
Polio was eradicated first in Europe, the Americas, and the WHO’s Western Pacific region, where routine immunization had reached 78 percent by 1988, compared with 59 percent in the three regions where the virus continues to circulate, Heymann wrote in a commentary in The Lancet medical journal in November. India had 34 national, regional, or subregional polio campaigns in 2009, he said.
At least $9 billion has been invested in the Global Polio Eradication Initiative over the past 22 years, raising concerns that more funding will be required if the strategic plan isn’t successful, said D.A. Henderson, 82, professor of public health and medicine at the University of Pittsburgh, and director of the WHO’s global smallpox eradication campaign from 1966 to 1977.
International donors are “spending more in one year than they spent in the entire 14 years that they funded the smallpox program,” Henderson said in an interview last year. “There’s a concern about somebody saying ‘We’ve done enough, it’s time to get out,’ without actually risking seeing the whole deck of cards coming down because if you pull out, then somebody else will pull out and we won’t have money to continue.”
Difficult to Stop
Polio is a difficult virus to eradicate because fewer than 1 in 100 people who catch it show signs of illness or are aware of the infection, enabling them to transmit the virus to others. Poliovirus from northern India was detected last week in raw sewage collected in Mumbai by surveillance officers in mid- November, indicating that the virus was being shed even though no cases of disease were found, said Oliver Rosenbauer, a WHO spokesman in Geneva.
Smallpox, in contrast to polio, is easily identified by the characteristic red rash it causes, speeding the identification of outbreaks and the commencement of vaccination programs in response. The cowpox-based vaccine used against smallpox protected almost everyone after a single inoculation, whereas with the most-common polio vaccine, at least three doses are required to fully protect 85 percent of children.
Even if reported polio cases fall to zero, the surveillance needed to confirm eradication will be difficult in conflict zones and in North Korea and Myanmar, where rates of infectious diseases are tough to monitor, Arthur Caplan, a bioethicist at the University of Pennsylvania in Philadelphia, wrote in a commentary in The Lancet medical journal in 2009.
Gates said in today’s letter that the polio campaign has some advantages that smallpox eradicators didn’t have.
“The advanced science we have today lets us sequence the DNA of the polio virus and develop an understanding of the history of transmission, which guides our work,” he said. “We also have far better communications and modeling tools than were available in the 1970s, and those are being used in smart ways to respond rapidly to every outbreak.”
Giving up on polio eradication will enable the virus to become re-established, Gates said, erasing hard-fought gains made since 1988.
“If we don’t get rid of it, it will spread back into countries where it’s been eliminated, and it will kill and paralyze children who used to be safe,” Gates said.
Eradication could save the world at least $40 billion to $50 billion if completed within the next five years, researchers said last November in a study published in the journal Vaccine.
“Success will energize the field of global health by showing that investments in health lead to amazing victories,” Gates said in today’s letter. “To win these big important fights, partnerships, money, science, politics, and delivery in developing countries have to come together on a global scale.”