Polio's days are numbered as teams close in on last few cases in 3 countries

This was originally published on Global Health TV on November 23, 2016.

PARIS, France — In 2012, Latif and his colleague were vaccinating children against polio in Pakistan when they were shot by extremists. Latif was shot in the leg. He had 11 metal rods inserted into his leg and was hospitalized for three months. His colleague died. Today, fully recovered and undeterred, Latif (his surname is withheld to protect his security) continues his anti-polio crusade in northwestern Pakistan.

Jim Costello, 73, contracted polio at the age of 15. It paralyzed his upper body: He has triple curvature of the spine, wears a spinal brace and has no use of his arms. His lungs are 75% paralyzed and he uses a medical ventilator for about 18 hours daily. He lives at home in Dublin, Ireland with his wife Delia, “my beloved partner of over 30 years,” on the weekends. During the week, he is in the hospital where he still uses an iron lung. Despite these limitations, he has led a productive life in the retail clothing business and in support of polio survivors. Since 1993, he has served as chairperson and board member of Post-Polio Support Group Ireland

Latif and Costello were two of five people honored as “polio heroes” at a World Polio Day event Oct. 24 at the Pasteur Institute here sponsored by Sanofi Pasteur and Rotary International, two organizations deeply invested in the fight against the disease. Meet Latif in this video and Khuram (an employee of Sanofi Pasteur) in this video (videos from Sanofi Pasteur/AKS Films).

Participants heard experts say that the world is tantalizingly close to eliminating polio, and that elimination could happen in 2017. As of last week, there were only 32 remaining cases of wild poliovirus — 16 in Pakistan, 12 in Afghanistan and 4 in Nigeria.  We are on the brink of eliminating the second human disease in history (smallpox, in 1980, was the first).

It is true that all three countries have security challenges. But in Pakistan, the country with the largest number of remaining cases, the security situation has improved markedly since 2014.

“There were close to half a million kids not reachable due to insecurity in 2014,” said Dr. Mufti Zubair Wadood, technical officer for the Global Polio Eradication Initiative at the World Health Organization (WHO) and former head of the WHO polio program in Pakistan. “Since then, the situation has been improving and right now there are almost no areas of the country that are not accessible. That has resulted in a significant drop in the number of cases. Pakistan deserves a huge pat on the back at a time when things were dire.”

Wadood believes the next six months presents an excellent opportunity because this cooler period is when the vaccine works best and the virus is not transmitting at a high rate. “If good campaigns are implemented in the next 3-6 months, there is no reason we cannot stop it in late 2016 or early 2017,” said Wadood.

The polio eradication campaign is the largest public health program in history. For nearly 30 years, national governments, WHO, Rotary International, the U.S. Centers for Disease Control and Prevention and UNICEF have worked on this issue. More recently, the Bill and Melinda Gates Foundation joined the effort.

Sanofi Pasteur is, by far, the biggest supplier of polio vaccine in the world. It has provided 6 billion doses of the oral polio vaccine over the last decade and more than 1 billion doses of the inactivated polio vaccine, through injection, which will protect people once polio is eradicated.

But polio vaccination will continue for years after eradication, said David Loew, executive vice president of Sanofi Pasteur. Loew said that Sanofi is even considering building a second factory in order to develop the production capacity necessary to produce the injectable version.

Polio eradication is not only a global health success but also an economic success. Eradication is expected to save between $40 and $50 billion during the period 1988 to 2035, according to Dr. Kimberly Thompson, professor of Preventive Medicine and Global Health at the University of Central Florida. “Polio eradication represents a gift from our generation to future generations.”

Elimination may be near but Latif, the Pakistani polio hero, is not ready to declare victory quite yet. “I want the children of my country to be healthy and protected from polio. I have participated in this fight from the beginning and I want to continue to the end, to see a polio-free Pakistan.”

Did he consider giving up after extremists shot him in 2012? “No, I never thought of that,” he said. “As a matter of fact, I don’t connect the pain I felt with the work I do. They are two different things in my mind.”

Costello, the indefatigable polio survivor wanted to make two points:

• “If the people who attack vaccination teams could see me and people like me, is that really how they would like their own children to live their lives?”
• “I would like to appeal to the WHO, Rotary International and other organizations working to eradicate polio. When their job is done, which I know will be soon, would they please consider turning their valuable efforts towards the millions of polio survivors, particularly in underdeveloped countries, that now face the problems associated with post-polio syndrome?”