It is not often that humanity can take pride in driving an organism toward extinction but today we can do just that. As of July 24 Nigeria has gone an entire year without a single case of endemic polio, an incurable and highly infectious disease that attacks the nervous system and can cause life-threatening paralysis.
Thanks to the pioneering vaccination work of the men and women who worked with Dr. Jonas Salk and later with Dr. Albert Sabin most Americans have not lived in fear of polio since the 1950s. 2015 marks the 60th year anniversary of when images of parents in iron lungs, children in leg braces or a president in a wheelchair began to fade from our collective memories. Not since 1979, when an outbreak occurred among a few communities of Amish living in the Midwest, has the United States had to worry about who might be the next to be struck down by a disease that has plagued humanity for most of our existence.
Sadly the rest of the world has not been so fortunate. Until recently most parents, particularly those living in developing countries have had to live with the fears that we Americans vanquished decades ago. Together with the World Health Organization, a number of NGOs have combined resources in the Polio Global Eradication Initiative, launched in 1988 with the goal of doing to the poliovirus what we successfully did to smallpox: wiping it off the face of the Earth.
Eradication of polio is possible because of several things. First, both the injected Salk vaccine and the orally administered Sabin vaccine are highly effective in protecting individuals against the virus. The vaccines are also very inexpensive, costing less than 15 cents per dose. Second, there are no known animal reservoirs of the poliovirus. Humans are the only known carriers of the disease, so if we can eliminate the virus from all populations there is no chance that it can reemerge from contact with infected wildlife. Finally the vaccines, especially the oral version, are very easy to deliver and can be administered by health care workers who have a minimal amount of training. These efforts have been tremendously successful and we have gone from an estimated 350,000 cases in 125 endemic countries in 1988 to just over 400 in 2013. Ironically, though, it is the ease with which we are destroying polio that may prove to be our undoing.
With its pending eradication in Nigeria (a country must go three years without a case of polio to qualify, although going one year with no new cases is a major milestone), endemic polio is now found in only two other countries: Afghanistan and Pakistan. In both countries the problem in eliminating the disease is not the lack of vaccine or scarcity of health workers. The major obstacle to becoming a polio-free planet is politics, specifically religiously motivated politics.
In those provinces where the Taliban and other militant organizations have control, teams of polio health workers are actively being targeted and murdered. In 2014 alone at least 80 Pakistani polio workers lost their lives trying to protect children. Major General Asim Saleem Bajwa recently vowed that terrorists would not be allowed back into territories where in the past they had successfully interfered with polio vaccination programs. But the danger persists. The 2014 documentary Every Last Child chronicles the ongoing struggle to protect children in Taliban controlled regions of Pakistan.
The rationale behind these killings is that polio eradication programs are nothing more than a ruse, a western government plot intended to sterilize or even kill Muslim children. As bizarre as this idea might seem, it unfortunately does contain an element of truth. In their efforts to learn the identity of a mysterious man living in a compound in Abbottabad the CIA devised a bogus vaccination program with the intent of obtaining DNA samples from children and determining their paternity. In this way they confirmed that the likely father of the children in this compound was none other than Osamabin Laden. The information gleaned from the bogus vaccination program proved decisive in supporting one of the most daring military missions in U.S. history, but it also badly damaged the credibility of those who now put their lives on the line to wipe out polio.
So now we find ourselves, 60 years later, on the cusp of destroying an opponent that threatens all of humanity only to be thwarted by our mistrust of one another. How ironic would it be to know that our efforts to destroy a human enemy has allowed an even more deadly viral foe to escape our wrath?
According to the World Health Organization, “As long as a single child remains infected, children in all countries are at risk of contracting polio. Failure to eradicate polio from these last remaining strongholds could result in as many as 200,000 new cases every year, within 10 years, all over the world.”