INFECTIOUS DISEASE

Polio, Eliminated: As former CDC Directors we are optimistic that the complete eradication of the disease is close

Thomas Frieden, M.D.

As former directors of the Centers for Disease Control and Prevention, we often view matters of public health through the lenses of our separate experiences and histories leading the world’s premier health agency.

And because these matters are almost always complicated, both clinically and politically, our histories can lead us to different conclusions about what the future might hold and the best way to address health and safety threats, both foreign and domestic.

A global movement has reduced cases 99 percent since 1988 and, since then, more than 2.5 billion children have been vaccinated against this paralyzing disease.

But on the question of polio, there is no difference among us. In fact, all of us are genuinely optimistic.

When it comes to polio, each of us is convinced that the ultimate achievement – complete eradication of this terrible disease – is unquestionably close. Each of us is a personal witness to years of relentless work, driven by strong science, sturdy and diverse partnerships, dedicated and sometimes dangerous work on the front lines, and sheer determination, that has brought us to the brink of eradicating a disease once so feared and widespread it was one of the world’s leading threats to people’s health.

Today polio is found in only three countries – Pakistan, Afghanistan, and Nigeria. In 2016, only 37 cases of polio were found in those last pockets, the smallest number of new cases in history. These are remarkable achievements. Not so long ago – 1988, in fact – polio was on the loose in more than 125 countries, where it paralyzed 350,000 children each year.

The progress has been so stunning and sustained that virtually no physician working today in the United States will confront a case of polio in his or her medical career. Stop for a moment and consider that fact, as well as the hard and largely unseen effort it took to make that happen.

Today polio is found in only three countries – Pakistan, Afghanistan, and Nigeria.

There are many to thank and praise. But an indisputable reason for the remarkable inroads against polio is the critical role Rotary International has played from the start, from initially proposing the goal to walking stride for stride with us in public health to defeat polio.

The story of polio’s decline is more than simply a story of science and innovation. It’s a story of partnerships that are both unique and historic; of UN agencies (WHO and UNICEF), a national agency with global reach (CDC), an international service organization (Rotary), and philanthropy (the Bill and Melinda Gates Foundation) locking arms with governments and societies around the world and working to maximize effect and benefit. The achievements so far represent an effort that is greater than the sum of the individual parts, and serve as a model of what we can accomplish in public health when we pull together. It is why CDC activated its Emergency Operations Center in December of 2011 to increase focus and determination in the battle against polio.

When eradication efforts experienced setbacks and disappointments, as they always do, Rotary redoubled their commitment and efforts. When the years stretched out and objectives seemed to fade into the future, they renewed their leadership role and showed by the thousands to ensure children made it to vaccination sites.

If anyone has doubts, cast a quick gaze at the scene playing out this week in Atlanta. That is where more than 45,000 Rotarians from around the world will meet for their annual convention, and it is where Rotary leadership and members will come together and redouble their efforts to defeat polio. Bill Gates, another leading voice in the quest to defeat polio, will address the Rotarians, affirming again the commitment of both the Bill and Melinda Gates Foundation and Rotary to work even harder to achieve a world free from polio.

The benefits of that work and the strong collaboration, including Rotary’s tireless efforts, are happily real and verifiable. We know a global movement has reduced cases 99 percent since 1988 and, since then, more than 2.5 billion children have been vaccinated against this paralyzing disease.

That’s why all three of us agree with Rotary International and the broad array of other partners that now is not the time to relent or shift our gaze, not when we’re this close to making polio the only disease besides smallpox to be entirely erased from our world.

We are confident that this point will come.

Thanks to widespread vaccination campaigns in more than a hundred countries, a disease that once paralyzed 1,000 children each day is now almost history. 

Anyone who has seen this crippling disease, as we have, feels the urgency to finish the job - to eliminate polio’s last, tenuous grip on our world and with it, the fear and hardship this disease brings.

For while we’re tantalizingly close to eliminating polio worldwide, we’re not there yet. That makes what’s happening this week in Atlanta the perfect time for introspection and to reaffirm our commitment to defeating polio once and for all.

The authors all served as directors of the U.S. Centers for Disease Control and Prevention; Frieden served from 2009-2017; Koplan from 1998-2002; and Satcher from 1993-1998.

Tom Frieden, M.D. is the former director of the U.S. Centers for Disease Control and Prevention.