Though incidences of polio have decreased by 99 percent since 1988, the disease still occurs regularly in India, Afghanistan, Pakistan and Nigeria. Until there is complete eradication, the disease will continue to reinfect other areas. A surge in the spread of polio has reached neighboring countries and children are being diagnosed with the disease in locations that have not seen an incidence in years.
Polio is spread by ingesting fecal matter through contaminated water. However, only about 1 in 200 infected become paralyzed, thus only a small fraction of the infected population is visible. The situation brings up a long-time debate about taking a “horizontal” or “vertical” approach to global health initiatives. A horizontal approach is more generalized and focuses on sanitation, hygiene, health worker training and general initiatives to combat a number of diseases, where as a vertical approach focuses on attacking one disease at a time.
Until now most strategies have been vertical, modeled after the successful elimination of smallpox.
As a major philanthropic donor in the fight against polio, Bill Gates traveled to Nigeria to check out the situation first hand, where he met with the Sultan of Sokoto, a spiritual leader in the country and necessary partner in fighting polio. “Other health issues should be looked into,” the sultan said in the Wall Street Journal, “instead of just facing one direction with polio eradication.”
That’s why the new strategy will combine both approaches. The focus will be on wiping out polio, but with attention being paid to the more broad health issues facing these areas. Progress has been to the extent of nearly reaching the end of this crippling disease, and steps are being made to make sure that it happens.
Next week the plan of action developed by the Bill & Melinda Gates Foundation, UNICEF, the Centers for Disease Control and Prevention and Rotary International will be considered by members of the World Health Organization.
The fight against polio is one of the largest global health initiatives to date. With millions of volunteers, large-scale immunization efforts and the help of organizations and political leaders, the movement to end this disease is continuing to progress. The goal is to come as close to eradication as possible by the year 2012.
Photo by Wen-Yan King via Flickr.