MEETING 13 JANUARY 2016

Lee Harmon, an ophthalmologist Rotarian from Arlington Washington presented a program outlining the history of the polio eradication program that has been one of the main Rotary international projects since 1984.

 

George Dutton, in his introductory comments, quoted Dr. Harmon: “I owe more to Rotary than I can ever pay back.”

 

Polio Plus, the Rotary-inspired program to end polio throughout the world started over 30 years ago. Initially funded with $100 million derived from contributions from the CDC, Rotary International and several other countries, the program was put together. After three years, little had been accomplished in terms of delivering vaccines to children. At that time the concept of national immunization days was introduced.

 

The natural history of the poliovirus includes living and reproducing within the human gastrointestinal tract, excretion into the environment where it can survive for 10-14 days. From the environment it can be reintroduced to humans by ingestion of contaminated water or soil particles and start another cycle. Normally it is contained to the intestinal tract, but in cases of paralytic polio it escapes the confines of that system and travels throughout the body and affects the central nervous system where it causes paralysis and other nerve damage. It can only be transmitted if there are susceptible and un-immunized people in the environment.

 

Dr. Harmon presented a picture of the devastation wrought by polio. Polio has been present in recorded history dating back to the Egyptians, and probably much earlier. At the peak of the epidemic in the 1950s there were over 350,000 cases with over 50,000 deaths attributed to this disease every year. In America, as well as other developed countries, numerous "iron long wards" were instituted to help tide infected children over the initial stages of their nervous system involvement. In principle, the iron lung is a closed cylinder with a bellows attached to it. The patient's body is sequestered within the iron lung, with only the head protruding. The back and forth action of the bellows helps to bring air into the lungs and expel it. The mortality of iron lung-treated patients was extremely high.

 

National immunization day programs coordinate the activities of hundreds of thousands of volunteers, Rotarians, and community workers. In a one-week period of time their coordinated efforts provide immunizations to entire communities, leaving no child un-immunized. This has been highly successful. Dr. Harmon presented his experience with the program in India where a team of 3 million volunteers, complemented by 100,000 Rotarians immunized over 150 million children in a one-week period of time. This is repeated in multiple countries throughout the world.

 

In 1984, there were 125 nations with endemic polio and over 350,000 cases per year. At the present time only three nations (Pakistan, Afghanistan, and Nigeria) currently have polio and there were only 70 cases reported amongst those countries in the last year. Recently Nigeria has come on the polio-free list and now there is no polio in Africa.

 

One of the risks of polio is that the trivalent vaccine that has been used successfully throughout the world has a tendency for the type 2 poliovirus to mutate into a form that can cause paralytic polio. This happens in approximately one out of 4 million cases. The Polio Plus program is now planning to implement an injectable form of the vaccine which utilizes a killed virus so that there is no chance of mutation into a paralytic form.

 

The program has instituted "hotspot teams" to respond to isolated outbreaks of polio with tapid and complete re-immunization of entire communities within a 5 km diameter of any index case in the world.

 

Despite the proven success of this program, there is still hostility and suspicion in the countries where polio remains. Volunteers and aid workers have been killed in their efforts to immunize children. Over 95 members of polio-plus teams have been assassinated during the course of the program.

 

Throughout the course of the program the Bill Gates Foundation has been abundantly generous in helping to fund the program. Many other countries, individuals, and organizations have contributed funds as well. Through matching programs, over $5 billion will be raised in the coming years to help continue this eradication effort.

 

Several slides in his presentation highlighted the importance and significance of this program and the impact that it will have on the health of the world. The sides are included in the photo albums associated with our Club runner website for those members wishing to refresh their memories of his presentation.

 

All members were urged to contribute to this program, particularly to help support reaching the goal of $5 billion. It would take an annual commitment from each Rotarian of approximately $28 to achieve this goal.