Nature Medicine | Spoonful of Medicine

Winning hearts and minds to beat polio

Poliodrops.jpgToday, in the historic New York City residence of former US president and polio survivor Franklin Delano Roosevelt, Bill Gates took to the podium. As he spoke before a group of journalists, the Microsoft founder detailed the goal of the Bill & Melinda Gates Foundation to help stamp out polio. His words come on the heels of an announcement last Thursday when Gates, together with the Crown Prince of Abu-Dabhi of the United Arab Emirates, pledged to donate a total of $100 million toward many vaccines, including that against polio.

But it’s clear that money alone won’t solve the polio problem. In the subsequent roundtable discussion, Governer Owais Ahmad Ghani of the Khyber Pakhtunkwa province and neighboring tribal areas described his own nation’s struggles to eradicate the disease. While vaccination efforts reduced polio cases in Pakistan from 1,155 cases in 1997 to a mere 28 in 2005, a recent resurgence — reaching 118 cases in 2008 — has alarmed officials.

According to Ghani, establishing vaccination programs in the remote tribal areas of Pakistan presents a tricky challenge. One possible approach he suggested for war-torn regions was enlisting the army in vaccination campaigns. And he hopes that the financial support of the Gates Foundation will help create permanent community centers in these regions in which workers are held accountable for new cases.

The real question is whether these vaccine campaigns and additional infrastructure will be enough to eradicate the disease. An estimated one out of every 200 Pakistanis refuse to get the polio vaccine. The WHO has downplayed this glitch as a minor problem in small pockets of the country. But in my opinion, this will nonetheless need to be addressed to truly get rid of the disease. We need only look to Nigeria where in 2003, a surge in polio cases occurred after women refused to be immunized upon hearing rumors that the vaccines contained sterility drugs and HIV. If there’s a battle for hearts and minds, it should be to help people understand that vaccines save lives.

Image: Administration of polio drops via USAID


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