By Saket Suman
New Delhi, Sep 28 (IANS) Reporting from the frontlines of the war against polio and drawing on detailed interviews with key players, Thomas Abraham has chronicled "the mind-boggling story" of the polio campaign in "Polio: The Odyssey of Eradication". He has asserted that the World Health Organisation (WHO) underestimated the spread of the poliovirus, and according to his findings, it is unlikely that the world can be polio-free before 2021.
"The WHO clearly underestimated how difficult the task of eradication would be. When the campaign was launched in 1988, it was generally thought that the job could be completed by 2000, or at the latest by 2005. But a variety of factors, including problems with the vaccine, the difficulties that poorer countries face in carrying out repeated vaccination campaigns, as well as the problems posed by conflicts, have all contributed to the problem. It is now unlikely that the world can be declared polio-free before 2021 at the earliest," Bengaluru-based Abraham, who was formerly Associate Professor at the Journalism and Media Studies Centre, University of Hong Kong, teaching health and science journalism, told IANS in an email interview.
He acknowledged that the polio eradication campaign has achieved "significant gains", and pointed out that the number of polio cases across the world "have come down from around 350,000 cases in 1988 spread over 125 countries to around 100 last year," mainly in Pakistan and Afghanistan. In places like the Democratic Republic of Congo and Nigeria, Abraham said, polio is caused by "a mutated form of the virus that the polio vaccine is based on".
Abraham, who has worked with WHO in Geneva, said that the delay in Pakistan is partly due to "the security situation in that country".
"From about 2012, the Pakistan Taliban had begun to target and assassinate polio vaccinators, as part of its larger war against the Pakistan government and against Western countries in general (polio eradication was perceived as a Western-funded and run campaign); polio vaccinators were regularly assassinated in Karachi, as well as in the frontier areas of Pakistan.
"The Taliban told people that polio vaccinators were spies for the United States and should not be allowed into their areas. The use by the CIA of a fake NGO to conduct vaccination campaigns (though not for polio) in Abbotabad, to try and identify where Bin Laden was living, also did not help the polio campaign, since the Taliban used this to justify their argument that all vaccinators were in fact spies," Abraham said.
He said that in Afghanistan, the Afghan Taliban did not pose the same set of risks to the polio campaigners, but access to children in these areas was often difficult, and many were missed during vaccination campaigns, allowing polio to survive.
"The movement of people between Pakistan and Afghanistan allowed the polio virus to travel between these two countries and persist," he said.
Another factor that has allowed polio to re-appear and even spread, according to Abraham, is, in certain situations, "the virus that the oral polio vaccine contains".
"The oral polio vaccine contains a weakened form of the poliovirus, that in normal circumstances provides protection against the disease, without causing paralysis. But in places where polio immunisation campaigns are not carried out regularly, this vaccine virus can re-acquire disease-causing properties, and cause paralysis. This is what we are seeing in the Congo and elsewhere today," he explained.
In the strictly Indian context, Abraham mentions in the book that the period between 2005 and 2011 was the polio eradication campaign's most difficult years.
"Polio had been controlled in most parts of India by around 2005, except for Uttar Pradesh and Bihar, where poor implementation of the programme by state governments led to persistent outbreaks. In Uttar Pradesh, there was also an issue with the Muslim communities in many parts of western Uttar Pradesh refusing vaccination, often due to suspicion of the state government's motivation.
"There were rumours that these drops would cause children to become sterile, and the fact that polio vaccinators were often the same health staff who provided family planning, helped to increase these fears. Once both these governments focussed on polio, the disease gradually disappeared," said Abraham, who was also a foreign correspondent for The Hindu for over a decade.
He also said that funding will increasingly become a problem, as it costs roughly $1 billion a year to run the polio campaign.
"Polio: The Odyssey of Eradication", published by Context, an imprint of Westland publications, released on September 17 in India and is priced at Rs 699.
(Saket Suman can be contacted at saket.s@ians.in )
