Public Policy vs Health Policy: Does it make sense to spend billions of dollars to wipe out the few remaining cases of polio?
On January 13, India became the latest country to celebrate a year completely polio-free. After more than a century as a global scourge and hundreds of thousands lives lost, polio may now be on the verge of being the second human disease wiped off the face of the Earth — after smallpox, which was eradicated 36 years ago. But the global battle to defeat polio is expensive — and we’re by no means sure of victory. That does raise the question: is it worth it?
In 1952, more than 50,000 kids were paralyzed by a polio outbreak in the United States. Today, the disease is unknown in America — and across much of the rest of the world. In 1981, there were more than 65,000 new cases reported worldwide to the World Health Organization. That number dropped to 1,348 in 2010 and 628 in 2011. That progress has saved as many as five million kids from paralysis worldwide and is thanks to a global effort involving millions of volunteers, health workers, and government officials, as well as the World Health Organization, UNICEF, and the Rotary and Gates Foundations.
Despite this heartening success, getting all the way to eradication is proving immensely hard. In 2010, the majority of polio cases were in countries once free of the virus. In 2011, six countries that had been polio-free the previous year saw the disease come back — although the good news is that incidents were few: only 66 cases between them. Unlike smallpox, most cases of polio don’t show any immediate symptoms, which complicates the response to outbreaks. Moreover, vaccinating against the disease takes repeated doses (India’s polio-free year involved two nationwide programs in 2011, each immunizing 172 million children over five days).
And, of course, global eradication depends crucially on parents being willing to vaccinate their kids in the countries still suffering outbreaks — not least Pakistan and Nigeria. Both countries have faced opposition to vaccination programs on the grounds that they are a Western plot to sterilize local girls. Sadly, these wild conspiracy theories were given an additional patina of credibility last year by the revelation that the CIA used a vaccination program to cover its attempts to get DNA samples from Osama bin Laden’s children in Abbottabad. Perhaps polio eradication will be another victim of the war on terror.