Time to fix polio funding gap

Deepak Kapur
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India must keep up its vaccination drive, and not become complacent. — K.V. Srinivasan
India must keep up its vaccination drive, and not become complacent. — K.V. Srinivasan

Governments and donors must step up assistance to ensure that polio, all but eradicated from the world, does not make a comeback in India and elsewhere.

The dream of a polio-free world is closer to becoming a reality as another successful year of eradication campaigns, immunisation programmes as well as awareness drives in countries across the globe is nearing an end.

But this is not the moment to sit back and bask in the glory of the achievements of the worldwide campaign, but reflect on the challenges that remain.

It is a time to come together with ever-more zeal and commitment to push the debilitating virus out of the planet. The efforts done at this point will secure future generations from disability at the hands of the dreaded virus.

With only three countries — Pakistan, Afghanistan and Nigeria — remaining out of the entire comity of nations to be declared non-polio endemic, complacency of any kind and in any area can prove detrimental to the entire global effort against the disease over the years.

The huge funding gap of $700 million estimated (as of October 2012) for 2012-13 can act as a spoilsport in a major health victory.

Up the Ante

Considering the massive immunisation as well as awareness activities that the Global Polio Eradication Initiative (GPEI) still needs to undertake, it is imperative that the campaign is now taken up on a larger scale so that there is no scope for the virus to return in the countries where it has recently been eliminated.

Core costs, planned supplementary immunisation activities and emergency response are the constituents of the 2012-13 GPEI budget estimates that total $2.18 billion. It is not surprising that such a huge amount of finances is required for the global polio eradication efforts.

Billions of doses of oral polio vaccine are used every year to vaccinate children below five years of age to protect them from the virus.

Immunisation activities such as door-to-door vaccination, formulating plans, making detailed maps, delivery of vaccines to supply centres and training of vaccinators comprise the operational cost of the campaign.

Surveillance exercises ensure that any cases of acute flaccid paralysis, which could be a warning sign of polio, can be detected and reported at the earliest without the slightest delay.

Extra-technical assistance for strategising and implementing the well-defined plans as well as social mobilisation to reach children in high-risk and remotest areas, would ensure that no child is missed in the process of immunisation.

Non-Endemic Countries

Since its launch in 1988, $9 million has been invested in the GPEI that is partnered and supported by national governments, the World Health Organisation (WHO), Rotary International, US’ Center for Disease Control and Prevention (CDC), United Nations Children’s Fund (UNICEF), the Bill & Melinda Gates Foundation as well as the volunteer support base.

Dedicated effort and planned activities over the decades have built a comprehensive infrastructure to reduce the burden of polio across the globe.

But the virus could return in non-polio endemic countries, including India, from the remaining three countries; therefore, the campaign needs to continue with more resources inflow and donor funding.

The funding gap facing the campaign can derail vaccination campaigns in several countries, making the threat of the spread of polio a potent reality. More human and other resources are required to make eradication a success.

This is where the contributions by national governments, global humanitarian organisation Rotary International, Bill & Melinda Gates Foundation and USAIDS count in the fight against polio.

Funding commitments such as Rotary’s $75-million promise over three years to the GPEI is towards bridging this gap and ensuring the campaign is not left wanting in funds.

In the same manner, Bill and Melinda Gates Foundation’s contribution of nearly $1 billion helps poor countries in continuing with their campaigns. The recent alliance announced by the Foundation with Nigeria’s top tycoon Alhaji Aliko Dangote will boost the work in the only remaining African nation that is polio endemic now.

India has set an example for other countries by becoming non-polio endemic with cooperation from all quarters. The Government shares a major responsibility of funding the effort.

In addition to the funds available with GPEI, the government sets aside a budget for the polio eradication programme. Indian philanthropists, including industrialist Harshad R. Mehta of Rosy Blue Group; Aditya Birla Group’s Rajashree Birla; and steel magnate Lakshmi Mittal’s wife Usha Mittal, have contributed millions of dollars through Rotary International to win the country’s fight against polio.

Further Resources

Urgent additional investments are highly essential for the success of the global initiative. Governments and philanthropists, and donors across the world, are encouraged to invest in the future of a polio-free world.

Further, new donors such as the Islamic Development Bank that recently declared a $227 million loan to Pakistan and a $3 million grant to Afghanistan for polio eradication efforts also add impetus to the campaign.

This will help ensure the Governments in these countries commit to the shared responsibility and deliver results.

Moreover, the cost effectiveness of the massive worldwide efforts has been established. For example, investments in polio vaccination in the US prevented one million cases of the crippling disease and saved more than $180 billion post-eradication, according to a cost-effectiveness study.

Organising National Immunisation days, awareness programmes and regular vaccination in far-off places requires a huge amount of manpower and resources. Purchasing oral polio vaccine, emergency response mop-ups and developing a vaccine stockpile for the future also requires funds.

If the virus rebounds in countries where it is non-existent at present, the costs for controlling it will be far more than required at the moment.

Moreover, funds are required to sustain the immunisation drives and related programmes in various countries.

Global leaders need to step forward in a mutually-collaborative effort during these final steps towards polio eradication from the world.

India has a chance to complete three polio-free years in 2014.

This can be achieved if the funds for the eradication campaign are sufficient for eliminating the disease, both within and across borders.

(The author is Chairman, Rotary International’s India National PolioPlus.)

(This article was published on January 4, 2013)
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