So near, yet so far
(Excerpts from The Economist , Jan 24th – 30th 2009, p. 58
(International)).
Humanity’s greatest accomplishment of the past five decades, declared Bill Gates this week, is the reduction in the number of deaths among young children by half, to 10m a year in 2007. The world’s most successful capitalist heaped praise on the WHO, while unveiling an ambitious new global scheme to eradicate polio within a few years. Bruce Aylward described the fight against the disease in the language of markets:
“Eradication is the venture capital of public health: the risks are huge
but so too are the rewards.”
The Gates Foundation, with its pots of money and businesslike approach, has transformed the bureaucratic and demoralized world of public health. It has helped revive ailing campaigns, including the fight against polio. This will now get a fresh $600m-plus, from British and German taxpayers, from the Rotary Club International, as well as from the Gates Foundation ($255m).
The decline from 350,000 new cases in 1988 (when the goal of rapid polio eradication was first declared) to 2,000 cases now (chiefly in Nigeria, India, Pakistan and Afghanistan) looks like a near victory. But the final stretch is the hardest. Only one in 200 cases is readily susceptible to early detection. Polio is far more infectious.
Other snags include the usual vaccine that has not worked well in densely populated, disease-ridden central India. Researchers are now working on new vaccines. The fighting in Afghanistan and Pakistan has hampered vaccination programmes there. Rumours among Muslims in northern Nigeria that the vaccination programme was in fact a conspiracy to sterilize children is facing health-care givers. These are the challenges.