Finishing the job of polio eradication
Dr Margaret Chan
Director-General of the World Health Organization
Mister Chairman, heads of CDC and UNICEF, distinguished Rotarians, ladies and gentlemen,
First and foremost, let me express my appreciation for this opportunity to speak to you about the Rotary advantage in polio eradication. This is an historical occasion. This is the first time that the heads of all four spearheading partners are together at a single event.
I find it most appropriate that this historical gathering occurs at a Rotary convention. We are here today because 1.2 million Rotarians envisioned a polio-free world, and then challenged governments and health agencies to pursue this vision.
The 1988 resolution by the World Health Assembly that committed governments to the eradication goal, was inspired by your conviction.
As a result, the number of polio cases has dropped by 99%. More than 200 countries are polio-free. The virus has been pushed back to some last strongholds in just four countries. At least 5 million children have been saved from paralysis. They walk, run, and play because of your vision.
I can say, with confidence, that we are closer to permanent victory than ever before.
This is the first Rotary advantage: the power of vision. And this power rests on another advantage of the world’s largest and most influential humanitarian service organization. This is an ability to build on experiences in one part of the world, think big, act collectively, and strive for the ideal.
Rotarians saw, first-hand, the devastation and suffering caused by polio in their own countries. Following a successful pilot vaccination programme in the Philippines, Rotarians realized that this devastation need not occur. All this suffering could be prevented.
You took the potential of prevention to scale in a spirit of fairness and humanitarian solidarity. Why not protect all the world’s children, regardless of place of birth or economic status? And you went one step further. Why not rid the world of this disease, and thus protect all future generations of children yet to come?
Ladies and gentlemen,
Since its inception, the drive to eradicate polio has been an expression of the power of public health partnerships to do great and lasting good. Rotary International is the top private sector contributor and volunteer arm of the eradication initiative.
In polio circles, Rotary is famous for its steadfast commitment, its hard-nosed determination. Rotary brought the advantage of a unique business-model approach to the many problems that face any health initiative, and especially one of this scale.
From the very beginning, Rotarians contributed practical, on-the-ground experience as proof that striving for a vision is indeed feasible. In Latin America and elsewhere, Rotarians knew what it took to deliver vaccine to the door of every household. To explain to parents the importance of protecting their children. To prepare communities to welcome the vaccination campaigns.
And Rotarians saw, first-hand, what it costs, again as part of a business model. Your eyes were wide-open to the costs of vaccine, vaccinators, strategic planning, logistics, surveillance, monitoring and evaluation.
To date, Rotarians have raised some US$ 700 million for polio eradication. Right now, you are matching, dollar for dollar, an award of US$ 100 million from the Bill and Melinda Gates Foundation.
Moreover, you encouraged, urged and frankly pestered governments in wealthy nations to top this up by another US$ 4 billion. Again, these are the advantages of influence and good business sense.
To get the job done, you mobilized and trained millions of volunteers, giving public health a new model of service delivery. This is another advantage: a unique service ethic that makes it possible to inspire voluntary service on a scale as grand as the challenge.
Rotarians are business and professional leaders. They are respected and influential community members. When I was in charge of the health department in Hong Kong, I saw Rotarians everywhere, from the corner shop to the office of the chief executive.
But Rotarians are also ordinary people who have earned respect and trust. Rotarians can open doors at the highest political levels, and you can open the doors of homes at the grassroots level. This is where trust counts especially much. When concerned parents want to know if a vaccine is safe, if it is really needed for a child, they trust the answers Rotarians give them.
Rotarians know how to take command and pull strings. Let me give just one example. Bihar state in India was planning an important polio campaign when health officials realized that vaccine supplies were inadequate. Phone calls and e-mails were sent to partners to appeal for emergency delivery of vaccine to this remote part of the country.
Within hours, Rotary had obtained special permission from the railway minister to use one of the country’s high-speed trains to deliver vaccine from other parts of the country. A truck was hired to carry even more. The result: some 4 million doses of vaccine reached Bihar within a week.
These are some of the advantages that Rotary has brought to the eradication initiative.
Ladies and gentlemen,
The life stories of polio survivors, especially those who suffered permanent disabilities, are stories about the resilience of the human spirit. Last month, a Tennessee woman who had spent nearly six decades lying in an iron lung died during a power failure. Her life was one of great courage, and she inspired many.
Her life should inspire all of us in this room. We must never forget the significance of what we have set out to achieve.
The polio threat has shrunk to such a small size that we can catch, count, and investigate each of the remaining cases. But these are not just numbers. These are people.
No one can question the worthiness of our shared objective. But is it technically feasible? I believe we can put that question to rest based on what has happened in India in just the past 12 months. Nowhere has it been harder to stop polio in recent years than in western Uttar Pradesh in northern India.
This has been a battle against the virus in its most firmly entrenched historical reservoir. Here I can say with confidence: polio is in retreat.
The remaining problems are not technical. They are operational. They are problems of implementation, programme quality, strategic performance. As every Rotarian knows, operational problems can be managed. They can be solved, when we have the resolve.
Following the launch of the intensified eradication effort early last year, I have visited the four endemic countries. I have spent quite some time discussing the polio situation with political leaders. I held discussions and reviews with all my senior managers, and I received strong commitments of support from each of the WHO’s six Regional Directors.
We made some decisions which I want to share with you today.
I am putting the full operational power of the World Health Organization into the job of finishing polio eradication. This is the power that eradicated smallpox. This is the power that stopped SARS, the first severe new disease of the 21st century, dead in its tracks within four months.
I am making polio eradication the Organization’s top operational priority on a most urgent, if not an emergency basis.
A type 1 polio outbreak is right now raging in northern Nigeria. Of every 10 children paralysed by type 1 poliovirus this year, eight are in Nigeria. In some parts of the country, more than a quarter of the children have never been vaccinated. This is an operational problem, and it can be solved.
It must be solved. The outbreak is similar to the one which re-infected 20 countries just a few years ago, paralysing more than a thousand children. We cannot permit another setback. This is one reason for the extraordinary actions I am setting in place immediately. We will move people and money wherever they are needed.
I am calling on my senior staff, at regional, country, and headquarters levels, to ensure that all administrative and operational bottlenecks within our own organization are unblocked. We will move fast, and we will use every effective trick in the book.
There is another reason supporting my decision. The credibility not just of WHO, but of many other health initiatives is on the line. If we cannot reach 80–90% of children with a vaccine, then what can we in public health hope to accomplish? So many other big challenges stand or fall on our ability to scale up population access to existing interventions.
As just one example, more than 10 million young children and pregnant women continue to die each year, largely from preventable causes. This is an operational problem, a problem of coverage and fair access.
We have to prove the power of public health. The international community has so very few opportunities to improve this world in genuine and lasting ways. Polio eradication is one.
Rest assured of my personal, my passionate commitment and support.
I ask those of you representing Rotary in Afghanistan, India, Nigeria and Pakistan to do even more. You have been the engines of polio eradication in your countries. I challenge you to raise the political stakes even higher, as I am doing with heads of state and political leaders. Political leaders must be mobilized and held fully accountable.
Ladies and gentlemen,
Let me mention another advantage that Rotary brings to polio eradication. This is a spirit of global solidarity born from respect for our common humanity. This is what everyone in this room has in common with the children of Afghanistan, India, Nigeria, and Pakistan. Our humanity.
I will close now with an expression of deep appreciation.
Thank you, all 1.2 million Rotarians, for your steadfast commitment to ridding the world of an ancient disease that has destroyed so many childhoods and broken so many hearts.
Together, we will bring this to an end, forever.