Polio Outbreaks Highlight Need to Eradicate Disease as Soon as Possible

The World Health Organization wants to certify the world as being polio-free in 2005, but problems with new polio outbreaks caused by vaccination could hamper that goal.

The World Health Organization has done an excellent job at getting polio under control. In 1988 there were 350,000 cases of polio reported worldwide. In 2001, there were only an estimated 600 to 1,000 cases reported.

But that success is also part of the problem. Until the world can be certified as completely free of polio, childhood vaccination must continue. But the oral polio vaccine itself can mutate and start off an outbreak.

The oral polio virus is a version of polio that is far less virulent. But simply through random mutation it an regain that virulence. It also has the ability to borrow genes from other viruses found in children it infects.

Now this sort of mutation would not get very far in societies with high levels of immunization. The problem is that there are parts of the world where vaccination is still only at 80 percent or less, and those areas are susceptible to outbreaks.

In fact just such an outbreak — albeit on a rather small scale — occurred in the Dominican Republic and Haiti in 1999 and again in 2001. As many as 20 percent of children in the Dominican Republic and Haiti are not vaccinated and are susceptible to a mutated version of the oral polio vaccine.

The latest outbreak highlights concerns over how long vaccination should continue after polio is declared eradicated, and also adds new importance and impetus to eradicating the disease as fast as possible to minimize the risk of a widespread outbreak.

Source:

Polio vaccine bites back. Tom Clarke, Nature, March 15, 2002.

Promise of eradicating polio experiences setback. National Center for POlicy Analysis, April 16, 2002.

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Is the World Health Organization Part of the Problem?

Brian Doherty has an excellent, scathing attack on the World Health Organization for the January 2002 issue of Reason which argues that the organization is a bureaucratic nightmare more interested in self-preservation than actually doing something about improving health in the developing world.

Doherty writes that when the WHO was founded after World War II it had a substantive impact on health, especially in the developing world. WHO played a major role in tackling a number of infectious diseases, culminating with its role in the eradication of small pox in 1977.

But after the victory over small pox, WHO started turning away from focusing on infectious disease in the developing world to most First World concerns. First under Director General Hiroshi Nakajima and then Gro Harlem Brundtland, WHO began to turn away from infectious disease. Doherty writes,

In a world still fighting infectious disease, Brundtland’s WHO has issued statements, studies, and reports on such topics as blood clots in people who sit still on airplanes too long, helping people remain active while aging, the hazards of using cell phones while driving, the importance of debt relief for poor countries, how tobacco is “a major obstacle to children’s rights,” and rates of alcohol abuse among European teens.

Doherty is especially troubled by the recent WHO analysis of world health problems which relied on a measurement called the disability adjusted life year. The idea behind the DALY is that someone suffering from a severe illness or disability is living a lower quality of life than someone who is not. But WHO’s attempt to quantify produced bizarre results whereby, for example, WHO claims that 16 percent of the years lost to disability in sub-Saharan Africa come from mental illness. Any organization that thinks mental illness is one of the major health problems facing that region, however, is crazy.

Doherty’s article finishes with a stark reminder of just how ineffective WHO is and how misguided its focus on things like years lost to disability are,

Nothing condemn’s WHO’s current agenda more than some of its own pronouncements. In a 1999 press release, WHO declared that six illnesses accounted for 90 percent of all infectious disease deaths among people under 44 years: malaria tuberculosis, measles, diarrheal diseases, acute respiratory infections (including pneumonia), and AIDS. The same press release declared that “the tools to prevent deaths from each of these six diseases now cost under $20 per person at risk, and in most cases under $0.35. Yet these diseases still caused over 11 million deaths in 1998.”

. . . we have WHO declaring that 11 million deaths — 90 percent of all infectious disease deaths for people under 44 years — could have been easily prevented with an expenditure of, at its lowest, $3.9 million, and at its highest, $220 million. That is, anywhere from 0.4 percent to 20 percent of WHO’s budget for one year.

What does WHO spend its money on instead? Doherty cites an analysis of WHO’s 1994-95 budget that found WHO spent as much on its meetings and its executive board as it did on immunizations, tuberculosis and diarrheal diseases combined. Seventy percent of its budget went to administrative overhead and its Geneva headquarters.

Source:

WHO Cares? The World Health Organization cares more about its own life than the lives of the poor. Brian Doherty, Reason, January 2002.

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Deadly Setback in Polio Immunization Efforts

As this site has mentioned before, efforts are under way to eradicate polio through intensive immunization efforts in much the same way that small pox was eradicated. That effort took a horrific turn in India where 500 children fell ill and at least nine died after a mass polio immunization campaign.

On Sunday, November 11, thousands of children throughout India were vaccinated against polio. Within 24 hours hundreds of children in the Indian state of Assam were taken to local hospitals and health officials report that nine children had died — all from the same village.

The BBC quoted non-governmental agencies as suggesting that the vaccines used in Assam may have been outdated. Regardless, clearly this is likely to be a setback to efforts to eradicate polio.

Source:

Deaths follow Indian polio campaign. Subir Bhaumik, The BBC, November 12, 2001.

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