Canadian Robert S. Scott (left), chair of the International PolioPlus Committee, joins Pakistani President Asif Ali Zardari (center) and other government officials on 10 October in Islamabad to launch National Immunization Days.

New tools, new tactics, and increased support from political leaders have put Rotary and its partners in the Global Polio Eradication Initiative  in the best position ever to finish the job of ridding the world of polio.

Dr. Bruce Aylward, director of the initiative at the World Health Organization, said 2009 was a watershed year in the fight against polio. For the first time, eradication workers discovered a chink in the armor of the disease "that has been tormenting mankind for thousands of years," he said.

"Our tactics are better, the tools are better, and our support is stronger than ever," Aylward told regional Rotary Foundation coordinators  (RRFCs) 18 March during a training event in Chicago. "You will be the Rotarians at the front in pushing forward this new strategy. I need you to make sure every Rotary club knows about this, because we will not get the job done without Rotary leading the charge."

The new strategic plan for the Global Polio Eradication Initiative involves mobilizing massive resources to reach more children in the areas where the virus remains endemic. For instance, a survey in the two endemic states of India, Bihar and Uttar Pradesh, identified thousands of homes and children who had not been reached by health workers. The two states have been a challenge because of high population densities in areas of extreme poverty, where poor sanitation can contribute to the spread of the virus.

Support from leaders

Another key element of the new strategy focuses on eliciting the support of political and traditional leaders, a move that is seen as critical to eradicating the disease in the remaining four endemic countries: Afghanistan, India, Nigeria, and Pakistan. Aylward said Rotary has led the charge to gain the leaders' backing. International PolioPlus Committee Chair Robert S. Scott visited the president of Pakistan in October to present him with a Polio Eradication Champion Award, recognizing his contributions toward a polio-free world. Bill Gates visited India in November and met with Rotary leaders there to line up the support of the state governors.

Rotarians have had a hand in securing letters from Taliban and NATO forces encouraging full cooperation with immunization efforts in Afghanistan. United Nations Secretary-General Ban Ki-moon told attendees at the 2009 RI Convention in Birmingham, England, that he'd work for Days of Tranquility in conflict areas to remove impediments to immunizations.

To address the immediate financial needs of mass vaccination campaigns, The Rotary Foundation expedited US$30 million in funding for a synchronized immunization drive 6-8 March, supported by leaders in 19 countries across Central and West Africa. Nine of the countries have had cases of polio within the last six months; the disease spread from Nigeria, where the virus has dug in its heels. A second drive is planned for 24 April, and the countries with active outbreaks of polio will receive a third sweep.

The new tool Aylward praised is the bivalent oral polio vaccine, first used in Afghanistan in December and since employed during immunization days in Nigeria and Pakistan. The bivalent vaccine has an advantage over monovalent vaccines because it is effective against both remaining types of wild poliovirus, types 1 and 3 -- type 2 has already been eradicated -- and was proved in clinical trials last year to be almost as effective as the monovalent vaccine.

The combination of new tactics and tools has been amazingly effective, Aylward said. In 2009, Nigeria had 388 cases of polio in 24 states. So far this year, there has been only one case in one state. In India, type 1 has been reduced to just one genetic lineage.

US$200 Million Challenge

John F. Germ, vice chair of The Rotary Foundation Trustees and chair of the Rotary's US$200 Million Challenge Committee, told the RRFCs that Rotarians have raised $115.6 million toward the challenge, and stressed that the fundraising effort is as important as ever. "The polio eradication campaign is the largest public health campaign the world has ever seen. We can do it, we must do it, because we have promised the children of the world that we would do it."

Germ said Foundation alumni and 11 Rotary fellowships have responded to the invitation to participate in the challenge, with alumni contributing $260,000. Interact clubs have raised $70,000, and Rotaract clubs $41,000.

Penny LeGate, an independent producer and freelance journalist who spoke at the 2010 International Assembly in January, shared personal stories from her participation in immunization drives in Ethiopia and India.

"I just can't explain the feeling I have when I hold that baby in my arms and I know that child will not get polio," LeGate said. She also shared the heartbreak of finding a girl, Minakshi, in India who had contracted polio. Volunteers had to explain to the girl's mother that they did not have any medicine that could cure her.

LeGate encouraged the RRFCs to consider taking part in an immunization drive, adding that she hoped the drives would not be needed much longer as progress toward polio eradication continued. "You will see firsthand why eradication is the very heart and soul of Rotary."