The Blog

Eliminating Polio Forever - Why Should We Care?

A quarter of a century ago, a million children's lives were ruined or lost to Polio every three years - today that number is just 400 a year. A disease that was once endemic in 125 countries is now confined to just a small handful - in Nigeria, Afghanistan and Pakistan.

A quarter of a century ago, a million children's lives were ruined or lost to Polio every three years - today that number is just 400 a year. A disease that was once endemic in 125 countries is now confined to just a small handful - in Nigeria, Afghanistan and Pakistan.

As the world focuses on the growing Ebola crisis in West Africa, another tragedy is brewing, thousands of miles away. Polio is threatening to return. We can and must continue our efforts to eradicate it - we are so close - or we risk a new global epidemic that will bring with it pain, suffering and death to millions of children.

Two years ago, I assumed Polio - as many do - was a problem of the past. Then I was contacted by Image Nation, a studio based in Abu Dhabi. They were looking for a director to make a film about the latest efforts to exterminate polio. They had big plans, seeking to revive interest in this almost forgotten worldwide public health campaign.

As I put down the phone, I asked myself a question. Why should we care about polio today? And why should I, in particular, devote a year of my life to a cause that seemed to have been won already? But I promised to look into it and within a week I was hooked. Scratching the surface, I found a fascinating microcosm of the ills that currently beset our planet. This personal journey, in turn, led to the creation of Every Last Child, my documentary on the Pakistan Polio epidemic, which will be released in 2015.

There is still a real job to do. Despite its absence from the front pages, the Pakistani eradication program - where over 80% of the cases occur - has stalled. It is continually disrupted by violent attacks on vaccinators, who are mostly poor women paid just a few dollars a day. Dozens were shot dead following a fatwa issued by the local Taliban in the summer of 2012. Polio cases are on the rise and the virus is turning up ever more frequently in environmental samples. Worse still, the Pakistani strain of the virus has broken out of the region and has infected children in war-torn Syria and Iraq.

What has gone wrong? Why has a previously successful public health programme, designed to save children from a lifetime of suffering suddenly in the crosshairs? The answer is complex, and understanding that is what Every Last Child set out to achieve.

So what did we find? Extreme poverty, local corruption and inefficient public services in Pakistan has slowed the effort. Poor sanitation, floods and earthquakes have made their contribution too. But such barriers have been overcome in India, Somalia and dozens of other countries with similar difficulties.

The real difficulties the Pakistan, despite the Government prioritizing polio, are not developmental problems, but a deep ideological resistance. Among the tribal peoples of the Hindu Kush, the belief is that the polio program is a western plot designed to disadvantage or weaken Muslims.

The conspiracy theories I encountered were fanciful. Some told me the vaccine would make Muslim girls more fertile and the boys impotent (what would Sigmund Freud have made of that?) Others said it was a slow poison that worked like AIDS - which of course had been invented in the West and exported to Africa to weaken the continent. One individual even managed to come up with a theory involving the CIA and the Bermuda Triangle.

Any national public health campaign, coordinated - as it must be - from the center, would instinctively arouse suspicion among people who feel disenfranchised. Why would the international community spend so much and make such an effort for polio alone? Weren't there other, more pressing health needs, like combating measles (a killer of thousands) or dysentery? For some that alone was proof enough of a conspiracy.

Resistance to vaccination campaigns is not just limited to Pakistan's tribal belt, or indeed to disenfranchised or poor communities. Not long ago, thousands of sophisticated middle-class parents in the UK refused to give their children the MMR (measles, mumps and rubella) vaccine because of a false report that it was associated with autism. Attempts to dispel their fears by scientists fell on deaf ears. The consequence - dramatic increases in these childhood diseases throughout the UK.

Fortunately, for the majority of Pakistanis, such anti-science ideas hold little sway. Active resistance to polio vaccination is only found in the tribal areas or in the urban neighborhoods which host Pashtun refugees fleeing natural disasters and the conflict in their homeland. In fact, many of the polio vaccinators consider it their Muslim duty to work on the program because of the Islamic principles of charity and social justice. Thousands turn up on campaign days in the full knowledge they are putting their lives in serious danger - a risk we have all been reminded of in week when the Taliban mounted its horrific attack on a Peshawar school that killed over 100 people, mostly children.

Before the eradication program came to Pakistan, some 20,000 children were crippled each year. The country's streets are still littered with the broken bodies of polio victims begging for a crumb. The volunteer vaccinators instinctively understand that if the campaign falters or fails, those numbers will return within a decade (official estimates predict 400,000 victims a year worldwide). The Pakistani people, despite all their difficulties, are working hard to end polio forever. We must share that burden and match their commitment with solidarity. It is a struggle humanity must win.

Tom Roberts feature documentary Every Last Child about the polio epidemic in Pakistan premiered at last month's DOC NYC and will be released in 2015.