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Infectious Diseases and Global Health: The Ongoing War against Polio and COVID

Boy receiving polio drops from a health worker, with his mother during a polio vaccination campaign in 2015. Vaccination against polio dropped by half in Ukraine between 2007 and 2014, from an estimated 98% coverage with the third dose in 2007 to a low of 45% in 2014. On 1 September 2015, Ukraine?s Minister of Health announced that circulating vaccine-derived polio had been identified as the cause of paralysis in 2 children living in south-western Ukraine. This outbreak was a threat not only to Ukraine, but to the entire European Region, which was declared polio-free in 2002. Les activités de vaccination contre la poliomyélite ont été réduites de moitié en Ukraine entre 2007 et 2014, passant d?une couverture avec la troisième dose estimée à 98 % en 2007 à 45 % en 2014. Le 1er septembre, le ministre ukrainien de la Santé a annoncé que la paralysie observée chez deux enfants vivant dans le sud-ouest de l?Ukraine était due à un poliovirus circulant dérivé d?une souche vaccinale. Cette flambée épidémique constituait une menace non seulement pour l?Ukraine, mais aussi pour l?ensemble de la Région européenne, qui a été déclarée exempte de poliomyélite en 2002. Zwischen 2007 und 2014 ist die Polio-Impfrate in der Ukraine um die Hälfte gesunken: von einer Durchimpfung mit der dritten Dosis von schätzungsweise 98% im Jahr 2007 auf einen Tiefstand von 45% im Jahr 2014. Am 1. September 2015 meldete das ukrainische Gesundheitsministerium, dass zirkulierende, aus Impfstoffen abgeleitete Polioviren als Ursache für die Lähmungen bei zwei Kindern im Südwesten des Landes ermittelt worden seien. Dieser Ausbruch stellte nicht nur für die Ukraine, sondern für die gesamte Europäische Region, die im Jahr 2002 als poliofrei erklärt wurde, eine Bedrohung dar. ? ?????? ? 2007 ?? 2014 ??. ?????????? ?????? ???????????? ? ??????? ??????????? ??????????, ? 98% ?????????? ?????? 3-?? ????? ??????? ? 2007 ?. ?? 45% ? 2014 ?. 1 ???????? 2015 ?. ??????? ??????????????? ??????? ??????? ? ????????? ?????????????? ??????????? ?????????? ?????????????, ??????? ???? ???????? ???????? ? 2 ?????, ??????????? ? ???-???????? ????? ???????. ??? ??????? ????? ??????? ?? ?????? ??? ???????, ?? ? ??? ????? ???????????? ???????, ??????? ??? ???????? ????????? ?? ???????????? ? 2002 ?.

The adverse effects of the COVID pandemic, which made its foul mark globally in 2020, are nothing short of devastating. More than 1.2 million US citizens have perished to the pandemic, marking a profound blow yet highlighting the intense battle fought by the medical fraternity. For centuries, the advent and spread of infectious diseases have triggered widespread alarm, misunderstanding, condemnation, and retreat, ultimately succumbing to defeat. Change, however, began to ripple after World War II, courtesy of antibiotics and vaccines that could prevent and treat diseases from polio to measles to mumps and tuberculosis.

Around the world, the COVID pandemic stands apart due to the velocity at which the scientific community, backed by government agencies, sprung into action for remedy. The resultant safe and effective vaccines have not only been groundbreaking but have spared an inestimable number of lives. Yet, this victory is overshadowed by the nomination of an anti-vaccine advocate to be the head of health and human services. Such a time should be reserved to acknowledge these remarkable feats and advocate for more resources for forthcoming healthcare battles.

Regardless, intense media scrutiny does offer some silver lining, as it uncovers hitherto unknown details about this nominee’s organization. Some have even called for a halt to infectious disease research for several years. The situation might even deteriorate. Will pseudo-science gain traction in pivotal decision-making bodies such as healthcare agencies? Would vaccines currently mandated by law turn into an optional choice or even cease to exist?

It’s not surprising that the global health community fears attempts to undermine vaccination programs, given this climate. The worldwide initiative to eliminate polio has yet to reach a consensus. Opinions diverge into those who consider this an unachievable goal, those who believe it to be a poor allocation of scarce resources, and others who propose containment as a more effective strategy than entire eradication.

Two kinds of vaccines have been utilized in the fight against polio: one, an injected dead poliovirus vaccine that came into use in the early 1950s, and an oral poliovirus vaccine developed a decade later. However, the campaign has been beset by perpetual delays. Year after year, the declaration that ‘We’re on the brink of eradicating polio’ endures, yet so does the disease.

The struggle to eliminate polio is akin to an unsettling game of whack-a-mole: no sooner does one region declare itself polio-free, the virus emerges somewhere else. The fight against polio continues, with sporadic successes on one hand and continued obstructions from civil discord, religious extremism, and suspicions of western interventions in remote areas on the other. These factors have continuously obstructed mass vaccination drives.

Added to this mix is the fact that to be effective, the polio vaccine needs to be administered in at least four doses. The question of the success of this mission remains debated. Nevertheless, the relentless pursuit of the ultimate goal is nothing short of inspiring. Funding is thankfully resilient, recruitment of volunteers is reaching millions, and there’s a rising trend of international cooperation, particularly among Middle Eastern and African countries.

The cause of global eradication has undeniably been impacted by Trump’s decision to withdraw from the World Health Organization and nominate the said activist. But even Trump’s message seems discordant. He has spoken of acquaintances who have fought polio, while also praising the vaccine as ‘the greatest thing ever’, akin to a miracle.

The journey to eradicate polio is far from over. Abandoning the mission would be tantamount to admitting defeat, possibly leading to a rise in global polio incidences, and acceding to the stance of anti-vaxxers that the disease doesn’t warrant compulsory vaccination, even within the United States.

Despite the setbacks and complexities, it is imperative to remember the power of vaccinations and the immense value they bring to global health. The COVID pandemic merely highlighted this fact, showing us the rapid strides science can make with adequate support and determination.

As our reality continues to evolve with our understanding and knowledge of infectious diseases, the importance of vaccination, and its role in the fight against such diseases, cannot be downplayed. Especially now, as we face new variants of COVID and the persistent menace of older diseases like polio, the success of vaccines is crucial.

Whether or not complete eradication might be within our immediate grasp, the fight against these diseases must continue. It is a timely opportunity for nations who have till now been sidelined in the battle to step forward and demonstrate their commitment to this cause.

Beyond political wavering and public skepticism, the absolute necessity of maintaining the forward momentum in developing and administering vaccines should be prioritized. The risks are too high, the stakes too significant. With every advancement, every victory, we move closer to ensuring a safer, healthier world for generations to come.