/ 23 July 2010

Good governance crucial in fight against polio

It’s a common sight in Africa’s streets: a young man pulls himself along on makeshift crutches, trying to sell you cigarettes or cellphone credit. Infected early with polio, this man has lost the use of his legs and must now work harder and longer than anyone else to make a living. The fact that he does, as do affected men and women across the continent, is a remarkable example of courage in adversity.

Polio is no barrier to success — just ask Archbishop Desmond Tutu, who suffered from the disease, or the Congolese band, Staff Benda Bilili, made up of polio survivors who are taking the world by storm — but it does make success more difficult to achieve.

And the real tragedy is that their suffering was entirely preventable. There is no longer an acceptable reason for anyone to contract polio. The debilitating disease, which has crippled and killed millions throughout history, can be completely eradicated thanks to effective and inexpensive vaccines and immunisation programmes.

A global campaign to eradicate polio — spearheaded by the World Health Organisation, Rotary International, the United Nations Children’s Fund and the United States Centers for Disease Control and Prevention – has already seen astonishing success in reducing incidences of the disease.

In 1988 more than 100 000 new cases of polio were reported annually on the African continent. Today the disease no longer appears in many African countries. Where it does, new incidents of polio are often measured in single digits rather than thousands.

The most recent success story is Nigeria; only five new cases of polio have been reported so far this year, compared with 388 cases at the same time last year.

There are two valuable lessons to be drawn from this experience. First, it emphasises the importance of good governance in fighting disease. The Kick Polio Out of Africa campaign has commended the political leaders of Nigeria, and government officials in West and Central Africa, for their commitment to polio eradication, a commitment that has manifested itself in effective policies and ultimately a decrease in new infections.

Eradication campaigns on such a large scale require, at minimum, cooperation from governments. Good governance is not always about direct action from governments; it is sometimes just about allowing others to do their jobs. A great example of this is the campaign to eradicate guinea worm, led by the Carter Center.

The campaign has been very successful and incidences of guinea worm have been reduced from more than three million to just 3 000.

One of the Carter Center’s major breakthroughs occurred in 1995, when the opposing parties in South Sudan, a badly affected area, agreed to a six-month ceasefire to allow health workers to get to previously inaccessible areas. This ceasefire became known as the “Guinea Worm Ceasefire” and was crucial in lowering prevalence rates in South Sudan.

Another important lesson is the necessity of cross-border cooperation and regional integration in fighting disease. Unfortunately, polio pays no attention to border posts or immigration officials, so countries have to work together. After a polio outbreak in northern Nigeria in 2008, the virus spread into neighbouring countries and as far as Angola, Mauritania and Kenya.

This highlights the need for all countries to have preventative vaccination policies to safeguard their populations. Cooperation on such a global scale might sound far-fetched, but it has worked before — smallpox was completely eradicated in 1979 after a joint global effort.

Although the fight against polio has been overwhelmingly successful, it has not yet been won. Although numbers of new cases have drastically decreased, outbreaks and epidemics are a constant threat.

This is not the time to relax and say “job done”. One final push could see polio eradicated completely, thereby preventing any possibility of a resurgence of the disease, protecting thousands of children across the world and allowing them to participate fully in the development of their continent.

A recent initiative from African Rotary members has sought to achieve just this; in the months leading up to the World Cup Rotary launched a massive vaccination drive across the continent, with 85-million children under the age of five being vaccinated by 400 000 volunteers in 19 countries.

At the end of the campaign a football signed by African leaders and dignitaries was kicked into the sea, symbolically kicking polio out of Africa.

Only a metaphor, perhaps, but a strong one, reflecting exactly what needs to happen with this deadly but preventable disease.

The author is founder and chair of the Mo Ibrahim Foundation, www.moibrahimfoundation.org.