The world is on the verge of a great success story: the eradication of polio. If and when successful, polio eradication will be only the second disease in human history to be eradicated, following the spectacular success of ridding the world of smallpox, completed in 1979. There is still ground to cover, a margin of success that will not only end a killer disease but will energize the world to fulfill the vital mission of public health in many other areas as well.
The success to date is remarkable. The Global Polio Eradication Initiative was launched in 1988 by Rotary International, the World Health Organization, UNICEF and the U.S. Centers for Disease Control and Prevention. Through the mass distribution of polio vaccines, the eradication campaign has led to a decline in cases from around 350,000 annually to fewer than 700 cases last year, a greater than 99 percent drop. India is now entirely polio-free.
Polio is now transmitted in small pockets of only three remaining countries: Pakistan, Afghanistan, and Nigeria. And the crucial news is that the leaders of all three countries have come together in a crucial commitment to finish the job. Many partners have also recently stepped forward. At a special session of the UN General Assembly last month convened by Secretary General Ban Ki-Moon, many governments and organizations stepped up with new pledges. In one important initiative, the Islamic Development Bank joined forces with the Bill and Melinda Gates Foundation to help complete the job in the remaining three countries.
Rotary, the original private sector partner in the polio eradication initiative, pledged $75 million in new money over the next three years, adding to the humanitarian group's total commitment of nearly $1.2 billion. The ongoing leadership of Rotary and the Bill & Melinda Gates Foundation, which also has contributed more than $1 billion to stop polio, demonstrates the capacity of the private sector to play a huge role in addressing the world's most pressing issues. In fact, it was Rotary's success at immunizing millions of children in the Philippines and other countries in the 1970s and 1980s that proved to the public sector that global eradication was even feasible.
Even though the current cases of polio transmission number less than 200 so far this year, the case for finishing the job - getting to zero - is more crucial than ever. If polio is fully eradicated, it can't ever return. On the other hand, if even a few cases persist, and the world lets its guard down, those few cases could become the start of a new epidemic.
Were that to happen, polio could quickly and tragically rebound to tens or even hundreds of thousands of cases per year. That's the nature of a lethal, highly communicable disease. And that's the overwhelming reason for completing the last push for full eradication.
The last push is definitely not easy. The remaining cases are in remote and sometimes violent areas. Local populations may be wary of vaccinators, and extremists may deliberately target the vaccination campaign so as to stir up trouble and chase away the international community. Yet the population in need is the real partner. Parents everywhere, whether in remote Afghanistan or our own neighborhoods, want their children to grow up healthy and to escape the scourge of polio and other killer diseases.
Some people ask why we should spend hundreds of millions of dollars to finish the job when there are so many other health priorities. The risk of rebound is one compelling reason. Yet there is another as well. The polio eradication campaign is improving public health more generally.
It is bringing vast populations into the reach of public health systems. It is training health workers by the hundreds of thousands around the world, who can go on to more general public health activities when eradication is completed. Today's army of polio vaccinators can become the community health workers of tomorrow supporting routine childhood immunizations, safe childbirth, malaria control, and other crucial public health measures that can save literally millions of lives per year. Bill Gates, Rotary and the other partners have pledged that their remarkable efforts to defeat polio in the remaining countries will help to build vibrant public health systems in those countries.
So close and yet so vulnerable: that is our current reality. With polio cases down to near zero, the world's patience and attention span could yet falter. The remaining budget gap to finish the job, a few billion dollars in the coming years, might remain unfilled. More than 3 decades of heroic efforts could yet be vanquished.
World Polio Day 2012, observed this week, is therefore the decisive moment to rededicate our efforts, to recommit ourselves to the unfinished business at hand. Every citizen should appeal to government to finish the job; every citizen can get involved by visiting the website endpolionow.org and taking personal actions to eradicate polio.
Afghanistan, Pakistan, and Nigeria may seem like far-off places, yet our and their fates are inextricably bound together. Let us work together to finish the great global effort to end polio once and for all, and to use the energy and experience gained in that global campaign to complete the challenge of providing health for all on our small and interdependent planet.
John Hewko is the CEO and General Secretary of Rotary International. Jeffrey Sachs is the Director of the Earth Institute at Columbia University and Special Advisor to UN Secretary-General Ban Ki-Moon.