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Gates Package, p.548 · gates:exh:00188
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Mapping the End of Polio
Polio eradication is a top priority for the foundation, a primary focus for me, and a powerful
example of the importance of accurate measurement. Starting in 1988, organizations including the
US. Centers for Disease Control and Prevention, Rotary International, UNICEE, and the World
Health Organization, along with many countries of the world, agreed to the goal of eradicating
polio. Targeting an explicit goal focused political will and opened purse strings to pay for large-scale
immunization campaigns that led to very rapid progress. By 2000, the virus had been wiped out of
the Americas, Europe, and most of Asia.
The number of global polio cases has been under 1,000 cases for the last two years, but getting rid
of the very last few cases is the hardest part. For some diseases like smallpox--which was visible
on the skin--you can track where the cases show up and focus on vaccinating children in those
areas. However, polio takes weeks to confirm, and over 95 percent of people infected with the polio
virus never develop symptoms--so they can spread the virus without anyone realizing it. That's
why it' called "silent transmission" In order to stop the spread of infections, health workers have
to vaccinate nearly all children under the age of five multiple times a year to achieve the necessary
immunity thresholds in polio-affected countries. It's estimated that this threshold is 80 to 95 percent
in the parts of Africa and Asia that still have polio. Achieving consistent coverage levels to reach
these thresholds requires timely, accurate, local measurement so you can see where you are falling
below the threshold, figure out what is wrong, and fix it.
Last January, after years of battling the disease, India celebrated a full year without a single case
of polio. Most people expected India to be the most difficult place to eliminate polio because
of its densely crowded urban areas, huge rural areas in the North, poor sanitation, large mobile
The Last Percent
'The number of polio cases dropped by 99 percent from 1988 to 2000, from 350,000 cases to less than 1,000,
yet it's challenging to eradicate the virus. India is a good sign: Once home to the majority of polio cases in
the world, the country has been polio-free since 2011, thanks to innovative approaches to eradication.
2,000 --
India reports
zero cases
1,500 --
d
5=
1,000 --
F
,
a
500 --
o-
'oo
'01
0304050607
"08
091011
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© Total Global Cases
"As of 1/15/2013
i Total India Cases
SOURCE: World Health Organization & Global Polio Eradication Initiative