EDITORIALS

The volunteers' contribution to polio eradication

Jonathan Majiyagbe

President, Rotary International, One Rotary Center, 1560 Sherman Avenue, Evanston, IL 60201-3698, USA (email: majiyagj@rotaryintl.org)

The desire to help others in need could be considered to be a fundamental human quality. Yet, with so many suffering from the crushing effects of poverty, hunger, violence and disease, we may wonder if it is possible to make a difference at all. As a Nigerian lawyer, and President of Rotary International, I have solid proof that the answer to this is "yes". Although they are not always seen, many people selflessly put aside life's daily demands to offer their time and compassion for those in need. For some, such personal philanthropy has become a lifelong passion.

Never has the spirit of volunteerism been demonstrated more eloquently than in the global effort to eradicate polio. With its worldwide community-based network of business and professional leaders, Rotary is the volunteer arm of the global partnership dedicated to ending this crippling disease. For nearly 20 years, Rotary members have quietly worked in cooperation with national health ministries, WHO, UNICEF, and the US Centers for Disease Control and Prevention among others, to immunize more than 2 billion children against polio in 122 countries. Why polio? During the first half of the 20th century, the disease paralysed half a million people a year. In the 1980s, Rotary International was looking for a common global task: protecting children from the cruel and sometimes fatal consequences of polio seemed a natural choice.

Rotary's polio immunization efforts began in 1979, when it committed itself to a massive project that some said would be impossible: to provide the financial and human resources to immunize 6 million children against the disease in the Philippines. Inspired by the programme's success, Rotarians expanded their efforts, resolving to purchase enough vaccine to immunize the children of the world against polio in time for Rotary's 100th anniversary in 2005. By 1988, Rotary had raised more than US$ 247 million, doubling its original goal of US$ 120 million, through its PolioPlus programme.

This programme, and Rotary's community-based leadership and volunteer support, provided the catalyst for the World Health Assembly's resolution in 1988 to eradicate polio. Since then, Rotary has committed more than US$ 500 million to the effort and, raised over US$ 80 million in 2003. Rotary has also provided volunteers to promote and assist with national immunization days in endemic countries around the world. Rotary members have helped with vaccine delivery, and squeezed countless drops of oral polio vaccine into the mouths of billions of children. To educate communities and appeal to parents to have their children immunized, Rotary members employ innovative strategies and election-style campaign techniques for mass mobilization, including: TV spots, radio promotions, folk songs, and promotional messages on billboards and in newspapers.

In January 2003, 100 000 Rotary members and their families joined members of the government of India to immunize over 165 million children in one day; the largest public health event ever. In Nigeria, 43 Rotary members from the United States and Canada joined Nigerian Rotary members and other volunteers to help vaccinate some 40 million children against polio in 2002. In addition, local Rotary members have been instrumental in educating Muslim and traditional leaders about the importance of protecting children from polio. In 2002, members met with Emir Alhaji Ado Bayero of Kano, one of Nigeria's most influential Muslim leaders, who subsequently made an unprecedented endorsement by publicly administering the polio vaccine to more than 20 children in his palace.

Apart from Rotary members, millions of other community leaders including parents, teachers, religious leaders and health workers have volunteered countless hours of their time to polio eradication. They have gone to heroic lengths to reach every child with the vaccine; travelling hundreds of miles on camel, by boat, by helicopter, on horseback, or on foot; setting up immunization programmes in war-torn nations; and have venturing literally into deserts, jungles, rivers and mountainous areas to reach every child that needed to be immunized. In 2002, 500 million children were vaccinated during 266 national immunization campaigns in 93 countries (Global Polio Eradication Initiative Progress 2002), using two billion doses of oral polio vaccine. The efforts of millions of volunteers worldwide have indeed made a profound difference. Never before has polio been more geographically contained, with 99% of cases found in only these countries: India, Nigeria, and Pakistan. In the 1980s, approximately 1000 children were infected by this crippling disease every day. In 2002, less than 2000 polio cases were reported in seven countries: Afghanistan, Egypt, India, Pakistan, Niger, Nigeria, and Somalia — down from the 350 000 cases estimated in 125 countries in 1988 (The Global Polio Eradication Initiative: progress 2002. WHO document WHO/POLIO/03.02. Available from: http://whqlibdoc.who.int/hq/2003/WHO_POLIO_03.02.pdf)

Today, half of the world's population lives in areas certified polio-free. The Americas were declared free from polio in 1994, as was the Western Pacific Region in 2000, and European Region in 2002. This remarkable progress would not have been possible without the enthusiasm and support of more than 10 million volunteers worldwide. However, finishing this historic health initiative will be the most difficult leg of the journey. The last endemic areas are proving recalcitrant and insufficient funding could threaten our ability to immunize every child.

We have a historic window of opportunity. If we stop now, polio will again spread rapidly, crippling thousands of children each year, as it once did. I challenge others — individuals, communities, and governments, to join Rotary and our partners in this effort, so that all children can enjoy a polio-free world. When that joyful day arrives, the legacy of the polio eradication initiative will show the world that civil society, with its dedicated volunteers, can truly make a difference and has a key role to play in future global public health endeavours.