Why Does Polio Still Exist?

Polio shouldn't exist anymore. The disease was first identified in 1840, a cause for its infection was singled out by 1908, and a vaccine was developed in the 1950s. Where polio infected some 360,000 in 1988, only 223 infections were identified in 2012 — largely due to the efforts of Rotary International, the World Health Organization, and UNICEF. While these groups have made considerable headway in nearly eradicating this disease, many would like to see polio go the way of smallpox. That is, into oblivion.

The question of why polio continues to exist is answered initially with a little bit of geography. Region by region, spaces have been declared as polio-free where a single case hasn't cropped up in at least two years. In 1994 the Americas were labeled the first region to be declared polio-free. Australia, China and 36 Pacific nations followed suit in 2000, and polio was eradicated in Europe in 2002. India was among the most recent countries to join this group in 2012. Today, nearly every case of polio can be traced to three countries: Nigeria, Pakistan, and Afghanistan. Only six cases of infection exist elsewhere.

The good news is that none of the factors responsible for the prolonged presence of polio are intractable. Here are four that need to be tackled:

1. Fear, suspicion and conspiracy:

Part of the reason polio continues to exist in some countries is religious opposition to the vaccine. An Islamic fatwa was issued against the use of the cure in Northern Nigeria, an area thought to be largely, if not totally, free of polio. Soon polio spread to the rest of Nigeria; now more than half the cases of polio worldwide are found there. The religious obstacle to vaccine administration is not a fundamental opposition to curing polio; rather, anti-vaccination movements are a vehicle to channel suspicions against Western aid. Delivering vaccinations via a more culturally-specific mode of outreach is the very least of what's needed to bridge the gap.

2. Violence against aid workers:

The factors generating polio tend to build upon themselves. Because polio vaccination has become a proxy for opposition to the West, aid workers are being attacked. Just last month, nine female vaccination workers were shot from a motorcycle in Kano, Nigeria. While these attacks are not widespread, they incite enough fear to deter health missions from moving forward with their work.

3. Lack of resources:

Not unlike other shortcomings of public policy, polio vaccination continues to wallow as an underfunded project. While the combined efforts of international organizations to eradicate the disease are projected to cost $1 billion a year, the campaign has come short $660 million in 2013. The issue here is not just a general lack of resources, but also the perceived magnitude of eradicating some couple hundred cases of a disease. That cost seems high for what few incidences exist, but experts point to the ability for seemingly isolated cases to spread.

4. Delaying action results in a self-perpetuating cycle:

The longer we wait to completely eradicate polio, the more it continues to wane and then pop up in other areas of the globe. The delay in treating polio itself generates more polio. In this sense, spending extra money on eradicating the disease is an investment for the future. In the last several years international organizations have put $9 billion toward this end. Each additional underfunded year that doesn't serve to nail the coffin of the disease potentially invites another year of underfunded missions to nail the coffin of the disease, and so on. 

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Rajiv Narayan

I'm currently a contributing curator at Upworthy and a grad student at the University of Oxford, where I study Medical Anthropology. In the last year I was an Associate at the healthcare information firm Close Concerns, where I covered research, drug, and policy developments in obesity and public health. Before that I was a Research Assistant at Social Policy Research Associates. And not too long before that I was finishing my undergraduate studies at the University of California, Davis, where I was very privileged to be a Regents Scholar and graduate Phi Beta Kappa with highest honors in a self-designed major. In college I was a 2010 Young People For fellow and the Senior Fellow for Health Policy at the Roosevelt Institute Campus Network. At various points over the last 4 years I've worked on an urban farm in Milwaukee, interned at the California State Assembly, and taught classes on the Social Theory of Eating Disorders at UC Davis. On the academic side, I researched obesity legislation in Argentina, food stamps in California, the racial dynamics of obesity policy in Southern States, and fat acceptance activism in California.

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