Polio Eradication: A Priority Investment?

by Quentin Wodon
Today is world polio day, the ideal day to launch “Rotarian Economist”. This blog will feature commentary and analysis to support Rotarians in their “service above self” mission. Given that polio eradication is a priority for Rotary International,  this first blog is about polio.

Polio image

Reports earlier this year have documented a polio outbreak. The wild poliovirus has spread in central Asia (from Pakistan to Afghanistan), in the Middle East (from the Syrian Arab Republic to Iraq) and in Central Africa (Cameroon to Equatorial Guinea). In May the World Health Organization declared that the spread of the virus constitutes an “extraordinary event”. The situation is most serious in Pakistan where most of the cases of paralysis observed to date for 2014 have been recorded.

Polio is preventable through vaccines. Yet polio eradication is at risk. The WHO Emergency Committee unanimously concurred that conditions for a Public Health Emergency of International Concern had been met, recommending among others to vaccinate all those traveling outside affected countries. While three in four people carrying the virus have no symptoms, they can all be highly contagious.

Polio used to be a devastating disease affecting 30,000 children per year in the United States alone in the mid 1950s. Thanks to vaccines and mass immunization campaigns reaching more than 2.5 billion children over the last 15 years, the number of polio cases worldwide has dropped to close to zero. But it is essential to reach the last mile. Unfortunately vaccination remains difficult in many conflict affected areas, and the risk of exportation of the virus from those areas to other countries is real.

The dramatic reduction in polio cases in the last fifty years has been a great success built on strong public-private partnerships. While many governments have funded the polio eradication campaigns, after the United States (with $2.2 billion in contributions and pledges) the two largest donors from 1985 to 2014 have been private foundations – the Bill and Melinda Gates Foundation ($1.9 billion) and Rotary International ($1.3 billion). Apart from financial donations, hundreds of thousands of volunteers – including many Rotarians from all over the world – have participated in polio vaccination campaigns.

In a February 2014 report, UNICEF and WHO estimated the price tag for polio eradication for the period 2013-18 at $5.5 billion. The available contributions amount to $1.8 billion, but the remaining funding gap is at $3.7 billion. Private partners such as the Bill and Melinda Gates Foundation and Rotary International are stepping up to the plate. But more needs to be done by donors and multilateral organizations.

As a Rotarian, I used to wonder whether it made sense to spend that much money on a disease that seemed to affect only a few children. But the available research suggests it does, not only from an ethical point of view but also from an economic or investment point of view. This is because the cost of a spreading virus could be much higher.

Another report for the Bill and Melinda Gates Foundation suggests that previous investments of $9 billion since the creation in 1984 of the Global Polio Eradication Initiative (GPEI) may have already generated $27 billion in net benefits out of $40-50 billion in potential benefits estimated by researchers in an economic analysis of the GPEI. While investments in polio eradication campaigns have higher initial costs than routine immunization, they have much greater long term payoffs.

In the case of polio eradication as in many other cases of investments in young children, investing what is required is not only the right thing to do: it is also the smart thing to do.

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