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Experts Weigh Giving Up on Killing Polio
Others are not convinced.
"We cannot continue forever," said Dr. Isao Arita, another WHO smallpox veteran. "Everyone wishes WHO to accomplish the task but there is a limit."
  A child awaiting to be treated for polio cries in the town of Birao, the small sun-blasted capital of Vakaga, a region held for a month by rebels until late 2006, Central African Republic, Sunday, Feb. 11, 2007. Central African Republic has struggled for more than a year to contain a homegrown low-intensity rebellion in the northwest. Now, a new insurgency in the northeast near Sudan's Darfur region has compounded this fragile nation's troubles and displaced tens of thousands of people. (AP Photo/Schalk van Zuydam) (Schalk Van Zuydam - AP) |
For WHO, giving up on eradication would a crushing blow.
"There's an almost religious conviction that they must see this through," said Dr. Samuel Katz, an infectious diseases specialist at Duke University and co-inventor of the measles vaccine.
"But there are other things we could do that would be as beneficial to child health rather than spending another billion dollars in frustration," he said.
In the countries where polio occurs, there are many competing health priorities, including respiratory and diarrheal diseases, malaria and AIDS.
Some experts say that a polio containment policy wouldn't necessarily be radically different from an eradication policy, except that it would free up money for other health problems.
Tighter regulation in countries where polio occurs could help trap the virus, and international officials might adopt measures such as requiring proof of vaccination for travelers coming from polio-endemic countries.
WHO and its partners insist it is possible to eradicate polio, and that the only challenges are logistical.
Different problems plague the four endemic countries: In Nigeria, the weak health system coupled with a vaccine boycott in some areas gets the blame; in Afghanistan and Pakistan, the virus moves back and forth across the border where the official focus is on the war on terror; in India, children are often infected with other viruses, making the polio vaccine less effective.
Some experts think a different vaccine could help. The eradication campaign uses the oral vaccine because it protects entire communities. But while the oral vaccine is cheap and easy to administer, there is a downside: For approximately every 2.5 million doses, it causes one case of polio.
WHO is looking into the more expensive injectable polio vaccine, which uses an inactivated virus that cannot trigger polio. Results from the studies won't be available until next year.
WHO insists it is considering all options _ except giving up on eradication.
"Any program would be negligent if it didn't check all the possibilities," said Dr. David Heymann, WHO's top polio official, "but our partners didn't want to hear about a control strategy."
