Why the U.S. shouldn't let the eradication of polio lag

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Friday, February 4, 2011; 8:27 PM

"THE MOST direct way of saying this is that every $2,000 cut in the most effective aid spending causes a child to die." So writes Bill Gates in his annual letter from the Bill and Melinda Gates Foundation. He's talking about foreign aid, particularly for vaccines - and his numbers have a way of putting the Washington fiscal debate in some perspective.

Mr. Gates's most intense focus is on polio, a scourge so preventable that most Americans only dimly remember what it is. But as earlier generations can attest, it is a terrible disease that kills many and leaves survivors permanently and severely disabled. Thanks to foreign aid - the primary donors being the United States, the Gates Foundation, Rotary International and India - there's a prospect for making it the second disease to be eradicated, after smallpox. But with foreign aid budgets threatened, there's also a danger that polio will stage a comeback.

Most of the world's children today receive polio vaccines, and the disease is endemic only in pockets of India, Pakistan, Afghanistan and Nigeria. But as long as those pockets exist, there's always a danger of outbreaks elsewhere. If it's not eradicated, Mr. Gates said during a visit to The Post this week, it's likely the world would see something like 200,000 new cases every year - that's 200,000 children killed or crippled.

If that number isn't sufficient argument, Mr. Gates has others. The cost of treating polio victims and continuing inoculation campaigns would be far higher over time than the cost of completing the drive to eradication. More broadly, the burden in poor countries of preventable disease is immense, in a lower average IQ among survivors, which holds back economic development, and in overpopulation: Healthier families have fewer children. The strategic and environmental consequences are obvious.

As Washington follows many states into an era of budget-cutting, the line of special pleaders will be unending, and many of them will have good arguments. One reason we wish that President Obama and Congress would get serious about a long-term debt reduction plan - and here we're straying beyond Mr. Gates's message - is that if the pain isn't shared among Medicare, Social Security and defense spending, deserving items such as foreign aid, national parks, college scholarships and research will have to take a disproportionate hit.

Even among the deserving special pleaders, though, foreign aid, particularly for vaccines, merits a place at the front of the line. "This year 1.4 million children will die from diseases for which there are already vaccines," Mr. Gates notes. For very little money, Americans could dramatically reduce that number. It's hard to imagine a better investment.

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