Bill Gates: The world can defeat polio

Child receiving polio vaccine Vaccination is key to controlling the disease

Glance at the latest figures for polio incidence and it would appear that the world is within touching distance of eradicating the disease.

Last year there were just 205 cases of naturally occurring poliovirus compared with 650 cases in 2011 and a staggering 350,000 a quarter of a century ago.

There are now three countries - Pakistan, Afghanistan and Nigeria - where transmission of the disease has never been halted compared to 125 countries in the late 1980s.

India has been polio-free for two years - a remarkable achievement.

This week the billionaire philanthropist Bill Gates will deliver the annual BBC Richard Dimbleby Lecture in which he will spell out his commitment to ridding the world of this dread infectious disease which can cause paralysis and even death within hours.

Bill Gates is the single most influential voice in global health, so when he turns his attention to an issue, it is worth listening.

Through the Gates Foundation, Bill and his wife Melinda have already given away nearly $30 billion of their fortune and there are tens of billions more in the pipeline.

He has spoken to me previously of his passionate belief in the power of vaccines and his determination to defeat polio.

In his lecture Mr Gates will liken the pace of innovation in computers with the fight against polio: .

He will say: "In the late 1970s we had a dream of giving everybody access to computer technology - a vision of a computer on every desktop. Now there is a computer in every pocket.

"The pace of innovation keeps getting faster. The same is true of polio.

"It was first recognised at least 4,000 years ago, but it was just 200 years ago we figured out it's contagious - just 100 years ago we learned it's a virus. Just 50 years ago we developed the vaccine to prevent it.

"Just 25 years ago we resolved to eradicate it. And so on."

But Mr Gates will also acknowledge that the final push against polio is proving extremely difficult: "I can say without reservation that the last mile is not only the hardest mile; it's also much harder than I expected," he said.

The killing of nine health workers in Pakistan last month was a shocking reminder of the challenges facing those trying to chase down the virus and protect every last child. I have written before of the hurdles facing immunisation teams.

Part of polio's danger is its utter portability - it can be spread across borders by one infected traveller, who can continue to shed virus for weeks on end.

Only last week an emergency vaccination programme was ordered in Cairo after samples of the polio virus were found in sewage - the strain matches that in southern Pakistan.

The oral polio vaccine can - in very rare cases - trigger polio. The WHO says this happens in one in 2.5 million first doses of vaccine.

Over the past decade 15 billion doses of polio vaccine drops have been given and there have been 200 confirmed cases of circulating vaccine-derived polio virus.

But with naturally occurring polio cases now so low there is a minority which claims the oral live vaccine is causing significant harm.

Dr Jacob Puliyel, a paediatrician in Delhi, wrote in the Indian Journal of Medical Ethics last year that "the polio eradication programme epitomises nearly everything that is wrong with donor-funded 'disease specific' vertical projects, at the cost of investments in community-oriented primary care".

Dr Puliyel said the money spent on fighting polio in India would have been put to better use on water, sanitation and routine immunisation.

Now or never

Dr Puliyel blames the polio vaccine for a sharp rise in India of cases of Acute Flaccid Paralysis - weakness or inability to move limbs.

But polio is just one of many causes, with other viruses and bacteria also responsible. Public health officials also point out that monitoring of cases is now far better than in previous decades.

In pure economic terms it is hard to justify the $1bn (£630m) spent annually on driving down polio cases by a few hundred each year.

It makes sense only if global eradication is achieved. Then the repeated - sometimes monthly - polio immunisation rounds in at-risk communities can stop and the vaccine be part of the standard childhood schedule.

This is a now or never moment - kick polio off the planet over the next few years or face a humiliating retreat which could see the virus re-emerge in scores of countries.

Bill Gates recognises what is at stake for global health: "Polio eradication is a proving ground, a test. It will reveal what human beings are capable of, and suggest how ambitious we can be about our future."

The 2013 Richard Dimbleby Lecture will be shown on Tuesday 29 January on BBC One at 22:35 GMT

Fergus Walsh Article written by Fergus Walsh Fergus Walsh Medical correspondent

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  • rate this

    Comment number 96.

    Further to tragedy

    Does need - in places - for 'repeated polio immunisation rounds', reflect very incomplete sweeps, or rapid population flux?

    Might risk of iatrogenic polio, or Acute Flaccid Paralysis, be dose-related, from poor-hygiene contacts, or inadvertent rapid repeats?

    Failing to deal globally, with poverty, we 'make' every task hard or impossible

    Trust is needed, in equal partnership

  • rate this

    Comment number 95.

    It'll be a struggle, but amazing if it works. Personally, I hold significantly more hope out for guinea worm eradication, however. (Much less chance of large new outbreaks wiping out prior achievements).

  • rate this

    Comment number 94.

    93. chinkinthearmour

    Agree totally. I keep thinking some comments here have hit a new low, and then somebody comes along and descends even lower.

  • rate this

    Comment number 93.


    BBC blogs often have offensive, bigoted or ludicrous troll comments, where polite responses or facts are summarily dismissed. Utter rubbish spouted by so many insular juveniles or geriatrics.

    Even as a non-Muslim, non-partisan westerner coming to terms with anti-Chinese or anti-Islam as Western norms, Indus describing children born in poverty as parasites deserve the highest accolade.

  • rate this

    Comment number 92.

    Gates is surely involved in pretty much the same game as with computer softwear: making sure absolutely everyone has to have his products whether they are any good or not.

  • rate this

    Comment number 91.

    So Bill Gates gets criticised for chanelling vast amounts of money into the good of humanity, whereas Steve Jobs is treated as a deity for banning charitable donations from his company and chanelling the money into his own pockets and those of his shareholders? Good on you Bill!

  • rate this

    Comment number 90.

    The biggest problem with polio eradication would now appear to be that those in control of the areas concerned misunderstand what is happening.

    As the old saw goes

    " If you think education is expensive, try ignorance!

  • rate this

    Comment number 89.

    Even if his primary objective is population control, what is wrong with that? All of us are littering our land, polluting the earth with our toxic waste and overpopulating it. There is no sign of stopping even though we have limited resources. Do we really want the population to continue to increase exponentially?

  • rate this

    Comment number 88.

    "Just My Opinion
    It is Bill Gate's money. He can choose any worthy cause to put his billions into."

    He obtained those billions by ripping off his customers by (proven) abuse of a monopoly position in the market to charge a premium for a substandard set of products.

    Still, he's realised in 100 years time he wants to leave a legacy of a better planet, not a footnote in the history of computing.

  • rate this

    Comment number 87.

    Your failure to mention the role of Rotary International in any article about the eradication of polio displays a depressing ignorance of the subject.

  • rate this

    Comment number 86.

    Anybody that tries to do good in this world should be applauded, what have YOU done today?

  • rate this

    Comment number 85.

    We may bring the transmission rate down to 0, but we will never totally eradicate it.

    USA and Russia will keep a sample as with Smallpox.

  • rate this

    Comment number 84.

    First off, human beings have been around about one million years ... not several billion. Secondly, in the whole of human history, we have never had such good health and life expectencies ( , particually in the west. This is largely caused by improved healthcare, part of which is vaccines. The best example of this is the end of smallpox.

  • rate this

    Comment number 83.


    I don't know whether this blog will take links but here goes:

  • rate this

    Comment number 82.

    Bill and Melinda Gates are taking all steps to make sure some greedy govt officials do not intercept this money by doing it themselves this should have happened years ago with many causes look at Haiti, Indonesia Africa the list of money that was sent but not received is to long

  • rate this

    Comment number 81.

    @Doug: I too had polio at 4 years of age but somehow manged to avoid Mr Indus's extermination program. Mine was Lansing Polio (type 2) so the paralysis was non-permanent.

    Despite my genetic for lower intelligence therefore, my two children went on to university too ;)

  • Comment number 80.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 79.

    We eradicate a disease, Smallpox, 33 years ago, we can eradicate Polio now.
    Vince Radke
    an old Smallpox warrior

  • rate this

    Comment number 78.

    47.V-4r-Vendetta "malnutrition is the cause of disease"
    Ahhhh! the sweet smell of ignorance!

  • rate this

    Comment number 77.

    Mr Indus @55
    I had polio at the age of seven months and like most polio 'survivors' in western countries rose to the top tier of my chosen profession. Unfortunately for you I have bred and my children are currently at university.

    Your viewpoint might have some truth if Polio was a genetic disease, it isn't, the only genetic link is those that get the paralytic form have a high intelligence.


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