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3 Government/BMGF contributions announced 4 One child triggers Indias emergency response 5 Polio partners support Angola 8 Special tribute to Bill Sergeant

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ISSN 1727-3730

A Newsletter for the Global Polio Eradication Initiative by the World Health Organization in association with Rotary International, the U.S. Centers for Disease Control and Prevention and United Nations Childrens Fund

Funding gap the greatest threat to eradication - oversight body

its report, released on April, the Independent I nMonitoring Board (IMB) 20itstheassessment of the of Global Polio Eradication Initiative (GPEI) offers Despite these challenges, the IMB concludes that polio eradication is feasible in the near term, but warns that this goal will only be achieved with heightened attention at all levels. The group urges countries to monitor their emergency response plans at the highest levels of government and encourages the World Health Assembly (WHA) in May to evaluate whether the persistence of polio now constitutes a global health emergency. With the economic case for completing polio eradication clearly established, the IMB reminds the international development community that full financing of the effort is a shared responsibility. Established in 2010 at the request of the Executive Board of WHO and the WHA, the IMB is scheduled to meet next on 30 June-1 July 2011. - Oliver Rosenbauer/WHO. n
Failure to act now to eradicate polio will mean that more children will be paralysed by the virus. Seven-year-old Umar Aminus right leg was paralysed as a result of contracting the virus in 2004. Christine McNab

2012 Milestone to stop all transmission at risk: suboptimal implementation in key countries

requiring the greatest urgency of action among all remaining polio-affected countries.

progress towards achieving the major milestones of the GPEI Strategic Plan 2010-2012 and calls the US$ 665 million funding gap through end-2012 the single greatest threat to the GPEIs success. The IMB noted considerable achievements: of 15 outbreaks with onset in 2009, all appear to have been stopped; and evidence so far suggest that none of the new outbreaks from 2010 has lasted more than six months. The group concludes, however, that of the remaining endemic and re-established transmission countries, only India is on track to stop poliovirus transmission by end-2011, and that therefore, the end-2012 goal of cessation of all wild poliovirus transmission is at risk. The IMB expresses particular alarm at the current polio situation in Chad, considering it a public health emergency

Pakistan rolls out new emergency polio plan

akistan is in danger of being the worlds last remaining reservoir of polio. The country has already reported 33 cases in 2011, compared to a single case each in India and Afghanistan, and eight in Nigeria (as of 26 April). The President of Pakistan, Asif Ali Zardari, took heed of the warning signs in 2010, and by the end of the year ordered an emergency national response plan be drafted with the support of international partners in the polio eradication initiative. The resulting National Emergency Action Plan 2011 (NEAP) was launched in Islamabad on January 24. The plans main focus is to reach children in high-risk districts, improve access to children in insecure areas, and identify and reach mobile and migrant populations. Along with access issues in conflict areas, poor management in high-risk districts leading to low quality campaigns is the most frequently cited reason for continuing transmission in Pakistan. Taking this on board, the President held an extraordinary meeting with the top administrators of

some of the 33 high-risk districts to ensure speedy and full implementation of the plan. Cells responsible for the plans implementation will be established in all provincial chief ministers offices, reporting to a special cell which has been created in the Prime Ministers Office, allowing the provincial leadership to take ownership of polio eradication activities. The performance of district health and political leaders in implementing the NEAP will be closely monitored, and provincial administrations are beginning to remove or transfer low-performing district officials. In line with the NEAP strategy, UNICEF is placing more communications staff at provincial and grassroots levels, focusing on the highest risk union councils. These staff will facilitate the work of the vaccinators, identifying at risk groups and increasing demand for the vaccine. While insecurity may continue to hound polio eradication efforts in Pakistan, the NEAP has brought reinvigorated spirit and a focused approach to eradication in the country, increasing Pakistans chances of success. - Cathy Williams/UNICEF. n

WHO Pakistan
President Zardari gives polio vaccine to a child at the launch of a national emergency plan to get the country back on track for polio eradication.

Government/BMGF contributions announced - UK, Abu Dhabi. Page 3

News

Bivalent vaccine puts squeeze on type 3 polio

ivalent oral polio vaccine, better known as bOPV, exceeded expectations in 2010. This form of vaccine, introduced in December 2009, is having a dramatic effect on both remaining forms of wild poliovirus particularly on wild poliovirus type 3 (WPV3). The introduction of bOPV had an immediate impact on WPV3 case numbers (graph) in 2010, dropping 92% from 2009 levels to a total of 87, the lowest-ever number of WPV3 cases. Only nine cases of WPV3 have been reported for 2011 so far, compared to 42 at this time in 2010 (as of 26 April). Dr Jacqueline Fournier-Caruana, Technical Officer at WHO, said that another exciting development was the effect bOPV has had on overall case numbers in endemic countries: After the use of the vaccine in endemic areas like Uttar Pradesh and Bihar in India, and in Nigeria, we have seen a huge impact on the number of cases, confirming the results of the preliminary trial conducted in India in 2009. It seems that bivalent is even more efficient in the field than expected. The introduction of bOPV is partially credited for the more than 94% reduction in overall case numbers in both Nigeria and India in 2010. Dr Fournier-Caruana and partners such as manufacturers and National

160 150 140 130 120 110 100 90 80 70 60 50 40 30 20 10 0

bOPV introduced

Global number of WPV3 cases reported by month, 2009 - 2010 (graph)

Regulatory Authorities have been working tirelessly in conjunction with UNICEF to speed up the licensing and prequalification processes and ensure that more children can benefit from the protection that bOPV provides. Four manufacturers have had their bOPV approved by the WHOs prequalification process and three more manufacturers look set to have their bOPV prequalified by the end of the year.

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Meanwhile, new cases in west Africa threaten the global progress made against WPV3. Long-term use of type 1 monovalent OPV to fight off outbreaks of WPV1 has left west Africa vulnerable to WPV3. Insecurity in Cte dIvoire complicates the outbreak response, but it is important that quick action is taken to improve immunity to WPV3 in west Africa before the virus can spread any farther. - Lauren OConnor. n

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What is prequalification?
The World Health Organization (WHO) plays a leading role in scrutinizing vaccines. When a vaccine produced by a certain manufacturer has passed WHOs rigorous quality testing, it is said to be prequalified. This information, in conjunction with other procurement criteria, is used by United Nations organizations (such as UNICEF, in the case of polio vaccine) to make purchasing decisions. Countries that do not have their own regulatory bodies also rely on this information to guide their vaccine purchasing choices. Prequalification is a sign a vaccine meets global standards of quality, safety and efficacy.

Ventilators help Congolese patients survive polio

magine you are a health worker in a hospital in Pointe Noire in the Republic of Congo. Not having seen a case of polio for years, your wards are
Asselin/UNICEF

suddenly overflowing with patients who have been paralysed by polio. Your hospital is not equipped for such a calamity, and without ventilators those patients whose lungs are affected will slowly stop breathing. All attempts at invasive mechanical ventilation so far have failed. What would you do? Faced with a surge in such cases and deaths late last year in Congo, the World Health Organization (WHO) sent a team to investigate the epidemic area, led by consultant Dr Martin Dnser. While the reasons for the repeated failure of invasive ventilation techniques were deemed unclear by the team, it was suggested that poor hygiene practices and the medical staffs lack of training probably played a role. However, Dr Dnser had arranged with the WHO to bring ventilators with him on the trip: Although I had never seen polio before, it was clear that patients require ventilators. Since electricity supply is unreliable and gas supply inexistent, it

was impossible to carry standard ventilators. This is why the polio department [of WHO], the Global Initiative on Emergency and Essential Surgical Care of the WHO and I had searched for modern homebased ventilators which could provide the required ventilatory modes. Thanks to great collaboration of all participants we could organize the four ventilators within 2 days. These new ventilators do not require invasive procedures and can therefore be utilized by the current staff of the Hospital Adolphe Sice in Point Noire. Mdecins Sans Frontires agreed to train the Pointe Noire health workers in the proper use and care of the machines. Congo faced a deadly outbreak of wild poliovirus type1 (WPV1) at the end of 2010, after being poliofree for almost 10 years. Of the 382 people who were paralysed by polio last year, 179 died, many of them teenagers and young adults. - Lauren OConnor. n

Unusually, most of those struck with polio during the Congo outbreak are young adults, not children under five. [When I got here I could still move my arms says Tony Boussana, 24.] 2

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News

Gates call to donor community answered by UK and the Crown Prince of Abu Dhabi
January 2011, Bill launched his third I nannual letterformeraGatesYork the historic with speech at Roosevelt House, the New home of will go to delivering polio vaccine to children in Afghanistan and Pakistan. A few days later, on 28 January, British Prime Minister David Cameron announced a matching grant which could see the United Kingdom double its current contribution to the Global Polio Eradication Initiative in 2011-12. Mr Cameron called on donors to back the polio eradication effort, declaring that for every $ 5 pledged by others from January 2011 to December 2012, the UK would increase its support by $ 1 - up to a maximum of 40million in new funding. Mr Cameron said: I passionately believe that we have a once-in-a-lifetime opportunity to rid the world of Franklin Delano Roosevelt, where the future American president recuperated after being stricken with polio at age 39. In this years letter, Mr Gates acknowledges that governments around the world are facing tough decisions about how to reduce spending, but he urges them to reconsider slashing foreign aid funding: Although foreign aid accounts for less than 1 percent of governments total budgets, it is one place being considered for cuts. As a result, health and agricultural assistance that saves lives and puts poor countries on a track for self-sufficiency is at risk. the evil of polio. We have the vaccines and the tools to do it. All thats missing is real and sustained political will to see this effort through to the end. Thats why I am announcing today that the UK is prepared to fully vaccinate an additional 45 million children against polio, through a doubling of our support to the Global Polio Eradication Initiative over the next two years. In return for that commitment, we ask other donors to do their bit, and affected countries to strengthen their routine immunization programmes. - Amber Zeddies/Bill & Melinda Gates Foundation. n
Bill & Melinda Gates Foundation - Bill and Melinda Gates join UK Prime Minister David Cameron in announcing new funding to eradicate the crippling disease polio worldwide. Bill & Melinda Gates Foundation

There is never a wrong time to do the right thing

- Prime Minister David Cameron. n The worlds poorest will not be visiting government leaders to make their case, unlike other constituencies, so I want to help make their case by describing the progress and the potential I see in key areas of health and development. In the case of polio eradication efforts, Mr Gates letter recognized the tireless work of Rotary International and the strong support from governments including India, the United States, the United Kingdom, and Japan. On January 25, the Foundation announced new collaboration with His Highness Sheikh Mohammed bin Zayed Al Nahyan, the Crown Prince of Abu Dhabi. HH Sheikh Mohammed and the Foundation together committed a total of US$ 100 million to global health partners the GAVI Alliance, the World Health Organization and UNICEF of which US$ 34 million

Bruce Aylward speaks at TED2011

TED known for T he effortTalks are wellpolio.whichpresenting ideas worth spreading one of is the incredible worldwide to eradicate Dr Bruce Aylward, then Director of the Global Polio Eradication Initiative, was invited to speak at TED2011 by guest host Bill Gates, co-founder of the Bill and Melinda Gates Foundation. Dr Aylward has recently taken on the position of Assistant Director-General at the WHO, elevating polio eradication to the centre of a new cluster designed to facilitate national and international cooperation in order to provide healthcare to the most vulnerable and hardest-to-reach populations. Footage of the speech will be available soon at: www.ted.com. n

WHO updates polio immunization recommendations for travellers

o minimize the risks of acquiring polio (for travellers to infected areas) and of reinfection of polio-free areas (by travellers from infected areas), the World Health Organization (WHO) has updated its polio immunization recommendations for travellers in its publication, International travel and health 2011. All travellers to and from countries or areas reporting wild poliovirus should be adequately vaccinated. Travellers to countries or areas reporting indigenous wild poliovirus who have previously received three or more doses of oral polio vaccine (OPV) or inactivated polio vaccine (IPV) should be offered another dose of polio vaccine as a once-only dose before departure.
3

Non-immunized individuals intending to travel to these countries or areas should complete a primary schedule of polio vaccination, using either IPV or OPV. Individuals living in countries or areas reporting indigenous wild poliovirus should have completed a full course of vaccination against polio, preferably with OPV, before travelling abroad. Such travellers should receive an additional dose of OPV 1-12 months before each international journey. In case of urgent travel, a minimum of one dose of OPV should be given, ideally four weeks before departure. For more, visit www.who.int/ith. n

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News

DR Congo girds up for polio fight

of the Congo, Joseph Kabila, invited the DirectorGeneral of the World Health Organization (WHO), Dr Margaret Chan and the WHO Regional Director for Africa, Dr Lus Gomes Sambo to meet with him in Kinshasa in February. Talk centred on ways to best implement and monitor the countrys emergency response plans. At a meeting with donors, partners and government officials, President Kabila expressed his governments firm commitment to ending the current polio outbreak.
Cornelia Walther/UNICEF Kinshasa, March 2011: While waiting until the National Football Team is ready to get vaccinated against polio, a security officer takes his chance. In response to a large number of older-age cases, recent rounds in Kinshasa have been expanded to cover adult as well as children.

with possible transmission F acedre-established ongoingDemocratic Republic of a poliovirus and new importations, the President of the

No threat could be more urgent than todays polio resurgence, Mr Lake said. Not only does it put lives and livelihoods at risk in the DRC, it also threatens to undo our global progress in eradicating polio. We have the ability to defeat polio, and because we can, we must. DR Congo is currently affected by three distinct outbreaks. Katanga, in the east of the country, continues to be affected by re-established WPV1 transmission, ongoing in the country since 2007. The two separate outbreaks in Bandundu / Kasai Occidental and in Bas-Congo / Kinshasa are linked to international spread from Angola. In a recent development, governors of the 11 provinces of DR Congo met on April 25 and issued a Declaration of Engagement to deploy the powers of their offices to eradicate polio and strengthen the Expanded Programme on Immunization. The cascading effect of national and sub-national commitment places DR Congo on the right track to polio eradication. - Lauren OConnor and Christian Moen/UNICEF. n

In early March, UNICEF Executive Director Anthony Lake also visited the country, meeting with the Prime Minister and the Minister of Health to discuss the governments vital role in putting an end to polio. During his visit, Mr Lake witnessed first-hand the daily efforts of community health workers in the capital, Kinshasa, where several cases of polio have been recorded since January.

Rukhsar: one child triggers Indias emergency response

Kolkata, 30 March 2011 - Rukhsar Khatoon takes one look at her visitors and tucks her face into her mothers shoulder, crying in fear. she was paralyzed polio, Rukhsar e ver sinceandconfrontdoctors,bypesky photographer has had to epidemiologists, physiotherapists nurses and this is the last straw. To her, they are all doctor-folk, and she wants nothing to do with them, her mother explains apologetically. immunization campaigns, but because Rukhsar was often sick with diarrhoea, Sabera and her husband Abdul Shah were reluctant to vaccinate her. When Rukhsar couldnt walk on 13 January of this year, her parents took her to the local hospital. On 7 February, analysis of her stool samples confirmed that she had polio. Within a week, a mop-up vaccination campaign was taking place around Rukhsars home, to ensure other children wouldnt fall victim to poliovirus. By May, three campaigns will have taken place in Howrah and the greater Kolkata area, to build a wall of immunity around West Bengal. I made a mistake, her father Abdul says quietly, by not giving her polio drops. I would beg every parent to vaccinate their child and not make the same mistake. Sabera adds, This is the one child I did not vaccinate, and now she is the one affected. You must vaccinate your child, she reminds her visitors. Although her condition is improving with physiotherapy, it is not certain that Rukhsar will regain the ability to walk. Married herself at 15, Sabera worries about her daughters prospects for schooling and marriage. Abdul, who works in the zari (fine embroidery) industry like most of his neighbours in their village, frets about the financial costs of Rukhsars treatments. The doctors have been very kind, Sabera says, but we have to think of the future and our other children. The virus which stilled Rukhsars legs is related to poliovirus found in New Delhi. Poliovirus can travel long distances easily, hitching a ride among travellers and migrants and ferreting out the most vulnerable the unvaccinated, the under-vaccinated, the very young. In Rukhsars village, which is largely Muslim, most families have a member working in Mumbai, Indias melting-pot megacity. The village also has contact with communities from Bihar and Uttar Pradesh, the two polio-endemic states of India. Many of Rukhsars neighbours are what public health advocates call the under-served. Poor, marginalized, often belonging to a minority or migrant community, these groups have less access to health and other government services. Polio in India is now nearly entirely restricted to these communities. The state and federal authorities use specific tactics to reach such children, tactics which range from mapping a migrant groups seasonal movements to special efforts to address the needs or concerns of minority communities about vaccination. But all of this matters little to Rukhsar, who is in treatment in a hospital in Kolkata. The paralysis has not affected her spirit, and she keeps her brows knitted in warning at her visitors, adding a sharp cry whenever they venture too close. She has always been a handful, Sabera rues. Everyone at home misses her. But I cannot leave here until she walks. - Sona Bari/WHO. n
From the safety of her mothers lap, Rukhsar Khatoon looks suspiciously at her visitors in the hospital where she is being treated for polio-paralysis. 4

The attention around Rukhsar started when her paralysis was reported to the health authorities in her district of Howrah, in the Indian state of West Bengal. She is the only child to have been paralysed by polio in India this year. Always a sickly child, Rukhsar was never vaccinated against polio. Her young mother Sabera Bibi explains, I didnt know what polio was. I thought the polio drops were for general good health. Saberas two older children were regularly given oral polio vaccine during supplementary
S. Bari/WHO

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News

Polio partners support Angola

invitation of the countrys leadership, to help halt the transmission of polio.
Graeme Williams/UNICEF Luisa Nzongo, holding her 17-month-old daughter Georgina Luisa de Deus Nzongo, meets with Gates Foundation Global Health Program President Dr. Tachi Yamada and UNICEF Executive Director Anthony Lake at her home, in Cacuaco Municipality on the outskirts of Luanda, Angolas capital. The toddler was recently diagnosed with polio.

epresentatives of Global Polio R supporting Angola therecent months,Eradication Initiatives partner agencies have been closely in at the At the end of January, President Jos Eduardo dos Santos received a joint delegation including UNICEF Executive Director Anthony Lake, Dr Tachi Yamada, President of the Global Health Programme at the Bill and Melinda Gates Foundation, and Dr Matshidiso Moeti, Assistant Regional Director for the World Health Organizations (WHO) African Region. The meeting centred on ways to strengthen the final push for polio eradication in Angola. Following his meeting with the delegation, President dos Santos reaffirmed his personal commitment to eradicating polio, agreeing to spearhead the countrys 2011 vaccination campaigns and ensure that they are conducted with determination and efficiency. On 9 February, Rotary International President Ray Klinginsmith met the Vice-President Fernando da Piedade Dias dos Santos Nand and the Vice Minister of Health, Evelize Frestas, who reiteratedthe Presidents plan to ensure the full engagement of provincial Governors in implementing the countrys emergency plan to eradicate polio. Rotarys top priority is polio eradication, said Klinginsmith. We have contributed more than

US$ 1 billion, and countless volunteer hours to do everything it takes to stop this terrible disease. Rotary has contributed more than US$ 421 million to support polio eradication efforts in Africa alone. Genetic sequencing confirms that Angola is experiencing ongoing transmission of a re-established poliovirus of imported origin, meaning it has not met its end-2010 milestone (under the Strategic Plan 2010-12) of stopping transmission. Anticipating

this risk, Angola formulated an emergency plan for polio eradication and fixed a target to interrupt polio transmission by June 2011. As of 26 April, two polio cases were reported for 2011. Synchronized National Immunization Days were help with Congo and the Democratic Republic of the Congo at the end of April. - Petina Dixon/Rotary International and Christian Moen/ UNICEF. n

Looking towards the second half of 2011

t the end the first overall A and Nigeriaofnumbers inquarter of 2011,countries polio case the endemic of India have fallen by more than 94% over 2009 levels, and global cases of wild poliovirus type 3 (WPV3) are down to their lowest ever levels. Immunity profiles are high in the key reservoirs of Uttar Pradesh and Bihar, India, and the profile in northern Nigeria is improving. The Global Polio Eradication Initiative (GPEI) has established a set of priorities for the next six months, to make the most of the current epidemiological opportunity. Given the role that India and Nigeria play in exporting polio virus to other countries, stopping transmission in these countries is a foremost aim in polio eradication. It will not be smooth sailing. Health worker strikes in Nigeria have prevented some areas of the country from holding immunization rounds. Even in India, the most recent case in West Bengal occurred among a highly mobile population which has been resistant to polio vaccination in the past. Meanwhile, uncontrolled transmission in Angola, Chad, the Democratic Republic of the Congo and Pakistan means that re-importation is always a threat. It is therefore important that India and Nigeria do not use their recent successes as an excuse to become complacent. Quick and effective mop-ups along with adequate coverage of migrant and mobile populations will help towards the objective of ending transmission in India
A child is vaccinated against polio in Kolkata, India, after a case in a nearby village.

and Nigeria. This will also be the focus in Afghanistan, which has only seen one case so far this year (as of 26 April). But it is also necessary to gain control of transmission in those countries with current outbreaks. In Cte dIvoire, Mali, Niger (and possibly Sudan), the priority is to improve mop-ups and surveillance. Countries with uncontrolled transmission have been asked to produce emergency plans to lay out clear strategies to end transmission in all areas (except those which are inaccessible due to insecurity). Obviously, ensuring the polio-free status of all other countries

will also remain an integral part of the GPEIs plans. This will be achieved by maintaining surveillance, continuing routine immunization and including oral polio vaccine in child health days and measles campaigns. These priorities, along with the implementation of the GPEI Strategic Plan 2010-2012, will set the framework for polio eradication in the coming months. - Lauren OConnor. n
Rod Curtis/UNICEF India

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ResouRce MoBIlIzATIoN
uring the week of 23 February, Rotary International celebrated 106 DStock Exchange by illuminating monuments worldwideincludingitsthe New anniversary York building, Charminar in Hyderabad, India; the KPT Government
th

Rotary pulls out all the stops

Building in Karachi, Pakistan; and Trevi Fountain in Rome, Italy with Rotarys pledge to End Polio Now.

For example, representatives of Rotary and Sanofi Pasteur, a leading provider of polio vaccine, helped ring the opening or closing trading bells in four European financial markets: Amsterdam, Brussels, Paris and Lisbon. A closing bell ceremony at the New York Stock Exchange included remarks by Rotary President Ray Klinginsmith and Michael Watson, Sanofi Pasteurs vice president of global immunization policy, plus an appearance by UNICEF ambassador and polio eradication advocate Angelique Kidjo, the popular singer from Benin. Rotarians in Great Britain and Ireland planned ahead, selling and planting 4.6 million crocus bulbs across the region in October so their purple blooms would flower in late February, just in time for the anniversary celebrations. The colour purple is meant to evoke the purple dye used to mark the fingers of children who have received the oral polio vaccine during National Immunization Days. The Rotary Club of Hitchin Tilehouse, in England, even earned a citation in Guinness World Records for the most people (636) simultaneously planting flower bulbs. Polio eradication has been Rotarys top priority since 1985. The international humanitarian service organization has donated more than US$ 1 billion and countless volunteer hours to help immunize more than 2 billion children. - Petina Dixon-Jenkins/Rotary International. n

Additional illumination sites include Kanazawa Castle, in Kanazawa, Japan; the Bill & Melinda Gates Foundation headquarters in Seattle, Wash.; Taipei 101 Building, Taiwan, China; the Capitol Building in San Juan, Puerto Rico; Byblos Castle in Byblos, Lebanon; and the Dutch Parliament Building in The Hague, Netherlands. Rotarys intent each year is to use the humanitarian organizations 23 February anniversary date as a platform for a dramatic visual public awareness campaign to build support for polio eradication. Other sites in recent years include the Sydney Opera House, Londons Tower Bridge, the Roman Coliseum and the Great Pyramid in Egypt. The illuminations are augmented by a variety of activities drawing attention to the progress that has been made towards polio eradication and the work being done to finish the job.

Charminar in Hyderabad, India. Ranjit Sinha

Rotarians, dignitaries and guests celebrate in front of the city hall in Lyon, France. Muriel Chaulet/Ville de Lyon

Chumsungdae, a centuries-old observatory in Gyeongju, South Korea. Eun Ok Lee

Economic benefits of GPEI estimated at US$ 40-50 billion

he economic benefits of eradicating polio in the next five years would be at least US$ 40-50 billion, mostly in low-income countries, according to a report published in the journal Vaccine in December 2010. The study provides a rigorous evaluation of the benefits and costs of the Global Polio Eradication Initiative (GPEI)the single largest project ever undertaken by the global health community. Entitled Economic Analysis of the Global Polio Eradication Initiative, the study looks at investments made since the GPEI was formed in 1988 and those anticipated through 2035. Over this time period, the GPEIs efforts will prevent more than eight million cases of paralytic polio in children. This translates into billions of dollars saved from reduced treatment costs and gains in productivity. The study also reported that add-on GPEI efforts improve health benefits and lead to even greater economic gains during the same time period. Notably, it estimates an additional $ 17-90 billion in benefits from life saving effects of delivering vitamin

A supplements, which the GPEI has supplied alongside polio vaccines. Polio eradication is a good deal, from both a humanitarian and an economic perspective, said Dr Radboud Duintjer Tebbens of Kid Risk, Inc., the lead author of the study. The GPEI prevents devastating paralysis and death in children and also allows developing countries and the world to realize meaningful financial benefits. According to the study, although delays in achieving eradication are costly, even with delays, the GPEI still generates positive net economic benefit estimates. Investing now to eradicate polio is an economic imperative, as well as a moral one, said Dr Tachi Yamada, president of the Bill & Melinda Gates Foundations Global Health Program. This study presents a clear case for fully and immediately funding global polio eradication, and ensuring that children everywhere, rich and poor, are protected from this devastating disease. n

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Calendar for 2011 puts humour into polio history

amiliar achievements can often be taken for granted, even forgotten. The International Federation of Red Cross and Red Crescent Societies (IFRC) has used humour to remind us of the strides made in polio eradication. The IFRC has produced a 2011 calendar on milestones in polio eradication which depict key polio dates based on cartoons, to provoke thought and discussion. From 1400 BC when evidence of polio showed up in ancient Egyptian art, to 1955 when Dr Jonas Salk developed the first polio vaccine, and most recently to 2010 when the new strategic plan for eradicating polio was launched: these events are narrated with amusing images. As we move towards eradicating polio, lets not forget where we have been and the many accomplishments already made. - Kate Elder/IFRC. n
Floris Oudshoorn/IFRC

New External & Domestic Contributions / Projections received for the period 2010-2012
All figures US$ millions (As of 6 April 2011) Donor Angola Australia Bangladesh Canada Central Emergency Response Fund (CERF) Crown Prince of Abu Dhabi Gabon Italy Japan UNICEF Regular Resources UK1 Total
1

2011 $ 2.04 $ 0.34 $ 11.90 $ 9.53 $ 0.37 $ 17.00 $ 1.66 $ 0.48 $ 3.25 $ 10.00 $ 2.65 $ 59.22

2012

2011-2012 $ 2.04 $ 0.34 $ 11.90

$ 7.65

$ 17.18 $ 0.37 $ 17.00 $ 1.66 $ 0.48 $ 3.25 $ 10.00 $ 2.65

$ 7.65

$ 66.87

Includes $ 1.18 million in reprogrammed unobligated funds from previous grants to WHO. (new contributions received between January to March 2011)

Rotary International, IFRC and many non-governmental organizations have been essential partners with governments in reducing polio by 99% worldwide.

What do Desmond Tutu, Amitabh Bachchan and Jackie Chan have in common?

hey are among the many influential leaders and celebrities around the world who have supported Rotary Internationals This Close campaign.

Publications
Annual Report 2010 Financial Resource Requirements IMB report - December 2010 and March 2011 Polio Pipeline, Winter 2011, No. 7. n

And now you can create your own version of the This Close ad, and join an online gallery of supporters worldwide. The online application, www.thisclose.net is now live! At the site, you can also view the existing This Close campaign, and add your name to the ranks of supporters of the fight to end polio. Once you create your ad, you can easily share your personalized This Close advertisement with your friends and family through email and social networks such as Twitter and Facebook in order to generate further awareness of the fight to end polio. You can also add a personal message of support, enter your country and see which countries are digitally leading the charge to spread awareness for polio eradication. (Note that due to technological limitations, the site is not currently available in Korean & Japanese characters.) - Petina Dixon-Jenkins/Rotary International. n
Polio still cripples thousands of children around the world. With your help, we can wipe this disease off the face of the earth forever. Visit rotary.org/endpolio to help. END POLIO NOW

Events
16-25 May: 64th World Health Assembly in Switzerland 28 July: Technical Advisory Group meeting in Chad 29 August-2 September: 61st Regional Committee for Africa meeting in Cte dIvoire 6-9 September: 64th Regional Committee for South-East Asia meeting in India 12-15 September: 61st Regional Committee for Europe meeting in Azerbaijan 2-5 October: 58th Regional Committee for the Eastern Mediterranean in the Syrian Arab Republic n

Rotary

We Are

ThisClose

to Ending Polio.

Archbishop Desmond Tutu

Rotary International 7

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Polio eradication mourns loss of true polio champion

I think the greatest danger is not from the virus itself. Its from people that might get discouraged. We must keep in mind how successful we have been, and there is no reason whatsoever why we cannot finish the work. of a commemorative - Bill Sergeant on receipt
Bill Sergeant holds the award given to him by the 2006 World Health Assembly, in recognition of his commitment to polio eradication.

Christine McNab/WHO

plaque from UNICEF in 2006. n

ill Sergeant, former Chairman of Rotarys Internationals PolioPlus Committee and true polio hero, passed away on 13 February at his home in Tennessee, USA.

Mr Sergeant was the Chairman of Rotary Internationals International PolioPlus Committee of the Rotary Foundation, from its inception in 1994 until 2006. During his tenure and under his guidance, Rotary International committed more than US$ 500 million to the global polio eradication effort. His personal commitment and tireless dedication to the achievement of a polio-free world was second-to-none. He was a towering force and a legend in polio eradication. There are countless children around the world today without lifelong polio-paralysis, as a direct result of Bill Sergeants dedication. Recognizing his personal engagement and drive for polio eradication, the World Health Assembly in May 2006 honoured him, as he truly represented Rotarys motto of Service Above Self. He was a true friend to the world, and he will be sorely missed. n

w w w. p o l ioe ra dic at ion . org

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