COVID-19 is not the first pandemic to wreak havoc on a massive scale. The 2003 SARS pandemic shocked the world, and other international outbreaks, such as polio and Ebola, have changed the way we think about public health. But COVID-19, with its global scope and rapid spread, has upended our way of life.
We have both the capacity and expertise to take on public health emergencies, and enhance our preparation against future threats. A case in point is the clear, comprehensive strategy deployed against poliovirus.
Like COVID-19, polio meets the WHO criteria for a public health emergency of international concern. Like COVID-19, polio once terrorized communities around the world – until effective vaccines were developed.
In 1985 Rotary International, a global volunteer service organization, decided to fight polio. This led to the launch of a global effort, the Global Polio Eradication Initiative (GPEI) consisting of Rotary International, the World Health Organization, U.S. Centers for Disease Control and Prevention, and UNICEF (the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance, later joined the partnership).
When the GPEI formed in 1988, there were 350,000 polio cases a year in 125 countries. Today the effort has resulted in a 99.9% reduction in cases. Today, only two countries in the world continue to report cases of wild poliovirus (Pakistan and Afghanistan). Almost 19 million people are walking today because they were immunized and 1.5 million polio-related deaths have been averted since 1988.
The polio experience has a unique capacity to contribute to the COVID-19 pandemic response, particularly in countries with fragile health systems. The GPEI is therefore placing the infrastructure built to eradicate polio at the service of the fight against COVID.
Three key strategies have carried us to the brink of eradicating a human disease for only the second time in history.
First, the deployment of community health care workers has been instrumental. Many of these health workers are women, as they are trusted to enter households and have the interactions with mothers and children necessary to deliver primary healthcare services. Thousands of polio workers are now working to trace contacts and educate communities in response to COVID-19.
Second, the logistics of eradicating global public health threats like COVID requires effective coordination. The development of Emergency Operations Centers (EOCs) has enabled governments to form the public health equivalent of a sophisticated ‘situation room’, and make decisions and assessments based on sound evidence provided in real time. Many polio EOCs are in active use to coordinate the COVID response.
Third, a sophisticated surveillance network, identifying victims, tracing contacts, and monitoring the environment for poliovirus, enables the initiative to rapidly increase immunity in places where the virus is circulating.
Borrowing from the polio program’s contact tracing tactics, the GPEI helped stop the Ebola outbreak in Nigeria in 2014 and a yellow fever outbreak in 2018, and is now identifying individuals with–and stopping the spread of–COVID-19.
While responding to COVID-19, the GPEI will take every step possible to continue protecting children and avoid a resurgence of polio. We will continue to strengthen immunization in at-risk areas, maintain our vaccine supply so that campaigns can begin without delay as soon as it is safe and sustain surveillance to detect the poliovirus. The EU should be proud of the US$283 million it has invested in polio eradication since 1988 (plus an additional US$2.6 billion invested by EU member states including the UK), support which now offers value-added capacity for the COVID-19 response.
It is vital that the EU continues to invest in the GPEI infrastructure, as it will enhance our ability to pre-empt, rather than react to, future disease outbreaks. Although the GPEI has the advantage of a proven vaccine against polio, we can still learn from its methods, both in containing the spread of COVID-19 and in enhancing public immunity once a vaccine is discovered.
As the EU and member states work to address the crisis, let’s remember that the day will come again when planes, boats, trains and cars will carry people around the world, and viruses will travel with them. The EU’s continued investment in the resources and infrastructure already in place will serve well in protecting us as a global community.