MEETING # 1599
MARCH 5, 1998
Rotary International's Polio Plus
The U.N. World Health Organization
by Arthur M. Jensen Ed.D.
Assembly Room, A. K. Smiley Public
BIOGRAPHY OF THE AUTHOR
Arthur M. Jensen is a native of Chicago, Illinois; he left Chicago when he was drafted
into the U.S. Navy in 1943. He is a veteran of WW II and the Korean War. He spent 31 years
in the U.S. Navy Reserve and retired in 1974 with the rank of Captain, USNR.
Arthur married Marion McBride in 1945. They have three grown children, Mary Jensen
Collier, Arthur Ray Jensen, and Patricia Jensen Frost, and six grandchildren.
Arthur received his B.S. and M.A. from Western Michigan University. He taught at
Comstock High School a short time, and then became Safety Director for the District. In
1956 he accepted a position at San Diego City College where he quickly advanced into
administration. He received his ED. D. from UCLA in 1965.
He left San Diego to become the Chief of the Bureau of Junior College Education for
California in Sacramento. In July 1967 he accepted "an appointment to become the
President of San Bernardino Valley College. He retired after serving 19 years, and now has
the title, President Emeritus, San Bernardino Valley College.
Arthur's community service includes:
Governor, Rotary District 5330, 1989-90.
President, Inland Empire Boy Scout Council, 1984.
President, Salvation Army Board, 1969-70.
President, San Bernardino Symphony Association, 1972-74.
Chairman, Campaign Drive for Arrowhead United Way, 1975.
President, Fortnightly Club, Redlands, 1996-97.
He served on numerous boards and committees, including the Board of Directors of the
World Affairs Council. He is also active in his church, and has served on the Board of
Deacons. He now serves on the finance committee.
During his year as Governor of Rotary District 5330, 1989-1990, the fifty-seven Rotary
Clubs in the District raised, $314,770.00, for the Rotary International Polio Plus effort.
In February, 1985, Rotary International announced it's commitment to help control polio
world wide by the year 2005. This is also the year that five other vaccines were added to
the polio vaccine and the Polio Plus Program was put into full swing in cooperation with
the World Health Organization and UNICEF.
In 1988, the goal to eradicate polio from the world by the year 2000, was set by the
World Health Assembly, at that time there were 166 member nations. This was the same month
that Rotary International celebrated reaching and surpassing their goal of raising $120
million for the Polio Plus effort.
In October 1991, a historic milestone was reached when a joint World Health
Organization/UNICEF statement declared the achievement of Universal Child Immunization.
This meant that 80% of the world's children were being immunized against six childhood
diseases; measles, diphtheria, whooping cough, tetanus, tuberculosis and polio. Rotary's
Polio Plus vaccine to put credit where credit is due. This was called "the most
massive peacetime international collaboration effort in history" and "the
greatest public health success story of the past decade."
"Since the Polio Plus program began in 1985, more than one billion children have
received polio vaccine and today at least 154 countries are polio free."
The crusade against polio must continue until every country has completed three years
of intense coverage of immunization. A country can be certified polio free when it has
reported no polio cases for three to five years. As long as polio endemic countries exist
there is danger of exporting the polio virus to polio free countries. It is an extremely
"By the year 2005, Rotarian contributions of $252 million and the
Foundation allocation of $8 million, together with investment earnings, are expected to
approach $400 million for the global polio eradication effort." The 1996-97 Rotary
International Foundation Report stated that, $265 million had already been awarded in
Polio Plus Grants toward eradication efforts world wide.
"By the year 2000, health leaders expect to see, along with polio
eradication, massive reductions in the incidence of measles, whooping cough, and
diphtheria, and the possible elimination of tetanus among newborns." (THE ROTARIAN,
Today in 1998, there are only two years left until the year 2000. Is it
possible to finish the immunization of the rest of the world's children in this short
time? Tens of thousands of people are working toward that goal.
ROTARY INTERNATIONAL'S DREAM OF A POLIO FREE WORLD
THE PHILIPPINE PROJECT 1978
IMMUNIZING THE AMERICAS, NORTH AND SOUTH
PARAGUAY AND MEXICO
THE ROTARY POLIO PLUS PLAN
THE PLAN OF ACTION FOR THE WORLD HEALTH ORGANIZATION
AFGHANISTAN AND SOUTH WEST ASIA
EAST MEDITERRANEAN REGION
Rotary International has four main avenues of service, club service,
vocational service, community service and international service.
World Community Service as been made a dominant emphasis in international
service by the Board of Directors of Rotary International. It offers to every Rotarian a
practical opportunity to fulfill that part of the object of Rotary that he is committed
to. "To encourage and foster international understanding, good will and peace through
a world of fellowship of business and professional men united in the ideal of
1978 - Rotary initiated a special fund called, "75th Anniversary
Fund", for the development of the Rotary International HEALTH, HUNGER AND HUMANITY
(3H) Program. One of the first Health Hunger and Humanity Grants led to a program that has
made a profound impact, and is being felt all over the world. In 1978, Rotary
International and the Government of the Philippines joined forces on a five year project
to immunize the children of the Philippines against polio. Out of this project grew the
extraordinary program known as Polio Plus.
"With the Philippine project, a strategy was developed to attack
polio and the necessary resources were marshaled to implement the plan. Thanks to the
efforts of Filipino Rotarians, the immunization effort was a tremendous success."
Rotarians learned a great deal from the Philippine project. It wasn't long
before Rotary International Board of Directors decided to undertake the extra ordinary
task of providing enough vaccine to immunize virtually all of the developing world's
children against polio for ever.
This became official in 1985, when Rotary International adopted a plan,
for helping to immunize all of the worlds children by the organization's 100th anniversary
Rotary International, began working in cooperation with inter-national,
national, and local health agencies. Five more vaccines were added to the polio vaccine.
Polio Plus was born and became part of a global effort to protect the children from five
deadly diseases; diphtheria, tetanus, whooping cough, red measles, and tuberculosis.
This paper covers the great campaign to eliminate the poliomyelitis virus
from every country in our world, and the part that Rotary International, a service club,
played, and is playing in this great effort. The eradication of the polio virus is not yet
completed, but the goal has been set by the World Health Organization for completion by
the year 2,000.
ROTARY INTERNATIONAL'S DREAM OF A POLIO FREE WORLD
"Poliomyelitis is an acute infectious disease, especially of
children, but not only of children, caused by a virus inflammation of the gray matter of
the spinal cord; it is accompanied by paralysis of various muscle groups that sometimes
atrophy (waste ; away) often resulting with permanent deformation."
Dr. Jonas Salk developed a form of Polio Vaccine in 1953. It was a vaccine
that creates antibodies that ward off the Polio Virus. While this greatly reduced the
number of paralytic cases, it did not provide long term immunity. This was an injected
polio vaccine (IPV).
In 1954, Dr. Albert Sabin developed an oral "live" vaccine; that
provided long term immunity, and broke the chain of transmission of the virus. This is an
oral vaccine (OPV), and easy to administer. As a result, in the late 50's, and early 60's,
community vaccinations of millions of pre school children, and school children took place
in many of the World's developed countries.
Rotary International President, Clem Renout, and the Board of Directors
dreamed of wiping out the polio virus by countries, and they began in the Philippines in
However, by 1980, it was estimated that only 20% of the worlds children
were being immunized against the dreaded polio disease. The problem was two fold, the
cost, and the difficulty of delivery. The great majority of developing countries could
neither afford the cost of vaccine necessary to immunize their children, nor did they have
a reliable way to deliver the vaccine to those who were most in need of it. In 1981,
66,052 cases of Polio were reported in the world.
THE PHILIPPINE PROJECT 1978
Clem Renout, Rotary International President in 1978-79 dreamed of eradicating Polio
from the Philippines. He worked through the Philippine Health Organization, and with a
Rotary Foundation Grant in 1978 the Philippine Government joined Rotary International in a
5 year project to eradicate Polio from the Philippines by immunizing all of the children.
The strategy for the Philippine Project was developed, and the necessary resources were
marshaled to implement the plan.
Thanks to the great efforts of the Filipino Rotarians, and many volunteers, the
immunization was completed by 1983, and was quite a success. (1986 R.I. Int. Pres. M.A.T.
As the reports came in on the success of the Polio Campaign in the Philippines, more
and more Rotarians were asking "Why not immunize the Americas, both North and
South?" Then the question asked was, "Why not the whole World?" The answer
to these questions came sooner than expected perhaps, because Rotary already had begun
working in Haiti and Bolivia.
In February, 1985, Rotary International announced its commitment to help control Polio
world wide by the year 2005. This would be Rotary's 100th Anniversary, and the dream
became a goal!
In June, 1985, the program was named, "Polio Plus -Immunize the children of the
world." The "Plus" was because five more vaccines were combined with the
polio vaccine to immunize the children against diphtheria, red measles, tuberculosis,
tetanus, and whooping cough. At that time the World Health Organization had a program
called, the "Expanded Program on Immunization". This was a care strategy to
improve child health and reduce the 15 million child deaths annually, 3 to 5 million
caused by vaccine preventable childhood diseases.
News of the Polio Plus Campaign began to spread around the world. It captured the
imagination of Rotarians, and Governments, but money was needed to fund the campaign. The
Rotary International Foundation set a monetary goal in 1985 to raise $120 million dollars
for Polio Plus.
Rotary Clubs all over the world were called on to help in the drive for funds, and
every Rotary Club rallied to the cause. The Foundation received several gifts of $100,000,
and then a one million dollar gift started funds really rolling in. Rotary Clubs put on
dinners, raffled off cars, had golf tournaments, and even took cruses to raise money. One
of the local clubs even tried a "nearly new" men's suit sale. They raised funds
every way possible. Rotary Club pledges also helped to raise the goal.
Three years later Rotary International would celebrate obtaining that goal and
surpassing it at their 1988 International Rotary Convention in Philadelphia, Pennsylvania.
IMMUNIZING THE AMERICAS, NORTH AND SOUTH
In the 1950's and 1960's, when Salk, and Sabin polio vaccines were developed, the North
American countries, United States and Canada, immediately began immunizing young children.
There were no longer any polio cases resulting from "wild polio virus" being
It was in May, 1985, that the Pan American Health Organization announced its Latin
American initiative to wipe out polio. Dr. Carlos Canseco of Mexico, then Rotary
International President, was invited to join the polio eradication effort because Rotary
had pledged, "to help to eliminate polio globally."
Rotary had already started its Latin America polio immunization effort in 1981 with
projects in Haiti and Bolivia. By 1985 the Rotary Foundation had already provided two
million dollars for additional projects in Belize, Costa Rica, El Salvador, Honduras,
Guatemala, Panama and St-Lucia.
Back in the 80's there was considerable skepticism about the value of a community
service organization such as Rotary, assisting the medical profession in the Public Health
In 1985, The World Health Organization, granted Rotary International Foundation Polio
Plus program, "consultative status" for a two year period, as a member of the
World Health Organization with full rights. Rotary was on probation.
To prove that Rotarians could, and would really help, Dr. Canseco, and his team decided
to go to Paraguay, a small country with approximately 600,000 children. Rotary established
National Immunization Days. The result was tremendous. In one year reported cases of polio
dropped from over 100 cases to no reported cases.
The World Health Organization was still not convinced that Rotary had made the
difference. Dr. Canseco and his team proposed to go to Mexico, with more than 15 million
As the President of Rotary International, Dr. Canseco went personally to see the
President of Mexico. Mexico's President supported the idea.
The Rotary Polio Plus Team took about a year to prepare for the National Immunization
Days in Mexico. However, by January, 1986, 13 million children were immunized in one day.
Over 500,000 volunteers participated in this massive endeavor. In October, 1990, Mexico
reported its last case of poliomyelitis.
The countries of Paraguay and Mexico became prototypes for Latin America. In just one
year, 1986 to 1987, Rotary International transformed its dream into an operational
Rotary International recruited and trained an International Polio Plus Task Force of
five members. The five members worked with professional staff to create club and National
Immunization Manuals to guide and inspire Rotarians around the world.
The leaders of Rotary International, and the Polio Plus Task Force were convinced that
community volunteers, when properly trained, utilized and supported, could measurably
increase the number of infant and child immunizations.
In 1986, the Rotarians, their friends and helpers proved that volunteers could do the
job. During three National Immunization Days, 2,300 volunteers helped vaccinate the
children, provide transportation, publicize the immunization days, and provide meals for
the vaccinating teams. They also contributed $440,000, in funds. Rotary proved that a
service organization with volunteers could indeed help the medical profession in the
Public Health Field. This type of support had an enormous impact among doctors, nurses and
other health workers.
The Rotary International Convention in Philadelphia, in May, 1988, was a great
celebration of not only reaching its fund raising goal of $120 million for Polio Plus, but
of surpassing it by over $100 million dollars. It was a great achievement!
Dr. Halfdan Mahler, Director of the World Health Organization, sent this video message:
As business and professional leaders, you have helped to change attitudes toward
immunization. And you have given Ministries of Health needed advice, - or stimulation in
making their programs more effective.
The World Health Assembly, also meeting in May, 1988, aware of the Rotary International
Polio Plus commitment, the progress in Latin America, and Rotary's successful fund
raising, adopted a resolution, "to eradicate poliomyelitis by the year 2000."
The Americas were working hard to eradicate polio by 1990. The Pan American Health
Organization, located in Washington D.C. was, by Spring of 1989, receiving the number of
new polio cases, or the absence of cases on a weekly basis. There were only 12 countries
that were still reporting polio cases. In these countries the polio cases being reported
were less than one percent of the children population.
In addition, polio eradication had been nearly achieved in this major region, North and
South America, and hopes were high that eradication would be certified there by 1995. That
means, of course, eliminating the wild polio virus from the environment, rather than just
protecting children from the virus.
The Rotary Club of Oruro, Bolivia, mobilized some 3,500 students, teachers and other
volunteers each month for nine consecutive months to conduct a census aimed at identifying
children for immunization. The polio vaccine was then administered to all of the
identified children. In the Americas only four cases of polio were reported in 1991, down
from 930 cases in 1988.
In a plan called "Operation Mop Up," Rotarians aided by experts provided by
the Pan American Health Organization, and local health workers, concentrated their efforts
on wiping out those last pockets of polio transmissions.
Previously, only one disease, Smallpox, had ever really been "eradicated". It
was hoped that with the help of so many National and International agencies working
together over the next decade, the crippling disease of Polio would no longer plague the
children of our World.
It was recognized that the World Health Organization already had offices and personnel
around the World to help administer and help carry out this tremendous dream of ridding
the world of Poliomyelitis.
China, Bangladesh, Nigeria and India, are home to more than half of all the world's
children, and was where more than half of the world's polio cases were reported. These
countries presented staggering logistical problems for the campaign. Not only are these
vast land countries, but much of the space is without needed modern conveniences such as
transportation and refrigeration,
THE ROTARY POLIO PLUS PLAN
The Rotary International Polio Plus Plan will provide the Polio Plus vaccine which
meets World Health Organization standards, for up to five consecutive years for any
approved city, state, country, or regional immunization program. Particular emphasis is
given to vaccine grants which accelerate coverage through intensified strategies to
supplement routine health delivery systems through vaccine days and similar events which
utilize volunteer assistance and develop broad community support.
Rotary was not working alone, but was supporting, and complementing the goals of the
World Health Organization, with their "Expanded Program in Immunization".
THE PLAN OF ACTION FOR THE WORLD HEALTH ORGANIZATION
At the Headquarters of the World Health Organization in Geneva,
Switzerland a small group of international experts gathered in September 1988. They were
there to review a twenty-one page document, "A Plan of Action for Global
Poliomyelitis Eradication by the Year 2000. Nine Nations were represented some of which
were veterans of the campaign to rid the World of Smallpox ten years before.
The Chairman of this Group was the same man who had led the Smallpox
Eradication Team, Dr. D. A. Henderson, Dean of the School of Public Health and Hygiene, at
Johns Hopkins University, in Baltimore, Maryland. Dr. Henderson also serves as an expert
consultant to the Rotary Polio Plus Program.
Expanded Program on Immunization (EPI) Director, Dr. Ralph "Rafe" Henderson started to prepare the draft plan within weeks of the World
Health Organization year 2000 resolution. For two days in September, the group, which
included Herbert Pigman, director of Rotary International Immunization Task Force (and
former R.I. general secretary), discussed and debated the strategies to be employed during
the next 12 years on the march toward a polio-free world. THE ROTARIAN, Feb. 1989, p
Many were concerned about the prospects of eradicating polio. Efforts to
eradicate malaria in the world had failed. However, the efforts to rid the world of
smallpox had succeeded. The smallpox campaign took 20 years, and a cost of $300 million.
The Polio Plus Task Force knew that the polio campaign would be a long and expensive
battle. However, the Director, Herbert Pigman r and others were sure
that it could be done. A big plus for the Task Force is that the polio virus cannot
live outside of a human host for a very long period of time. If, in the world a large
enough number of children are immunized, and kept immune, the "transmission of the
disease can be interrupted and eventually the virus will die."
The Team also knew that they would be facing both great technical, and very difficult
social problems. However, the world has changed a great deal since 1953 when the smallpox
campaign began, and it was successful. That success gave the Polio Plus Campaign a big
In 1988, more than 50% of the developing world's 117 million newborns had received the
third dose of the vaccine, and 70% were getting at least one dose. In 1973, less than one
child in 20 was being immunized.
The two largest countries of the world, China and India needed the most help, and
presented Rotary with the greatest challenge. These two countries, and a few others are
covered in more detail. China, and some of the other new, or developing countries had no
Rotary Clubs to call on for volunteer help. India, and many of the other countries do have
Rotary Clubs with eager members to call on for volunteer help.
China represents one fifth of the worlds population, and was at that time averaging 23
million newborn each year. China has the largest population of any country in the world,
1.22 billion people. China also has the largest area of fertile land even though half of
the country is covered by mountains. Thirty-one percent of the world's polio cases were
reported in China.
There are no Rotary Clubs in China, but they wanted to participate in the world polio
eradication effort, and to have their own facility for producing polio vaccine. In 1991,
Rotary Foundation awarded China a $15 million dollar Grant to help build the polio vaccine
On October 8, 1992, ground breaking ceremonies were held in the City of Kunming, in the
Province of Yunnan, located in South Central, Peoples Republic of China, for what would
become the largest polio vaccine production plant in the world. It became a reality after
five years of planning and technical training. The World Bank administered the Rotary
Polio Plus Award.
The National Institute of Public Health and Environmental Hygiene in the Netherlands
received the contract to construct the Kunming factory. The facility produces polio
vaccine from visceral substrates, an innovative technique approved by the World Health
Organization in 1987. China's Ministry of Health supervised the construction of the
factory with Rotary and World Bank representatives monitoring its progress.
This new facility to produce polio vaccine was integral to the effort to eradicate
polio world wide. It will insure that, for the first time, children in China will receive
vaccine that meets the standards set by the World Health Organization. The new completed
factory was scheduled to begin to produce vaccine in 1996. It produces 100 million doses
of oral polio vaccine annually. This project represents an unusual, important
non-government collaboration with the World Bank.
A Polio Plus Grant also provided $900,000 to fund 20 training centers and laboratories,
built throughout China, to train persons to monitor progress toward polio eradication.
This program was in cooperation with UNICEF.
The first National Immunization Day was planned to immunize 100 million children in a
24 hour period. It was held on December 5, 1993. China reported that 85 million children
were given the polio vaccine that day.
In late 1992, Royce Abbey, of Australia, and Chairman of the Rotary Foundation,
received an invitation from the Government of China to observe the second round of polio
immunizations to be conducted throughout The Peoples Republic of China, on January 5,
1994. He reported that he personally administered polio vaccine to a number of infants. He
traveled 161 Kilometers by car on busy roads outside of the major cities to visit country
areas. Immunization efforts were visible in all areas.
National Immunization Days such as these in China are very expensive, and China needed
help to carry them out. Japanese Rotarians raised an additional $750,000., and the Japan
Government gave $2 million dollars; $300,000. was given by the private sector. The Rotary
Foundation contributed $2 million dollars toward the two National Immunization Days. On
the second National Immunization -Day China did meet their goal of immunizing 100 million
China, the world's most populous country is, of course, critical to the success of
achieving polio eradication in the Western Pacific. With a record of 183 million children
immunized in two days, China was off to a good start.
Once a strong hold of the polio disease, China in the past three years has
organized and completed six days of national immunization, serving from 85 to 100 million
children each day. This is a world record! Immunization Day is held about once every six
China's massive campaigns have nearly wiped out the disease in that vast country. The
World Health Organization has reported only one laboratory confirmed case caused by the
wild polio virus in 1996, which they believe was imported from neighboring Burma. It is
difficult to control the boarder of China to keep out people who may be carriers of
India is the largest country in south Western Asia with 1,173,828 square miles, and a
population of 968 million people. This is an increase of over 500 million people in just
30 years (1967 -1997).
India had more polio cases than any other country in the world, an estimated 45% of the
world's total. With 25 million newborns every year, India was one of the greatest
continuing challenges for the Polio Plus campaign.
During India's "Shishu Surakoha Divas" (baby protection days) in October
1991, Mother Teresa conveyed her appreciation for the Polio Plus program. She prayed for
the program's success, and she wrote a message in the 1991-92 Polio Plus Operation Manual.
"May God's blessing be with you all is my prayer for you."
In the first two years of India's Program, Rotary provided, $24.2 million dollars for
oral polio vaccine, social mobilization and technical support staff.
The Polio Plus vaccine grant and the social mobilization efforts of Indian Rotarians
have helped immunize 100 million children during the past four years (1989-1993~.
The Polio Plus program in India has mobilized more than 50,000 volunteers from it's own
ranks. Rotarians from 1,642 clubs. Interactors, Rotary Village Corps, and Inner Wheel
members are active in all phases of polio immunization.
The Team had to work on training both Rotarians and thousands of volunteers. They
implemented training workshops, and wrote an OPERATIONS MANUAL for Rotary Clubs. They also
wrote POLIO ERADICATION GUIDELINES for private physicians, training videos, a volunteer
handbook, and had motivation posters made to attract the mothers to bring their children
to be immunized.
Since the majority of Rotary Clubs are located in urban areas, they were encouraged to
"adopt" slum areas in need of immunization. This on going support resulted in
developing a special rapport between the Rotarians and the community at the local level.
Another way of raising public awareness was through street plays and rally 's. An
unusual and innovative project was a 255 kilometer (1,554 miles) skating expedition by a
seven year old girl, organized in November, 1992, to promote polio eradication and to
bring more children to the polio vaccine center.
Rotary Clubs and their individual members helped in four major areas; raising
awareness, assisting at immunization sites, providing cold-chain equipment needed to
transport heat sensitive vaccine, and tracking and reporting possible polio cases
All of the above are collaborative efforts with India's Ministry of Health, UNICEF, the
World Health Organization, and the U.S. Agency for International Development.
Even high school and college youth were recruited and assigned to slum areas where they
promoted immunization and follow up.
In the State of Tamil Nadu, Rotary Clubs supplied a large amount of ice-lined
refrigerators, deep freezers, and ice packs for vaccine carriers. These clubs are
"Polio Plus Partners." When a country has a need they can register the need with
Polio Plus Partners program, that in turn puts the need on the Internet. Clubs wishing to
help can then provide the need.
In 1990, Rotarians started holding Special Vaccination Days. These days are now held
each year in the Spring.
The National Polio Plus Immunization Committee sponsored seven work shops on
surveillance for district immunization officers in five priority states. Rotarians who
attended these work shops went back to their clubs to educate their members and the public
on how to identify and report suspected polio cases.
On December 9, 1995, India held it's first ever National Immunization Day, - dubbed
"Pulse Polio Immunization" (PPI) by the government.
Throughout the cities and villages of the country, 32 states and Union Territories,
health workers and volunteers, including some 100,000 Rotarians, spouses, and Inner Wheel
members geared up for this major battle in the war against polio.
Two years later, in 1997, India set a world record in mass immunization, with 127
million children immunized in one day.
SRI LANKA (CEYLON)
Even though the Northern part of Sri Lanka was in civil war, the Government remained
committed to immunization of Polio Plus for the children. The President called for
"Days of Tranquillity", a cease fire in the war, so that the National
Immunization Days could be held.
In 1997 they marked the third year that Sri Lanka had no new polio cases. The President
was presented a Polio Eradication Champion Award, for outstanding commitment to the polio
eradication effort. She thanked Rotary International, UNICEF, and the World Health
Organization for supporting her immunization days. From 1987 to 1997, Polio Plus grants to
Sri Lanka totaled $2.4 million for Polio Plus vaccine and social mobilization activities.
Rotary was presented with many challenges throughout Africa. In 1981, the rate of
immunization coverage was less than ten percent. However, by 1990 the rate of coverage was
raised to 56 percent which was very low, compared to other regions which averaged 83
The World Health Organization, Rotary Polio Plus, and UNICEF were concentrating on
promoting local community awareness, improving the "cold chain", and gaining
support from the local governments and political leaders. The "cold chain"
refers to the transportation of the polio vaccine. It must be kept cool, and in areas
where there is no refrigeration, or electricity, it must be kept on ice and in
refrigerated containers until it is ready to be used.
In 1996, R.I. President Luis Vicente Giay. and Rajendra Saboo, Chairman of the Rotary
Foundation, met in Johannesburg for the official ceremony to launch President Nelson
Mandela's, KICK POLIO OUT OF AFRICA campaign. Both of these Rotarians became members of
the committee for, "A P-olio Free Africa."
KICK POLIO OUT OF AFRICA was printed on posters and pamphlets and distributed all over
the country to make people aware of the campaign and encourage parents to bring their
children to be immunized. The Government was committed to rid Africa of polio by the year
During the next 18 months, 29 sub-Saharan African Nations held National Immunization
Days, and immunized more than 100 million children. Africa, at that time. was one of the
last bastions of the polio virus in the world, reporting more that 12,000 cases every
The leaders in Africa were very optimistic that their 1' countries would be able to
complete their National Immunization Days as planned. However, several trouble spots for
the disease were still active. Some areas were suffering from internal conflicts, and/or
general lack of resources.
It was noted that in order for the world to be polio free by the year 2000, they must
begin the three year immunization program by 1997.
Bob Keegan, public health advisor to U.S. Centers for Disease Control and Prevention,
"lists 15 countries that are at risk for not achieving polio eradication on time. In
1997 they were, Angola, Burundi, Djibouti, Ethiopia Liberia, Nigeria, Rwanda, Sierra
Leone, Somalia, Sudan, and Zaire, in Africa; and Afghanistan, Iraq, Pakistan, and Yemen in
the Middle East.
However, Keegan states that "in 1996, twenty-eight countries conducted National
Immunization Days in sub-Saharan Africa, immunizing approximately 52 million children.
[THE ROTARIAN, June 1997]
Angola had canceled the National Immunization Days, and was on Keegan's list. But,
Angola did complete them. Angola, a country racked for 30 years by civil war, and strewn
with land mines, did a remarkable job. They have virtually no health care system in place,
and they report an infant mortality rate of 200 per 1,000 births. Nevertheless, Angola
conducted two National Immunization Days that reached 4.2 million children under the age
of five. This was 90 percent of the target population.
This remarkable success was achieved with unprecedented 20 collaboration between
governmental health officials and members of the opposition group, the National Union for
the Total Independence of Angola.
African Rotarians worked closely with government leaders, the World Health
Organization, and UNICEF to organize the historic vaccination drive. They encouraged
businesses to donate vehicles, to transport vaccine, and two Rotarian doctors accompanied U.N. Staff to distant provinces to help administer the vaccine.
Afghanistan is a war torn country with 20 years of civil war. It seemed impossible for
them to have National Immunization Days. However, the World Health Organization, and UNICEF arranged with the warring forces to have, "6 days of
tranquillity", when there would be a cease fire for all sides. The 6 days became
National Immunization Days. Some of the soldiers called it, "peace for
In South West Asia there were 5,000 "Health Posts" set up in remote areas.
Over 13,000 health workers and their support volunteers traveled to these distant out
posts for immunization days, some by train, some by car, and some even by mule to the
remote mountain areas. This is an example of the tremendous effort that is being put forth
to eradicate polio from the world.
There were no Rotary Clubs in Russia until 1989. They did however, conduct a polio
campaign in 1995. Russia was the last major country to begin it's fight against polio.
In 1994 there was a polio epidemic in the war torn region of Chechnya, where 6 children
died of the disease and 138 were taken ill. At that time there were 152 polio cases in
Russia. Health officials feared in 1995, that polio might spread through Russia's big
cities as they had become havens for Chechen war refugees.
In 1995, the Health Inspectorate in St. Petersburg declared a massive campaign to
eradicate polio by the year 2000. There was at that time speculation that the disease had
been brought to St. Petersburg from Chechnya.
The city's Health Inspectorate drew up a plan for the city. He declared March 18 - 20,
and April 22 - 26, National Immunization Days, and he declared that every child under five
years of age should receive a polio vaccination. He also declared that all children in the
city's orphanages should be vaccinated regardless of age. [City declares all-out war on
The USSR now has become individual nations, and some of them are at war. The arm of
Polio Plus is reaching out to each one of them because in order to rid the world of polio,
every country must be included.
A polio epidemic broke out in Albania in 1996, just when everyone thought
the country was free of polio. Albania had not reported a case of polio since the 1980's.
With the new epidemic they reported more than 100 cases, and 12 polio related deaths. The
Albanian Government appealed for help. Rotary Foundation gave $100,000 in emergency funds
for polio vaccine to be rushed there to vaccinate both children and adults. This epidemic
illustrates how important it is for polio free countries to continue their immunization
efforts. [THE ROTARIAN, Dec. 1996]
Romania had no Rotary Clubs, but a district in France applied for a Polio
Plus Grant of $427,000. for Romania. That Rotary District in France will send assistance
to Romania for National Immunization Days.
Bulgaria had it's first polio outbreak in ten years. They found that 18 of the 19 cases
reported were in among Gypsies. They are now in their 3rd year of National Immunization
In Turkey the Rotarians are spreading publicity to get people to take their children to
be vaccinated. They sent a plane to drop pamphlets over remote areas to publicize the
great need for immunization.
EAST MEDITERRANEAN REGION
In both Pakistan and Egypt they aimed to finish their National Immunization Days by
1994, and be polio free. Rotarians helped in all phases of immunization.
Lebanon had great internal strife, but UNICEF and Rotarians worked to get the National
Immunization Days set. They have immunized 82% of children under 5.
THE WORLD HEALTH ORGANIZATION (WHO)
PLAN OF ACTION
World Health Organization's global Poliomyelitis eradication plan has three stages. By
1990 the principal goals are to:
1)Increase national capacities to report polio cases and coverage on a
"district" basis. This enables nations to pinpoint where their immunization
programs need strengthening.
2)Assure that all countries use a polio vaccine that meets WHO requirements.
3)Establish a cooperative network of regional laboratories with the ability to isolate
and type polio virus and differentiate vaccine-like virus from wild polio virus.
4)Introduce training courses and materials for health workers that will result in
better surveillance and reporting systems, vaccine potency testing, and serological
(blood) tests for polio immunity.
5. Define the most effective polio outbreak control procedures, review current oral
polio vaccine formulations, and review possible combined use of inactivated and oral
6)Establish regional advisory bodies to review progress and to coordinate support from
UN agencies, governments, and private and non-governmental groups.
The goals for 1995 seek to stop polio transmission in European and Western Pacific
regions, and to certify formally its eradication in the Americas. In addition, health
experts envision that polio-free nations and zones will be achieved in Africa, the Eastern
Mediterranean, and the Southeast Asian regions.
By the year 2000, the plan envisages no cases of clinical poliomyelitis associated with
wild polio virus; eradication of the virus; and the start of certification.
What is the total price tag for polio eradication? The cost cannot easily be separated
from the costs of the EPI program, which covers not only polio, but the five other
Currently, WHO estimates that it costs about U.S. $10. on average for each child to be
fully immunized against the six childhood diseases. That adds up to $500 million a year at
the present coverage levels (50% of newborns).
The developing nations themselves provide about 80% of their EPI costs at present. As
coverage increases, however, many nations will need more aid. The special costs incurred
by WHO to eradicate polio will total an estimated minimum of $155 million during the
period 1989-2000. (This amount is over and above the ongoing support to EPI from all
sources, including Rotary's contribution.) Most of this will be invested in expert help to
nations which lack the technical capacities to achieve the goal. (THE ROTARIAN, Feb.
1989, p 47)