OF REDLANDS, CALIFORNIA  - Founded 24 January 1895


MEETING # 1599

4:00 P.M.

MARCH 5, 1998

Rotary International's Polio Plus
Working With
The U.N. World Health Organization

by Arthur M. Jensen Ed.D.

Assembly Room, A. K. Smiley Public Library


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 contagious virus.

"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, February 1989)

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 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 service."

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 in 2005.

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.


"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 1978.

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.


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. Caparas.)

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.


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 reported.

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 Field.

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 children.


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 program.

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 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".


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 46

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 boost.

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 plant.

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 children.

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 months.

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 disease.


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 (surveillance).

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.


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 percent.

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 2000.

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 year.

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 immunization."


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 polio. Internet]

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 Days.

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.


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.



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 vaccines.

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 childhood diseases.

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)

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