Gates pledges $1.2 billion to speed end of crippling poliovirus

Bloomberg— Bill Gates claims polio came close to being eradicated this spring, before new outbreaks occurred in Africa and a man was paralyzed in New York. Now, the billionaire’s philanthropic foundation pledges $1.2 billion to complete the mission.

The Bill & Melinda Gates Foundation announced its largest financial commitment to date to the Global Polio Eradication Initiative in Berlin on Sunday. The money will help fill a funding gap that, along with flooding in Pakistan, the war in Ukraine and the Covid-19 pandemic, have thwarted a 35-year effort to rid the world of this crippling disease.

“About six months ago was when we were closest,” said the co-founder of Microsoft Corporation. in an interview on Thursday. For more than a decade, eradicating polio has been the top priority for the foundation that he co-chairs with his ex-wife Melinda French Gates. The Seattle-based nonprofit, with an endowment of some $70 billion, has donated nearly $5 billion directly to the cause.

“We’re very committed,” said Gates, 66. “I can’t say forever, but quitting would mean hundreds of thousands of children would be paralyzed”.

Since the World Health Organization declared the international spread of wild poliovirus a global health emergency in 2014, cases worldwide have dropped from 359 to just 29 in 2022. In the same period, cases linked to a mutated strain derived from the oral polio vaccine have skyrocketed from 56 to 398 after the pandemic forced a four-month suspension of immunization and disease surveillance campaigns in 2020.

The current five-year strategy of the eradication program needs 4,800 million dollars to reach 370 million children a year with polio vaccines and other essential health services by 2026. As of last week, before Gates’ latest promise, he only had indications of support of $2.2 billion, after the The UK and Norway, historically key donors, will cut their planned contributions. Gates said he hopes the gap will narrow when Germany co-hosts a pledging event at the World Health Summit on Tuesday.

“We’re a little bit disappointed that some of the other donors are not as generous as they have been historically,” Gates said. “There are so many distractions right now, it’s harder than you think, given the value of getting this eradication done.”

The UK government committed to the polio program before cutting its aid spending to 0.5% of gross national income from 0.7% in 2021.”Some things got prioritized and some things didn’t,” Gates said. “But this one seems quite urgent. It’s a bit ironic that we now have some polioviruses in environmental samples, not only in London, but also in New York City.”

Wastewater analysis can detect the presence of the virus in an area.

disease eradication

Smallpox remains the only human disease eradicated so far. World health leaders went after polio in 1988, hoping to complete the task in 12 years, the same time it took to defeat smallpox. However, ending polio has proven to be a more elusive goal.

Nearly $19 billion in financial aid and heroic efforts to vaccinate hundreds of millions of children have reduced polio cases by 99.9%. That has left Pakistan and Afghanistan as the only two countries where this ancient enemy has never been stopped. From that stubborn stronghold, wild poliovirus has again spread to southeastern Africa.

In May, it caused the first outbreak in Mozambique in 30 years, prompting three national vaccination campaigns targeting more than 4.5 million children.

“As long as these viruses exist anywhere in the world, the entire world is at risk,” said Carol Pandak, director of Chicago-based Rotary International’s PolioPlus program, whose members launched an immunization campaign in the Philippines in 1979 that helped inspire the Global Polio Eradication Initiative nine years later. “It is in our interest to see this through to the end, to eliminate that risk for all populations.”

Gates is focusing on Pakistan, where eradication was “very close,” with a single strain circulating in an area of ​​Waziristan, a mountainous region bordering Afghanistan. In recent months, floods have inundated a third of the country, displacing millions of people and fueling the spread of poliovirus.

“Sadly, that has flourished and spread to other parts of the country,” Gates said. “And with the floods, it’s likely to show up reasonably widely across Pakistan.” Vaccinations are expected to resume in Waziristan next month, once serious flooding problems have been resolved, he said.

Gastrointestinal tract

Polio, known medically as poliomyelitis, is a highly infectious disease caused by one of three types of poliovirus that replicate in the human gastrointestinal tract. Infected people shed the virus through their faeces, allowing it to spread easily in areas without good sanitation and hygiene. It is difficult to eradicate because less than 1 in 100 people who contract it show signs of illness or are aware of the infection, allowing them to silently transmit the virus to others.

Smallpox, on the other hand, is easily identifiable by the characteristic red rash it causes, which speeds the identification of outbreaks and the initiation of response vaccination programs. The smallpox-based vaccine used against smallpox protected almost everyone after a single inoculationwhile with the oral polio vaccine – used in some 150 countries as of 2016 – three or more doses are needed to fully protect 85% of children.

That vaccine, developed by Albert Sabin, uses a live, attenuated form of the poliovirus. If the weakened virus is spread from person to person over a long period of time in an undervaccinated community, it can undergo genetic changes that turn it back into the form that causes paralysis. Such a strain caused polio in an unvaccinated man in New York’s Rockland County in June.

Most cases worldwide are caused by a derivative of the type 2 oral poliovirus vaccine.. The Gates Foundation helped fund the development of a new version that cannot revert to its pathogenic form.

The WHO authorized the emergency use of the new vaccine almost two years ago. Since then, nearly 500 million doses have been administered in 25 countries, Hamid Jafari said., director of polio eradication for the WHO Eastern Mediterranean region, based in Amman. According to him, it is the best weapon to stop vaccine-derived cases and end polio transmission by the end of next year.

“We are on track to stop all polio by the end of 2023,” Jafari said in an interview. “A lack of funding would be very tragic.”

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Gates pledges $1.2 billion to speed end of crippling poliovirus