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Panama’s Role in Silent Polio Victory


Polio victims in Nigeria

Posted 30/08/2020

By Dr R. Richel

This week, the world reached a milestone that it has been fighting for for decades. In the midst of the Covid-19 pandemic, it went unnoticed by many. On Tuesday, the vilified WHO declared the African continent polio-free. A healthcare success of dimensions that are difficult to beat.

 In 1985, 350,000 people, mostly children, suffered from this terrible viral infection. Many of those who did not die during the acute illness were condemned to live with severe motor sequelae for the rest of their lives. This, despite the fact that vaccines against this infection had been available since the 1950s.

During the 1985 Rotary International world convention, the organization's president, the Mexican physician Carlos Canseco, launched a challenge to make Rotary the spearhead of an ambitious program that would seek to eradicate this disease from the face of the earth.

Thus was born the flagship program for Rotarians worldwide, which we call PolioPlus. That year, Rotarians pledged to donate $120 million for vaccines.

In the 35 years since then, Rotarians have contributed more than $1.3 billion to purchase oral vaccines, immunizing 2.5 billion children in 122 countries around the world. Thousands of Rotarians have participated in vaccination brigades, traveling to remote places, far away from their countries, to vaccinate the population. It is assumed that, if you quantify the time represented by volunteer hours, Rotary's contribution to the PolioPlus campaign has been in 30 years, greater than$8 trillion.

India was, until recently, the country most affected by cases of polio. Rotary began a massive vaccination campaign throughout India, in which thousands of volunteers participated, breaking the record for vaccinations in a single day, reaching figures that were around two and a half million children vaccinated daily.

These efforts received further impetus in 2007 when the Bill and Melinda Gates Foundation joined PolioPlus, offering to donate $2 for every dollar Rotarians donate. That year, Rotarians donated $110 million. Since then, the Gates Foundation has already donated more than $350 million in total.

In 2015, Nigeria had its last case of wild polio. After five years without cases, Africa has been declared free of the disease. The last two countries where there are cases are Afghanistan and Pakistan, where wars between radical groups have made it very difficult for vaccination programs to succeed.

These results clearly demonstrate to us the success that is obtained when science works hand in hand with the international community and philanthropic organizations to achieve common goals.

Pseudo Science
Although it made no noise, Panama has had its direct participation in these achievements. For years, our country has been an important center for vaccine research, with particular emphasis on polio. Several studies developed in Panama have been published in important medical journals in the world. And, the Cevaxin vaccine research center, where more than one hundred Panamanian professionals and independent researchers from Hospital del Niño participate, has been invited by the Gates Foundation to participate in its global vaccine development program.

In fact, the latest oral vaccine, safer than previous ones, and that has served to cut the few outbreaks that remain in the world, was developed based on research done in Belgium and Panama. Sadly, an outburst of pseudoscience, sponsored by a few doctors and "influencers" who barely know how to get sick in medicine, has taken on the task of questioning whether research is being done in Panama to develop vaccines against Covid-19. Luckily science does not waste time on these hindrances.

What has been achieved this week in global public health was surely overshadowed by the "box office" news of the moment. The Covid-19 pandemic and the European outbreaks, the United States elections, the racial violence in Wisconsin and the hurricanes in the Gulf of Mexico. However, for all who have worked to eradicate polio from the face of our planet, it has been a giant step towards achieving this ambitious goal. It is time to congratulate the scientists, philanthropists, physicians, and Rotarians who have done their part to achieve the success of this magnitude. With each passing day, we are getting closer to the total eradication of this terrible disease. !! Congratulations!!

The author is a physician and a Rotarian



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WORLDVIEW: Biting the hand that doesn't feed


Administering polio vaccine

Posted 01/09/2020

 By Jonathan Power

There was a great piece of news announced last week by the World Health Organisation. Wild-polio has been wiped out of Africa, thanks to a vaccine. It only remains in some isolated parts of Pakistan and Afghanistan where public health officials fight  against the polio virus and t inbred conservative peoples, some of whom who are prepared to kill the health workers on the grounds they are spreading the disease.

This fight to eliminate polio has been going on since 1988, a warning that even when a vaccine for Coronavirus is invented there will be many barriers to surmount before it has done its job.

One must say thank heavens that the battle against polio was practically done and over in Third World countries before the Coronavirus pandemic got up speed. Since Coronavirus swept the world the battles against tuberculosis, malaria and AIDS/HIV have been slowed down, partly because of peoples’ worries about visiting health clinics, many of which have been closed for fear of contagion. It’s estimated that about 80% of programs have been disrupted. One in four people being treated for HIV have reported problems in getting hold of their medications. In India diagnosis of TB cases has dropped by nearly 75%.  In country after country the Coronavirus has resulted in sharp drops in diagnosing TB: a 70% decline in Indonesia, 50% in Mozambique and South Africa and 20% in China. Yet, if ranked by numbers and importance, TB eradication should be given priority over Coronavirus which has only claimed around half a million deaths this year, against TB’s annual 1,600,000. So should malaria treatment where also more lives are being lost than those from Corona.

According to the New York Times, a 3 month lockdown across different parts of the world and a gradual return to normal over the next 10 months could result in an additional 6+ million cases of TB and 1.4 million deaths from it.

Measles immunisations have been suspended in 27 countries. Western companies making Coronavirus test kits are diverting their resources to producing tests kits for it because they can sell that for €10 against 18 cents for a rapid malaria test. Moreover, restrictions on air and sea travel have severely limited the delivery of medications to the hardest-hit regions.

It’s quite amazing that Africa, despite the hurdles, has done better than any other continent in fighting Coronavirus. Is this because its population is relatively young? But India’s is also young and now has a million cases, a world record. It’s more likely that one reason is that the virus was late in coming to it, giving time for preparation, and because there is less human traffic with the rich countries. Most important is that Africa confronts so many of the world’s diseases it has built up the infrastructure to deal with them. For, example because of dealing with the deadly Ebola virus in West Africa, medical staff already had in storage protective suits and head-coverings and knew how to act when it came to hygiene and isolation.

The African “good news” somewhat balances the bad when it comes to epidemiology. But when we start to look at the economics of development the story is largely but not entirely a negative one. The International Monetary Fund says that the continent, after 25 years of rapid growth, with some countries being the fastest growing economies in the world, will suffer its worst recession since the 1970s. The World Bank talks about what the Latin Americans used to call “a lost decade”

In the fragile states- Somalia, South Sudan, Zimbabwe and those of the Sahel- hunger is steadily advancing. The UN’s World Food Program and NG0s are fully stretched already. A devastating attack of locusts in East Africa has added to the misery. There has also been a sharp loss of markets in the developed world.

This is the price of the coronavirus which was incubated in China but was spread mainly by the highly developed countries in Europe, Japan and North America. Have they shown any signs of compensating Africa,Latin America and India for the damage and destruction they have caused? Not one bit.

We don’t need to be told that if there is a vaccine the developing countries will be last in the queue. President Donald Trump will insist on “America First”. Europe, Japan, Canada and Russia will quickly follow.

Moral Hazard

The rich countries have helped their poorer people (although in the US that has now stopped) but they have done little to help the poorer Third World countries. Talk of debt moratoriums has brought warnings of rating downgrades. A proposal to increase the IMF’s Special Drawing Rights- a form of global money printing- to help poor countries has got nowhere, yet the rich countries have not hesitated in doing something similar for themselves. The Financial Times has written, “The idea of making cash available to some of the poorest people on earth, either through grants, concessional loans of debt write-offs, has elicited tuts of “moral hazard” (bankers’ terminology for making it too easy for the wrong-headed to make the same mistake again)”.

Mark Lowcock, the emergency relief co-ordinator of the UN, estimates it would cost €90 billion to protect the poorest 10% of the world’s people from the worst impacts of the virus. This includes many people in Africa as well as such countries as Afghanistan and Syria. A lot? No, it is only 1% of the stimulus rich countries have spent on themselves, even though they should know well enough that if things are left as they are there will be hunger, violence, political instability, domestic violence, especially against women, and migration, flooding Europe and America with boat people.

All is not lost. As a BBC program highlighted it maybe that the extent of the damage to Africa is not as bad as the IMF says. A large part of their economies are in the informal sector- making and selling goods away from the eyes of tax officials and number counters. They have a flexibility and durability that big established companies don’t have. Also people can change their diets to equally nutritious foods- from imported rice to domestic cassava. This could mean that instead of the World Bank’s “lost decade” the setback may be as small as 3 years in the more successful African countries. During the fall out from the 2008 American-induced financial crash Sierra Leone kept its poverty rate falling despite the added burden of Ebola.

The spread of the internet in the Third World has had a dramatic effect on development. The United Nations Human Development Agency estimates that without access to the internet the decline in human development would be two and a half times worse. Even in these dark times the spread of the internet is growing.

Nevertheless, although I have tried to underline the positive side, in sum the virus has been devastating. The rich countries have it within their resources to mitigate the worst of it.

Why don’t they? It’s in their own interests to contain the effect of Coronvirus in the Third World which, over the long run, will affect their well-being as well. Once the rich countries have conquered their infections do they want the virus still active in Africa to come back and bite the hand that doesn’t feed it?



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