We Can’t Lose The Fight Against Polio. Here’s How To Beat It Again — For Good

My early memories of polio are vivid and terrifying. I remember stories about polio patients trapped in iron lungs, huge steel boxes fit with contraptions, just so they could breathe. I also witnessed the ravages of the disease up close every time I saw my best friend’s father dramatically pitch the right side of his body forward to walk.

So the emotion I felt when my mother and I lined up at the school gym to get the new oral polio vaccine was overwhelming. When we got in the car to go home, my mother felt such relief that she started crying — I was now safe, she explained.

Now, over 50 years later, polio has resurfaced, with new cases reported in Israel, the U.S. and the UK, and wastewater samples tested in London and New York make clear that these are not isolated cases. The time to act is now.

Since my inoculation all those years ago, polio had not crossed my radar again until many years later until I served as a member of President Barack Obama’s national security staff and then as the administrator of the U.S. Agency for International Development.

Polio, a contagious, debilitating, and life-threatening disease, has been a global threat for hundreds, perhaps thousands, of years. It was not until the late 1700s that the disease was officially identified. It took 50 years after that to determine that it was contagious, and another 60 years to confirm that it was caused by a virus. The first major outbreak in the U.S. occurred in 1894, with another in 1916; similar outbreaks were recorded in Europe.

It was, and remains, a terrifying disease — one that affects the central nervous system and triggers muscle weakness, paralysis, and sometimes death. It spreads like wildfire.

In the mid-1950s, Dr. Jonas Salk developed the first polio vaccine, and in 1961, Dr. Albert Sabin developed the oral vaccine.

Over the next half century, the world made breathtaking progress. The polio vaccine became part of the standard immunization package for children all over the world. Countries mounted national immunization campaigns. Wartime truces and national vaccination days were agreed upon in Liberia and the Democratic Republic of the Congo to combat polio. And by the time I joined the Obama administration in 2009, the virus was only endemic in three countries: Nigeria, Pakistan, and Afghanistan.

Finishing the fight in those countries proved challenging. In Nigeria, religious and political leaders in the north directed parents not to have their children immunized, falsely claiming that the vaccine could infect them with HIV and cancer. In 2013, nine vaccination workers were murdered. Boko Haram, a terrorist organization that still wreaks havoc over large swaths of that country and was condemned around the globe for kidnapping 276 schoolgirls in Chibok, actively fought the vaccine drive. But even in the most challenging environments, polio can be overcome, and in 2020, Nigeria was declared free of endemic polio.

To this day, ending polio can be a dangerous enterprise. Attacks on vaccine workers in Afghanistan and Pakistan are common, but in both countries courageous health workers keep up the fight. During my time in government, cases popped up from time to time in Syria and South Sudan, for example.

Financed with donations from countries all over the world, the Global Polio Eradication Initiative, or GPEI, is at the forefront of the effort to certify every country in the world polio free, including those where the challenge is most daunting. It was founded in 1988, when polio was still in play in over 125 countries — and is led by some of the most important actors in the global public health community, including the World Health Organization, the U.S. Centers for Disease Control, the Global Alliance for Vaccines, UNICEF, Rotary International and the Bill and Melinda Gates Foundation.

On two occasions I was asked to speak to large delegations of Rotary International members who were visiting the White House. Both times, the discussions that followed were peppered with questions and pleas on polio. A little-known fact is that Rotary International was an early adopter of the fight to end polio, having made an initial commitment in 1985 of $150 million for eradication efforts. Years later, the group is still highlighting the fight as one of its top priorities.

The determination of Rotary members from across the U.S. and around the world is palpable, as is the determination of Bill Gates, who raised polio in every meeting he had at the White House during my time there. The passion of these advocates has been driven by the common sense that we can end a preventable disease.

The re-emergence of polio is worrisome, particularly considering the politicization of and uneven response to the Covid-19 pandemic. Panic, however, is unwise. What is needed is vigilance and vaccination coverage. Fortunately, there are millions of people who are living proof that polio vaccines work.

This is a moment when the world can do the right thing and eradicate a preventable disease. Since the mid-1950s, a concerted global effort has confined endemic polio to only two countries and proven that this is a virus we can defeat.

Going all the way is a moonshot and a win for the world. It is not without its challenges, of course. But it is far easier right now than defeating Covid, or malaria, or AIDS. One can only hope that ridding the world of a disease known as “infantile paralysis” might be something we can all agree on — if not for ourselves then for the children whose lives continue to be at risk.