29th October 2000

Polio Virus Eradication: Polio milestone passed.

BBC News Online (http://news.bbc.co.uk/) carried the following report dated Sunday, 29 October, 2000, 04:32 GMT:

Scientists have announced the eradication of the crippling disease polio from 37 Pacific Rim countries.

And they have dismissed warnings that use of a particular sort of polio vaccine to achieve this increases the risk that the disease could re-emerge.

The World Health Organisation has overseen mass immunisation programmes in countries such as China, Vietnam, Cambodia, and South Korea.

The campaign has had to overcome huge logistical difficulties to reach remote areas with vaccines.

However, a study published in the Lancet medical journal on Friday [see below] suggested that the use of "live vaccines" - which contain active but genetically altered copies of the actual polio virus, could mean the illness could return if vaccination efforts stopped.

The live poliovirus vaccine is given by mouth to children, often in the form of a sugarlump or a droplet.

It has long been established that the altered viruses it contains can be replicated in the gut of immunised children, and gradually revert to the form which causes disease.

Indeed, there are a small number of cases of vaccine-induced polio which occur as a result of immunisation programmes.

Sewage system.

The Japanese researchers found that children given the vaccine were excreting poliovirus into the sewage system - and that there were detectable levels there.

They believe that this creates a risk that polio, far from being eradicated, could strike again if immunisation ever stops.

The researchers wrote: "There is an environmental risk of vaccine-associated paralytic poliomyelitis as long as live oral poliovirus vaccine is not replaced with inactivated polio vaccine."

However, the WHO is against the universal use of inactivated virus vaccine - in which the virus is rendered completely incapable of replicating - on the grounds that it is less effective than live vaccines.

Dr Bruce Aylward, the coordinator of the programme in Western Pacific region, said that despite the presence of poliovirus in sewage and river water, there had never been a recorded case in which anyone had acquired the virus from this source.

He said: "The study is valuable work, as it helps us put together our strategy for the endgame against polio.

"In Cuba, they found a similar thing was happening, but that the presence of the virus died away naturally shortly afterwards.

"We have never seen an outbreak caused by this in 30 years."

He said that even in countries in which polio had been eradicated, ongoing vigilance was essential to make sure the virus could not come back.

He mentioned one recent case in northwest China which was traced to a long distance trade route between there and a region of India.

"This kind of case is the main threat," he said.

The full text of the article can be found at http://news.bbc.co.uk/
hi/english/health/newsid_994000/994799.stm

Polio Virus Eradication: Polio: we're not out of the woods.

Last Friday's the Lancet published three related items on polio virus eradication. All three are included in that part of the journal that is freely available. Access requires pre-registration which is free. However, the Lancet has selected the polio virus study as the lead item in the current issue and part of the coverage can be accessed from the entry page (http://www.thelancet.com/home) without pre-registration, at least until a new issue is published next Friday. The individual article links below will require pre-registration.

The Lancet Talking Point: Polio: we're not out of the woods.

'There is an environmental risk of vaccine-associated paralytic poliomyelitis as long as live oral poliovirus vaccine is not replaced with inactivated vaccine'

The eradication of poliomyelitis from the western Pacific region is due to be declared on Oct 29. However, two studies in this week's issue highlight the remaining hurdles that must be overcome before polio can be eradicated globally. Hiromu Yoshida and colleagues studied the molecular characteristics of type 3 polioviruses isolated from environmental samples in Japan. They found that all 29 isolates were vaccine-derived, and that 16 (55%) were expected be highly neurovirulent. Yoshida and colleagues stress that polio will be difficult to eradicate completely while live vaccines are used. In the second study, Chushi Kuroiwa and colleagues investigated surveillance and vaccination activities in 16 districts of Laos -- a land-locked country bordering the southeast Asia region where polio is yet to be eradicated. They found eight cases of unreported acute flaccid paralysis, and a disappointing understanding of the need for surveillance.

The full text of the article can be found at http://www.thelancet.com/
journal/vol356/iss9240/full/llan.356.9240.talking_points.14011.2

The Lancet Original Research: Characterisation of vaccine-derived polioviruses isolated from sewage and river water in Japan.

Hiromu Yoshida, Hitoshi Horie, Kumiko Matsuura, Tatsuo Miyamura.

Department of Virology ll, National Institute of Infectious Diseases, Gakuen 4-7-1, Musashimurayama, Tokyo, 208-0011, Japan (H Yoshida MMedSci, T Miyamura MD); Japan Poliomyelitis Research Institute (H Horie PhD); and Department of Virology, Toyama Institute of Health (K Matsuura BS)

Summary.

Background. A nucleotide change from U to C at position 472 in the 59 non-coding region of the type 3 poliovirus is associated with increased neurovirulence. Moreover, the proportion of type 3 polioviruses containing this mutation (472-C revertants) correlates with the neurovirulence of a particular sample. We used mutant analysis by PCR and restriction-enzyme cleavage (MAPREC) to estimate the neurovirulence of environmental samples obtained from Toyama prefecture, Japan.

Methods. Sewage and river water were collected between October, 1993, and September, 1995, and concentrated samples were inoculated into three different cell types. Isolated type 3 viruses were analysed to determine whether they were derived from the live oral poliovirus vaccine strain; they were then tested for neurovirulence by MAPREC.

Results. 29 type 3 strains were isolated -- all of which were vaccine-derived. 16 (55%) comprised between 2% and 91% 472-C revertants by MAPREC and were expected to have high neurovirulence. The remaining strains included less than 0·25% revertants, and were regarded as attenuated viruses. Both types were isolated about 3 months after routine oral poliovirus vaccine administrations in May and October. Three strains isolated from river water were of the virulent type.

Interpretation. Our results emphasise that there is an environmental risk of vaccine-associated paralytic poliomyelitis as long as live oral poliovirus vaccine is not replaced by inactivated polio vaccine.

Lancet 2000: 356: 1461-63.

The full text of the above study can be found at http://www.thelancet.com/
journal/vol356/iss9240/full/llan.356.9240.original_research.13991.1
Alternative PDF version can be found at http://pdf.thelancet.com/
pdfdownload?uid=llan.356.9240.original_research.13991.1&x=x.pdf

The Lancet Research Letters: Risk of poliomyelitis importation and re-emergence in Laos.

Chushi Kuroiwa, Phengta Vongphrachanh, Toru Chosa, Hitoshi Murakami, Masahiro Hashizume, Susumu Wakai, Masahiro Tanaka.

The declaration of poliomyelitis eradication in the western pacific region is scheduled for Oct 29, 2000, in Kyoto, Japan. Our survey in the border areas of the southeast Asia region, however, revealed that there remains a risk of re-emergence and importation of poliomyelitis into Laos. We report the evidence based on our border area investigations during the past 4 years under the bilateral supervision of the governments of Laos and Japan.

The full text of the report of which the above is the opening paragraph can be found at http://www.thelancet.com/
journal/vol356/iss9240/full/llan.356.9240.original_research.14012.1
Alternative PDF version can be found at http://pdf.thelancet.com/
pdfdownload?uid=llan.356.9240.original_research.14012.1&x=x.pdf

For Polio eradication and vaccine related resources see our directory Polio Virus, Vaccine and Eradication

20th October 2000

[Polio] Vaccine recalled over BSE fears.

The London Times (http://www.thetimes.co.uk/) reported today:

A polio vaccine regularly used to inoculate children and travellers was today ordered to be recalled amid fears over mad cow disease.

[UK] Health chiefs said there had been a breach of health guidelines in the manufacture of the vaccine.

European rules say oral medicinal products should not use bovine materials from countries in which there are known cases of BSE.

The Department of Health said the recall affected only one particular brand of polio vaccine, which was due to be replaced anyway. All remaining stocks are being recalled.

A spokesman said: "As the national supply of polio vaccine has already switched to a different manufacturer, the impact of the recall on the polio vaccination programme is likely to be minimal."

The risks to humans of catching CJD - the human form of BSE - as a result of the vaccine is "incalculably small", the department said.

GPs were being advised that, as a precautionary measure, all stocks of the Medeva oral polio vaccine should be withdrawn immediately, with replacement supplies made by Smith Kline Beecham being brought in as quickly as possible.

Smith Kline Beecham confirmed it has sufficient supplies to meet demand, the health department said, though this may mean smaller but more frequent deliveries.

The recall is based on the discovery of a breach of European guidelines issued in 1999 as a precautionary measure to protect public health in the light of developing information about the theoretical transmission of BSE.

The first guidance, issued by the Committee on Safety of Medicines in 1989, asked that UK-sourced bovine materials should not be used in the manufacture of injectable medicinal products.

The implementation of this guidance led to a phasing out during the early 1990s of vaccines that had used UK-sourced bovine material in their manufacture.

A Department of Health spokesman said "hundreds of thousands" of doses of the vaccine had been given since last year in breach of guidelines designed to protect patients.

The company, Medeva, commanded a third of the market until September this year, when production ceased.

The vaccine contained a growth agent made from foetal calf serum sourced from the UK, in breach of guidelines which specified that only bovine material from countries not affected by BSE should be used in the manufacture of medicines.

The Committee on Safety of Medicines (CSM) introduced guidelines in 1989 which covered injectable medicines but technically did not apply to oral vaccines.

Last year new guidelines were issued which covered oral medicines and the Medicines Control Agency (MCA) wrote to all manufacturers seeking assurances that their products did not contain UK-sourced bovine material.

The spokesman said: "We sought and received assurances that these guidelines were being adhered to."

Assurances were given in 1996 and 1999 that the vaccine did not contain UK-sourced bovine material. But in June, the CSM decided it wanted to collect better records and tighten up procedures.

The MCA wrote to all manufacturers again, and Glaxo Wellcome, the company which produced the vaccine until 1991, told the agency that plans had been made to switch production when it was sold to Medeva.

Suspicions were raised and the MCA contacted Medeva again, when it was found that the company was breaching the guidance.

Because the guidelines do not have any legal force until next year, no legal action can be taken against Medeva.

Worried parents and patients are being advised to contact their GP or the helpline NHS Direct.

Copyright 2000 Times Newspapers Ltd.

The full text of the article can be found at http://www.thetimes.co.uk/article/0,,22543,00.html

For Polio vaccine related resources see our directory Polio Virus, Vaccine and Eradication

17th October 2000

Paralympic Games due to open on 18th October.

The Paralympic Games will be held from 18 - 29 October, 17 days after the Closing Ceremony of the Olympic Games. There will be 4000 athletes from 125 countries competing at the event in the 18 sports on the competition program, 14 of which are also on the Olympic sports program. Unique to the Paralympic Games are boccia, goalball, powerlifting and wheelchair rugby. A Paralympic sports festival atmosphere will be created at Sydney Olympic Park, Homebush Bay, which is home to 14 of the 18 sports. Cycling, equestrian, sailing and shooting will be held at satellite venues within 30 minutes drive of Sydney Olympic Park.

The official web site of the Olympic Games is also the official web home of the Paralympic Games. See http://www.olympics.com/eng/paralympics/index.html.

The Sydney Morning Herald offers useful press coverage of the Games with quite a number of articles even before the opening ceremony. See http://www.smh.com.au/olympics/paralympics/.

One of those articles examines how the Games are likely to be televised:

In May the International Olympics Committee banned Webcasting from the Sydney Games because of concerns that it would violate contracts signed years ago with TV broadcasters. However, the Sydney Paralympics Organising Committee (SPOC), which had no pre-existing TV contracts - and in fact was struggling to sell the TV rights - negotiated TV and Internet rights at the same time. Webcasting was more important for the Paralympics than for the Olympics, said SPOC's TV manager, Mr Simon Thomas, "because we struggle to get on mainstream commercial television". The Paralympics broadcast operation, while much smaller than the Olympics, will be the second biggest ever at an Australian sporting event. TV broadcasters from 30 countries, including Britain's BBC, the ABC in Australia and Fox in the US, will show the Paralympics from October 18 to 29. Yet there will be few, if any, live images on TV. Sceptical of its ratings value, most TV networks will show only highlights of the Paralympics, placing a tremendous importance on the Webcasts, Mr Thomas said. "There is a huge potential audience out there that, if it wasn't for the Webcast, wouldn't be able to access coverage." WeMedia sports programmer Mr Jay Rosenstein said the increased coverage should help the Paralympics movement overcome the marketing difficulties it had faced in the past.

The above is an extract from Web site ties up TV rights to Paralympics by David Higgins published on Monday, August 7, 2000. See http://www.smh.com.au/
olympics/paralympics/20000807/A53743-2000Aug6.html

WeMedia referred to in the article is offering free access to webcasts. See http://www.wemedia.com/paralympic/gateway.jhtml. However, the subscription procedure while robust, appears to require MS Internet Explorer 5.x and Windows Media Player 6.2 or above to be installed.

Update (UK Residents only). Starting 18th October, BBC2 are broadcasting an early evening program of highlights from the Games every day. Program start times vary between 1715hrs and 1855hrs depending on the day.

Update. BBC Online News is providing comprehensive coverage including RealMedia Audio/Video clips. See http://news.bbc.co.uk/sport/hi/english/olympics2000/paralympics/default.stm

Update (US Residents only). U.S. television coverage of the Sydney 2000 Paralympics begins on October 18, as well with the Fox Sports Net program produced by WeMedia debuting at 11:30 in most areas of the country and the coverage on PAX TV, also produced by WeMedia, begins at midnight.

Polio Virus Eradication: Cape Verde Launches Vaccination Campaign Against Polio.

Fox Market Wire (http://invest.foxmarketwire.com/) carried the following XINHUA report from Luanda on October 16th:

Cape Verde started on Monday an "extraordinary" vaccination campaign to wipe out the fatal disease poliomyelitis, the Angolan official news agency Angop reported.

"This campaign is very special because it will be carried from door to door, with no child aged between zero to five years escaping the group of vaccinators," a government official was quoted as saying. Children in this age group are most susceptible to the disease.

With a five-day duration, the first phase of the campaign will cover three districts of the archipelago country, respectively Santiago, Sao Vicente and Sal e Maio, where several cases of acute flaccid paralysis were registered in recent weeks.

During the second phase of the campaign, which is postponed due to the delayed arrival of some 200,000 doses of vaccine ordered by the World Health Organization (WHO), will extend the vaccination to the nine inhabited islands of the country.

In order to help the Cape Verdean citizens become aware of the danger of poliomyelitis, the Cape Verdean health authorities will start soon an awareness campaign through the mass media of the country.

Currently, many western African countries are carrying out the campaign against poliomyelitis with the help of WHO.

The full text of the article can be found at http://invest.foxmarketwire.com/news/news_h_st1.sht

For Polio eradication and vaccine related resources see our directory Polio Virus, Vaccine and Eradication

11th October 2000

U.S.A.: Attorney Robert Provan, Polio Survivor and GINI Presenter, Challenges HMO on "A&E's Investigative Reports" Series.

Gazette International Networking Institute (GINI) (http://www.post-polio.org/) has issued the following notice:

Robert Provan, an attorney in Austin, Texas who is a polio survivor, will share his landmark case against an HMO on "A&E's Investigative Reports" series this Friday, October 13, 2000 at 10 p.m. Eastern time, 9 p.m. Central. Bill Curtis will feature Provan's story along with three others in the program on "Managing Your HMO". Provan's case will go to trial on November 6th. He spoke at GINI's Eighth International Post-Polio and Independent Living Conference about "The ADA: An Unfinished Revolution". The Summer, 2000 issue of Rehabilitation Gazette (Volume 40, No. 2) reported segments of his speech. Please pass this information on to others and check your local listings for details in your area.

According to A&E's web site (http://www.aande.com/) the program is repeated in the early hours of the following morning, Saturday October 14th at 2 a.m. Eastern Pacific time, 1 a.m. Central.

For Disability related resorces see our Directory Disability Living

Polio Virus Eradication: Ceasefire for Afghan polio campaign.

Tuesday, 10 October, 2000, 09:27 GMT 10:27 UK, Susannah Price reports from Islamabad for the BBC (http://news.bbc.co.uk/):

Afghanistan's warring sides have agreed to a three-day ceasefire starting on Tuesday to enable the United Nations to immunize children against polio.

The UN said both the Taleban authorities and the opposing northern alliance had given their commitment to respect a ceasefire while the immunization programme takes place. During the last polio vaccination programme in May and June this year, a similar ceasefire was respected by both sides.

Polio burden.

The UN has set itself a daunting task in Afghanistan - the volunteers aim to vaccinate more than five million children during two rounds of national immunization days.

The UN says it needs to reach all children up to the age of five and special measures would be taken to ensure children who were internally displaced by fighting were vaccinated.

It said those crossing borders would also require special attention and the programme is taking place in Pakistan on the same dates.

The programme has been particularly successful in Pakistan, where the number of polio cases has dropped dramatically.

The UN said polio placed a burden on the Afghan population in terms of suffering, lost productivity and the increased need for medical resources.

The UN said they would carry out a further programme in November.

The full text of the article can be found at http://news6.thdo.bbc.co.uk/
hi/english/world/south_asia/newsid_964000/964852.stm

For Polio eradication and vaccine related resources see our directory Polio Virus, Vaccine and Eradication

Polio Virus Eradication: U.N. to begin anti-polio campaign in Africa.

Modesto Bee / Nando Times (http://www.nandotimes.com/) carried the following Associated Press from Geneva on October 10, 2000 9:35 a.m.:

The United Nations is preparing for a five-day immunization campaign to try to immunize 70 million children in 14 West African countries against polio, the U.N. Children's Fund said Tuesday.

The campaign, which runs from Monday to Friday next week, comes as U.N. agencies embark on a final five-year plan to wipe out the disease by 2005 - a target set in 1988. Taking part next week are Benin, Burkina Faso, Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone and Togo.

Three more countries - Cameroon, Chad and Ivory Coast - will join a second round of mass immunizations in November, UNICEF said. The agency identified Nigeria, Africa's most populous nation, as a key to the effort to eradicate polio.

The push comes as incidences of polio have been dropping sharply: Twelve years ago, there were at least 350,000 polio cases around the world. Last year there were 7,000 cases. So far this year, there have been 1,149 cases.

Polio is highly infectious. It usually strikes children under 5, affecting the spinal cord and brain and causing paralysis and sometimes death.

The disease now is limited to 30 countries in South and Southeast Asia and sub-Saharan Africa. But stamping out polio in some of those countries - such as Congo and Sierra Leone - is complicated by the need for access to war zones.

UNICEF spokeswoman Lynn Geldof conceded that rebel-held areas in Sierra Leone will not be reached by next week's effort, billed as the largest public health initiative yet undertaken in the region.

The simultaneous effort, involving thousands of health workers and volunteers, is aimed at ensuring children are immunized in a region where frequent cross-border movements caused by conflicts have reduced the effectiveness of single-country campaigns.

The full text of the article can be found at http://www.nandotimes.com/
24hour/modbee/healthscience/story/
0,1655,500267319-500415374-502558362-0,00.html

For Polio eradication and vaccine related resources see our directory Polio Virus, Vaccine and Eradication

8th October 2000
Polio Virus Eradication Roundup.

23 September 2000: Claims on polio high on rhetoric.

The Times of India (http://www.timesofindia.com/) carried the following report from Lucknow:

Not many are willing to share the optimism of the chief minister or the minister for family welfare, Sardar Singh, who have publicly pledged to make UP polio free this year. In fact, experts fear that the grim power scenario and floods in eastern UP may seriously hamper the success of the last leg of the polio eradication drive slated for September 24 in the state.

Reports from our correspondents in the flood-affected districts belie official claims of "foolproof arrangements." The distict magistrates, they inform, have been directed to provide boats to ferry polio vaccines to the marooned areas. However, in Gorakhpur where 300 villages have been totally cut off from the district headquarters owing to floods, polio vaccination is the last thing on the public's mind.

Majority of the marooned villages, specially those on the banks of Sisai Bandha, have yet to receive the first instalment of relief supply even after seven days. "When the administration has failed in this primary duty, expecting it to send the vaccine by boats is expecting the impossible," our correspondent has reported.

Failure of the drive is a foregone conclusion in Bahraich. Reason: non-cooperation by the district magistrate who has allegedly refused to provide boats for sending vaccines to the submerged areas. The CMO, in turn, has pleaded helplessness saying there are no funds to hire boats.

Reports from Siddharthnagar, Basti, Deoria, Balrampur and Shravasti are no different as the harried administration in each of these districts looks upon the polio vaccination drive as an "unwelcome burden." Besides, the recent boat tragedy in Gorakhpur has sent panic waves among health workers who are reported to be unwilling to risk a boat ride to the marooned areas, it is learnt.

Maintenance of cold chains is yet another serious problem. Vaccine vial monitoring (VVM), point out experts, requires an uninterrupted power supply of eight hours, which is impossible in most of these districts. Interestingly, even as the government claims to have provided generators, in districts like Bahraich they are yet to be installed.

The full text of the article can be found at http://www.timesofindia.com/today/23mlkn18.htm

23 September 2000: Efforts to make polio programme a big success.

The Times of India (http://www.timesofindia.com/) carried the following report from Patna:

Alarmed at the incidence of polio reported from the different parts of the state during the last 32 months, the state government has increased the number of booths by 35 per cent for the next round of Pulse Polio Immunisation Programme scheduled for September 24 to cover all the 1.9 crore children in the 0-5 year age group particularly those not covered during the earlier rounds. About 3.6 lakh children in this age group could not be covered during the earlier rounds.

The government had also set up a District Task Force to ensure better co-ordination among the people associated with the implementation of the Pulse Polio Immunisation Programme. Vehicles, manpower and cold chain system would be made available as per the district plan needs. For the first time, the government would deploy two vaccinators at each polio booths who would also be available for house to house coverage after every immunisation day. The period for house to house coverage has also been increased to five days from three days. The number of booths have been increased to 74,724 from the existing 48,000. The next three rounds are due on November 12, December 10 and January 21, 2000. All the activities would start at least four days in advance while all the training would be completed by September 22.

The Medical Education and Family Welfare Commissioner, Afjal Amanullah, while addressing a media sensitisation workshop on polio eradication activities in the state organised here under the joint aegis of the Care, Bihar, and the government of Bihar on Thursday admitted that the rate of routine immunisation was very poor in Bihar ranging between 12 to 34 per cent only. Amanullah said that the government had decided to increase it to 70 per cent by the end of the current year. UNICEF representative M R Survade also addressed the workshop.

Amanullah said that about two per cent children in the 0-5 years age group were not covered in the earlier rounds which was matter of serious concern as they might be the carrier of polio virus. Altogether 317 cases of polio were reported from the different parts of the state during the past three years the break up being 158 cases in 1998, 123 in 1999 and 36 in the first eight months of the current year. He, however, said that the incidence of polio was clearly on decline due to the several rounds of pulse immunisation drive undertaken by the government during the past five years which was evident from the fact only 36 cases had been reported this year so far.

Another reason for the government to make special efforts to eradicate polio from the state was the fact that polio virus were concentrated in north Bihar, UP and Nepal. Amanullah said that the two-third of the polio virus of the world were concentrated in Bihar and UP only. When asked as to why the polio virus were concentrated in north Bihar, both Amanullah and Survade said that it was mainly due to the high density of the population in that area which spread the disease very fast unlike in south Bihar where the population density was low making it easier to control the disease.

Referring to the excercise undertaken this year to make the programme a big success, Amanullah said that it was for the first time that the governmment had laid emphasis on bottom up planning, urban area planning, focussing on inter personal contact, using standardised vaccine apart from deploying 1.5 lakh fully trained vaccinators for the purpose.

The full text of the article can be found at http://www.timesofindia.com/today/23mpat8.htm

24 September 2000: Union Health Minister comments on the Pulse Polio Immunisation Programme.

The Times of India (http://www.timesofindia.com/) in an article titled "Thakur rules out privatisation of health care system" reported from Patna:

With regard to the Pulse Polio Immunisation Programme, [Union Health Minister C P Thakur] said that it had been a great success throughout the country which was evident from the fact that there had been a significant drop in the incidence of polio in the country. He said the number of polio cases had come down to only 124 in the first eight months of the current year from 4,320 in 1998 and 2,810 in 1999.

Replying to a query, the minister said that the PPI drive would continue till the disease was totally eradicated from the country. He indicated that it would continue till the year 2005.

While maintaining that the polio virus were located in north Bihar, UP and Nepal, the minister said that even in Bihar there has been a significant drop in the incidence of the disease which had come down to 39 from 123 in 1999 while in UP only 78 new cases were reported this year. He, however, said that the detection of new cases of polio despite several rounds of pulse polio drives undertaken by all the state governments since 1995 had forced the Centre to undertake the drive in co-ordination with bordering countries Nepal and Bangladesh.

Thakur said that while no new polio case had been reported from Bangladesh this year while only one case had been reported from Nepal. Thakur attributed the new cases of polio to the failure of the respective state governments to reach all the children in the 0-5 year age group. The minister strongly denied rumours that pulse polio immunisation could lead to infertility among the vaccinated children. He said that education and information were key to the success of this programme.

Thakur said that in an order to reach all the 14 crore children in the 0-5 year age group, the numver pulse polio booths had been increased in all the state including Bihar, UP and West Bengal. He said that in UP the number of such booths had been increased to more than 95,000 from the existing 75,000 while in BIhar it had been increased to 74,724 from 48,000 while in West Bengal it had been increased to 34,000 from 27,000. He said that the centre had been receiving very good support from all the state government in the implementation of the programme.

Replying to a question, Thakur said that the Bihar government had sent utilisation certificate for the 85 percent of the fund released to it for the execution of the programme in 1999. He said that the Bihar government had also sent utilisation certificates for the fund released to it during previous years.

The full text of the article from which the above is quoted can be found at http://www.timesofindia.com/today/24mpat1.htm

24 September 2000: Polio programme to extend beyond 2002 deadline.

The Times of India (http://www.timesofindia.com/) carried the following report from Calcutta:

Polio eradication programmes will continue in India till 2005, Union minister of health and family welfare C. P. Thakur said on Friday. The time limit to eradicate polio from India is 2002 and for next three years vaccination will continue as a safety measure and to ensure that it does not reappear.

Progress in the right direction is on, the minister said, stressing that the World Bank has sanctioned a loan of Rs. 1118.40 crores for strengthening pulse polio immunisation programmes.

The bank has reportedly drawn up a three year time frame for total eradication of the disease. Currently only four states, Uttar Pradesh, Bihar, Delhi and West Bengal, have reported polio cases in the country. Widespread polio transmission is observed in these states due to various reasons including cross bor[d]er infestation of virus, said the minister.

Currently there are 27,000 polio booths in West Bengal and an additional of 7,000 will be set up under the current drive Thakur said. The programme will start on September 24 and will aim at health education, giving polio vaccination to all possible places and involve NGOs like Rotary Club into the action. "Media," emphasised Thakur, "have to play a major role to make the programme a success."

The full text of the article can be found at http://www.timesofindia.com/today/24mcal14.htm

24 September 2000: 'Help make India polio-free'.

The Times of India (http://www.timesofindia.com/) carried the following report from New Delhi:

Over 160 countries have already become polio free. The aim now is to make India a polio-free nation through the Pulse Polio Programme.

Speaking at an awareness rally organised by the Green Field Public school in east Delhi city health minister A K Walia said giving polio drops time and again increases the immunity of the children. He said, "Polio spreads through the wild polio virus which inhabits the intestines of the children. When all the children are administered polio drops on the same day, the polio virus is driven away from the body."

The minister said if a child is not given the virus, it will not only stay in the intestines of the child but also spread to other children. Dr Walia said, "It is essential that all children under the age of five are given the drops." He appealed to all parents with children under the age of five to bring their children to the pulse polio centres.

The nation wide pulse polio campaign begins from Sunday and will continue till January 2001.

The full text of the article can be found at http://www.timesofindia.com/today/24mdel10.htm

25 September 2000: Pulse polio campaign begins to immunise every child.

The Times of India (http://www.timesofindia.com/) carried the following report from New Delhi:

The Pulse Polio programme began in the city on Sunday with chief minister Sheila Dikshit administering polio drops to children at her residence. The campaign aims at eradicating polio from the city by the year-end.

Nepal Prime Minister's daughter Sujata Koirala was the chief guest for the pulse polio campaign this year. Apart from the Delhi government, the World Health Organisation (WHO), UNICEF and Rotary International also participated in the campaign.

Delhi health minister AK Walia said the programme was a success and thanked the parents for making it one. He said nearly 8,000 polio kendras were set up for the programme and more than 25,000 health personnel were deployed there. Dr Walia said, "The polio vaccines were stored in 46 regional stores and made available at all the polio kendras by maintaining the proper cold chain."

The minister said nearly two to three per cent of the targeted children remain deprived of pulse polio drops due to certain reasons. "Therefore, house to house immunisation will be carried out. Children, who have been administered the polio drops, have been marked with blue ink on the little finger of the left hand."

The minister said over 15,000 personnel have been deployed for the house to house immunisation in the next five days so that not a single child is left out. He said, "Still, the parents of the children who are immunised will be asked to come to the next pulse polio campaign."

Dr Walia also stressed the campaign should not be mixed with routine polio immunisation. "The routine immunisation programme and the pulse polio supplement each other. Every child must get polio drops at the age of 1.5 months, 2.5 months, 3.5 months and one-and-a-half years under the routine immunisation programme."

`India, a threat to polio-free nations'.

Rotary International, which is one of the partners in the polio eradication programme, said, "The country recorded 121 cases of the wild polio virus this year as compared to 2,817 in 1999 and 4,320 in 1998. India is a major reservoir of the wild polio virus, and is posing a strong threat to polio-free nations. Also, cross border transmission within the polio endemic countries and polio free zones is another major issue."

The full text of the article can be found at http://www.timesofindia.com/today/25mdel18.htm

25 September 2000: Pulse polio immunisation campaign begins.

The Times of India (http://www.timesofindia.com/) carried the following report from New Delhi:

The National Pulse Polio Immunisation campaign for 2000-2001, aiming at a polio-free India, was launched here on Sunday.

It was launched by former Prime Minister I K Gujral, Minister of State for Health Rita Verma and Rotary International President Frank Devlyn at the Vigyan Bhawan, where the three-day International Population Summit is being jointly hosted by the government and the Rotary International.

Polio drops were given to children of construction site workers, who comprise a major chunk of the missed population.

During this phase the main targets are mobile migrant people, specially migrant labourers from various states.

Afghan refugees in Garhi area have also been brought under the purview of the campaign. Camps have been set up at railway stations and inter-state bus terminals (ISBT) in the city to cover as many children as possible. A five day door-to-door immunisation campaign will start on Monday.

The first special round is being conducted in four high burden states of Uttar Pradesh, Bihar, Delhi and West Bengal.

Only 121 cases of wild polio virus have been detected in the entire country in the running year till now as against 2,817 in 1999 and 4,320 in 1998.

Tamil Nadu and Kerala followed by Orissa in North are heading fast to be polio free soon.

It is estimated that even after five years, since the campaign was first launched in 1995, 20 lakh children under the age of five are yet to be covered. Up and Bihar alone contribute 54 per cent of the total number of polio cases in the world.(PTI)

The full text of the article can be found at http://www.timesofindia.com/today/25hlth7.htm

26 September 2000: Pulse Polio targets achieved.

The Times of India (http://www.timesofindia.com/) carried the following report from Mohanlalganj, Lucknow:

More than 23,706 children under five years of age were given polio drops against the target of 23,783 here on Sunday. According to an official release, in addition to this nearly 12,367 children above five years of age were also administered polio drops.

The town wore a festive look as people came out of their houses with their children to the pulse polio booths.

Ninety-five stationary and four mobile booths were set up in the town and rural localities by the health department. Mobile vaccine vehicles had also been arranged to visit villages.

Social and voluntary organisations like the Durga Vahini, Nehru Yuva Kendra and Bharat Sewa Samaj played an active role to make the drive a success. Besides the block pramukh, village pradhans, school teachers, aganwadi workers as well as health workers showed keen interest, said Dr Rawat, superintendent of community health centre, Mohanlalganj.

The full text of the article can be found at http://www.timesofindia.com/today/26mlkn20.htm

26 September 2000: Big hurdles to anti-polio drive, say Indian authorities.

Iclinic (http://www.iclinic.co.za/) carried the following IPS report by Ranjit Devraj from New Delhi, India:

Five years after India began its ambitious polio eradication drive, which is vital for the global elimination of the crippling disease, its managers admit that there are serious hurdles. Bad road links to remote villages in this mainly rural nation, social barriers and religious taboos are hobbling the country's biggest public health campaign, they say.

The World Health Organisation (WHO) had targeted a polio-free world by the end of this year. This depended on the success of the pulse polio drive in India, which accounted for more than 70 percent of the 5 000 polio cases reported worldwide last year.

India aimed to complete the job in just three years. But there are still large uncovered pockets in the thickly populated northern states.

More than a thousand polio cases were confirmed, by laboratory tests, to have been caused by the wild polio virus in the most populous state of Uttar Pradesh.

"Increasing coverage in these areas is a critical challenge if India is to interrupt transmission of the virus," says Stephen Atwood, chief of the health section at the UN Children's Fund (Unicef) office in India.

Shobhan Sarkar of India's Ministry of Health and Family Welfare warns of 'volunteer fatigue' if the drive is prolonged.

"If we cannot achieve eradication soon, we could lose the network of volunteers, expertise and commitment, and never be able to revive it again," he says.

According to WHO's Gary Hlady, the countries of the world could save more than $150 billion annually in public health costs if the wild polio virus was declared completely eliminated.

The US alone spends more than $100 million annually on polio vaccines, despite having eradicated polio from the country years ago.

It is estimated that each of the two annual immunisation days in India costs $100 million.

"In the remote parts of India, there are physical barriers such as rivers with no bridges, or villages, which are miles away from any road, that make it difficult for volunteers to reach children on immunisation day," says Unicef programme manager K Suresh.

The world children's body is one of the managers of the campaign, besides the WHO and Rotary International.

India's complex caste system and religious values are also interfering with the smooth delivery of the oral polio vaccine. This is specially true in the two most populous and backward states of Uttar Pradesh and Bihar in the north, which are home to more than 250 million people.

"An upper caste worker may refuse to go into a village of low caste people or a low caste volunteer could be denied entry into an upper caste village. Similarly, health workers have no access to women in 'purdah' [Islamic veil for women] and their children," says Suresh.

India's battle against polio is publicly backed by the world's most famous people. US President Bill Clinton personally administered polio drops to children during his visit to India in March. The world's richest man, Bill Gates, too fed polio drops to children in a squalid, low-income squatter colony in the Indian capital earlier this month.

The Bill and Melinda Gates Foundation, along with RE Turners' United Foundation, has given $50 million to the Indian programme.

However, in several Indian villages, polio campaign workers are viewed with suspicion. Here any government health scheme is associated with attempts at forcible birth control.

"There is little confidence in government programmes in many villages," says Suresh.

Another problem is India's huge floating population of migrant workers, he adds. Every day, tens of thousands of people from the villages move into the big cities in search of a livelihood and it is difficult for anti-polio campaigners to keep track of them.

"Each additional year will cost up to $30 million more until eradication is finally effected," says OP Vaish, who leads Rotary International's 'Polio-plus Programme', which provides funds, volunteers and vehicles for the campaign.

Public health researcher Lester Coutinho accuses public health authorities of inflating polio eradication figures. Programme managers are under pressure from their bosses to report success and fudge the figures, he says.

"No health worker dares to report a polio case," says Coutinho. Critics also doubt the efficacy of the polio vaccine used by the programme. There are several instances of those vaccinated, getting afflicted with polio. This could be because of spoilage of the vaccine due to breakages in the "cold-chain", say some experts.

It was only recently that WHO thought of using temperature-sensitive colour codes on vaccine vials.

According to health ministry officials, the next anti-polio drive will use some 630 million doses. These are kept under refrigeration and will be distributed through a 'cold-chain' using special containers and some 2.5 million workers and volunteers.

However, other experts say that the polio vaccine being used is not suitable for Indian conditions where children suffer from severe diarrhoea. Children with diarrhoea do not retain the oral vaccine long enough in their bodies to acquire immunity, says Pushpa Bhargava, former head of the Centre for Cellular and Molecular Biology in the the southern city of Hyderabad.

"Continued virus transmission is maintained through poorly immunised children," says Narendra Arora of the country's top medical research centre, the New Delhi-based All India Institute of Medical Sciences (AIIMS).

Arora led an AIIMS evaluation of the polio drive last year. The high-profile polio drives, with their huge funds, are also accused of diverting attention from other pressing public health problems.

"It is as if other diseases like diphtheria, measles and hepatitis - which need vaccination support - have simply vanished," says Coutinho.

The anti-polio campaign is funded by the governments of the United States, Denmark and Britain. It is also backed by the US-based Centre for Disease Control and Prevention, the European Commission and Japan's International Cooperation Agency.

The full text of the article can be found at http://www.iclinic.co.za/sep00/polio26.htm

27 September 2000: Delhi has the maximum polio victims.

The Times of India (http://www.timesofindia.com/) carried the following Navbharat Times report from New Delhi:

Children in this Capital city run a very high risk of contracting polio. Of the total polio-afflicted children in the country, 85 per cent are in Delhi alone.

Dr Harshwardhan, a consultant at the South Asia Regional Directorate of the World Health Organisation (WHO) said that while 48 children were attacked by the polio virus in 1998, the number increased to 73 in 1999. 85 per cent children of the children are from slums or rehabilitation colonies and some 15 per cent from urban areas.

This year the programme for administering polio drops to children (below five years of age) has been fixed for four days. These are Sept. 24, Nov. 5, Dec.10 and Jan. 21. Along with Delhi government, several social and political organisations have announced their full support to make this programme a success.

Harshwardhan stressed on the need for extensive plans to eliminate the virus. Areas which are susceptible to polio should be marked and targeted. For this, mapping of each area should be done and polio drops given to children at their door steps.

The full text of the article can be found at http://www.indiatimes.com/nbtit/27indi7.htm

27 September 2000: Polio hangs on in Angola despite eradication efforts.

In a CNN (http://www.cnn.com/) report, CNN World Report Staff write:

As tens of thousands of children with paralyzed limbs filled hospital wards in Belgium, Denmark, Germany and the United States, the terrifying virus seemed unstoppable. Parents forbade their children from frequenting public swimming pools, and watched helplessly as youngsters encased in iron lungs gazed up at them. Then in 1955, Dr. Jonas Salk successfully tested a defensive vaccine against the virus that causes paralytic poliomyelitis, commonly known as polio.

That vaccine, perfected in an oral form by Dr. Albert Sabin in 1957, spelled the end of the polio epidemic. Polio cases dropped from 58,000 in the United States to zero in a matter of years, and the last reported incident of the disease in the Western Hemisphere was nearly a decade ago in Peru. Yet this is not quite the happy ending researchers and public health officials had hoped for: Polio continues to ravage the lives of thousands of children in many parts of the world.

Sub-Saharan Africa, alongside South and Southeast Asia, continues to be the main battleground in the fight against polio. The World Health Organization (WHO) set a goal in 1988 of complete eradication of the disease by 2000, and while the number of cases reported each year worldwide has dropped from 350,000 to 6,400, much remains to be done, particularly in southern Africa. The virus rages unabated in countries such as Angola, where civil unrest has made the distribution of immunization material especially difficult.

CNN World Report contributor TPA was present when Angola's president Jose Eduardo dos Santos was recognized recently for his role in the efforts to eradicate polio. Presenting the award of "Champion for the Elimination of Polio" were representatives of the Rotary International organization. Rotary has joined the WHO, UNICEF and the U.S. public health authority Centers for Disease Control and Prevention (CDC) in the fight against polio around the world.

Dos Santos vowed to continue to work for a world free of the polio virus, and promised a stepped-up effort on the part of the Angolan government in the country's immunization campaign.

"We will spare no efforts... to intensify the battle against polio," the president emphasized. "We want an Angola without polio."

27 September 2000: Global deadline set to eradicate polio by 2005.

CNN (http://www.cnn.com/) reported from the United Nations:

In the 12 years since an ambitious health initiative was launched to eliminate polio worldwide by the end of the year 2000, there are still some 30 countries to go.

"The disease is eradicable," said Ciro de Quadros, director of the division of vaccines and immunizations for the World Health Organization. "We have good vaccine to eradicate the disease (and) all countries are committed."

By the end of last year, the number of cases had fallen by more than 95 percent, world health authorities reported at a Global Polio Partners Summit that began Wednesday [See NewsBites 27th September 2000]. Participating were U.N. Secretary-General Kofi Annan; U.S. Health and Human Services Secretary Donna Shalala; actress Mia Farrow, a special representative of the United Nations Children's Fund; and delegates from the World Health Organization and Rotary International.

More than 150 leaders from government and the private sector took part in the global polio summit. A new deadline has been set to eradicate polio by 2005.

"Until we eradicate the disease worldwide, there remains a threat to anyone else in the world who isn't immunized against it," said Dr. Jeffrey Koplan, director of the Centers for Disease Control and Prevention in Atlanta, Georgia. "So we continue to provide vaccination for young children."

Polio remains a deadly threat, mostly in parts of sub-Saharan Africa and the Indian subcontinent. It is considered particularly acute in Afghanistan, Angola, Bangladesh, the Democratic Republic of the Congo, Ethiopia, India, Nigeria, Pakistan, Somalia and Sudan.

"We have to provide vaccinations in places where people are being killed daily in armed conflict," said Koplan. "In some of the countries we're working in, there are the worst natural disasters going on -- cyclones, floods, typhoons -- and yet the eradication effort is continuing on a daily basis."

Other countries identified as remaining at risk are Benin, Central African Republic, Burkina Faso, Cameroon, Chad, the Democratic Republic of Korea, Egypt, Eritrea, Ghana, Guinea, Iraq, Ivory Coast, Liberia, Niger, Mali, Nepal, Sierra Leone and Togo.

"Those are countries in which the health infrastructure is the weakest," said de Quadros. "They don't have a health center on every corner. They don't have a good logistics system so it needs investment to improve the logistics, to improve the distribution system."

Caused by a virus, poliomyelitis affects the nervous system and can cause total paralysis in hours. Symptoms include fever, headache, fatigue, stiff neck and pain in the extremities. Irreversible paralysis usually takes place in 1 in 200 cases. As many as 10 percent of those infected die when breathing muscles are paralyzed. The disease is most prevalent in children under the age of 3.

Eradication would save $1.5 billion annually.

The last case of polio recorded in the Americas was in 1991, in Peru.

Challenges remain in the climate of aggression in many countries where polio is still a problem, as well as a lack of resources.

Although substantial investment has already been made, health officials here said at least another $450 million is necessary to finish the job.

"This is really very little money," said de Quadros, noting that about $1.5 billion should be saved in yearly treatment costs once the disease is vanquished. "I must underline that those obstacles have always been overcome when resources are available and when the countries are committed."

The goal to eradicate polio depends upon:

• Accessing children in all countries, especially in areas of heavy conflict
• Generating necessary funds
• Ensuring the political commitment necessary to accomplish the goal

CNN Medical Correspondent Rhonda Rowland contributed to this report.

The full text of the article can be found at http://www.cnn.com:80/
2000/HEALTH/09/27/polio.eradication/index.html

See also UNICEF's Carl Tinstman discusses eradicating polio worldwide at http://www.cnn.com:80/
2000/HEALTH/09/27/chat.transcript.polio/

27 September 2000: War on polio corners virus, but it's elusive.

In the Atlanta Journal-Constitution (http://www.accessatlanta.com/) M.A.J. McKenna, Staff Reporter, writes from New Delhi, India:

Vikas was already wailing, a piercing cry of fright and exhaustion, when his father carried the limp toddler into the office of Dr. Bina Ahuja. The two had traveled more than 350 miles, by train and sardine-packed bus, to reach the concrete-walled cubicle at Kalawati Saran Children's Hospital. Kelosh had carried his son the entire way; for four weeks now, the boy had been unable to walk.

Switching fluently between Hindi and English, the diminutive specialist coaxed a medical history from Kelosh. On one day, the 4-year-old could walk normally; on the next, he could no longer stand up. Now he could sit, if someone propped him in position, but one arm no longer worked, and his legs were floppy from the hips down.

A final piece of information made her frown. Vikas had received eight immunizations against polio, three more than the minimum necessary to protect a child in the developing world. Yet tests confirmed he had the disease.

"This is not uncommon," said Ahuja, digging her fists into the pockets of the white coat covering her sari. "We are having many cases of polio who have been immunized."

This morning at the United Nations in New York City, world political and public health leaders will gather to commit their countries and organizations to the last stages of the battle against polio. The goal is to stop new cases of the virus within two years, and to maintain that result for three years so that in 2005, the world can be declared polio-free.

Third World roadblocks.

The goal is in sight, if not yet within reach. In 1988, when the World Health Organization launched the global eradication effort, polio was regularly infecting children in 125 countries. It has been eliminated from about 100. But in the rest, the campaign faces significant roadblocks: political unrest, natural disasters, lack of funding and failures in the network that carries vaccine to children like Vikas.

"This is like a marathon," said Dr. Jeffrey Koplan, the director of the Centers for Disease Control and Prevention, who is attending the U.N. meeting. "We've gotten to mile 22. Now's the time to rally the team --- not to stop and have a picnic at the side of the road."

The Atlanta-based CDC is one of four organizations coordinating the polio effort, along with the WHO, UNICEF and the service organization Rotary International. Their leaders will speak this morning: Kofi Annan, secretary-general of the U.N.; Gro Harlem Brundtland, director-general of the WHO; Carol Bellamy, executive director of UNICEF; Frank Devlyn, president of Rotary; and Donna Shalala, secretary of Health and Human Services, who oversees the CDC.

They will be joined by Ted Turner, whose U.N. Foundation is distributing $1 billion to international efforts that include health campaigns, and who is expected to announce a new fund-raising initiative for polio.

Deadline missed.

The summit meeting is billed as the launch of "the race to reach the last child": Every child in the world younger than 6 must be immunized before polio can be considered beaten. Organizers haven't specified what they are racing against --- but there is clear concern that attention and funding will lapse before the job is done.

"The purpose of this summit is to focus attention both on how far we have come, and how important it is not to risk losing everything by letting up," said Dr. Stephen Cochi, the chief of CDC's polio effort. "There's such a temptation to go on to other priorities, because polio is disappearing."

But not fast enough. The campaign has missed one major deadline: WHO had hoped to eradicate polio by this year. At the end of 1999, 30 countries still showed evidence of polio transmission; in May, WHO conceded that only 10 of them would eliminate the disease by December.

Missing the 2000 goal is a minor embarrassment that throws the faults in the current effort into high relief.

"Many health initiatives are late on deadline," said Dr. Jon Andrus, a professor of international health at University of California-San Francisco who has worked in polio for CDC and WHO. "Usually, it's an indication that not all the factors were taken into account."

Poorest fare worst.

The factors are formidable. The countries where the disease still circulates are among the world's poorest and most unstable. Most lack basic infrastructure: In some areas, the vaccine must be carried by animal or on foot because there are no roads, and must be kept cold even when there is no electricity.

Parts of Afghanistan, one of the problem countries, are snowbound for months every year. Parts of Bangladesh are regularly inundated by monsoons that trigger chaotic migrations. Large areas of some African countries such as Angola are in the hands of rebels who will not give passage to vaccination teams. Heads of state in some countries have declined to make polio a national priority, leaving the immunization campaigns vulnerable to political jockeying.

Even in countries with solid health systems, there are difficulties. India, which in 1999 had half the remaining known cases of polio, has developed thorough surveillance systems, a top priority since polio can be detected only through the paralysis that strikes one case out of every 200. Yet a recent CDC report said 40 percent of the surveillance posts in the most problematic Indian province, Bihar, are empty.

And children who ought to be adequately immunized continue to develop the disease. The oral vaccine that is used in the developing world is less effective in tropical countries, possibly because children are already infected with other bugs that blunt its efficacy. So more doses of vaccine are needed to protect a child.

But if local manufacturing has produced a less-potent vaccine --- or if the "cold chain" of vaccine transport has been broken, as happened two years ago in two Indian states --- children remain vulnerable.

Meanwhile, world attention is turning to funding other health problems: HIV/AIDS, which so far has killed more than 18 million people worldwide and infected an additional 34 million; tuberculosis, which kills almost 2 million people each year; and malaria, which annually kills more than 1 million and infects up to 300 million.

In contrast, there were only 7,000 proven cases of polio in 1999, though the actual number is probably closer to 20,000. And to eliminate the disease by 2005 will require $450 million more.

Yet those in the polio campaign argue that the job must be finished. Unlike other diseases bedeviling the world, it is theoretically extinguishable: It has no reservoir other than humans, it is preventable by vaccine and its elimination does not require trained health care workers, expensive equipment or radical changes in behavior.

If polio cannot be eradicated, they predict, no other disease is likely to be.

"It will be such a black mark if we don't do this," Andrus said. "If we can't eradicate polio, we will have lost all our credibility."

The full text of the article can be found at http://www.accessatlanta.com/
partners/ajc/epaper/editions/today/news_931df971f29b81bb00b6.html

27 September 2000: UN head launches countdown clock for ridding world of polio.

ABC Australia (http://www.abc.net.au/) carried the following report:

The UN secretary-general, Kofi Annan, will today unveil a countdown clock for the eradication of polio by the year 2005.

Last year, thousands of cases were reported in developing countries, particularly in central Africa and on the sub-continent.

The highly infectious disease mainly affects children under the age of three, causing paralysis in a matter of hours. There is no known cure.

But Bruce Aylwood of the Global Polio Eradication initiative says that just as the world got rid of smallpox, wiping out polio is possible.

"This is completely feasible that we deliver a gift of a polio free world in the very near future," he said.

"The key strategy is not only routine immunisation, but then to supplement that with what we call national immunisation days. These are massive activities where any remaining infected country, immunises every single child on a single day."

The full text of the article can be found at http://www.abc.net.au/
news/science/health/2000/09/item20000927183404_1.htm

28 September 2000: Diary of a polio survivor in Goa.

At http://www.rediff.com/ school teacher Caroline D'Souza in Calangute, Goa writes:

Tucked among the news items the day I found the headline' World Bank to give Rs. 11.18 billion for polio project.

That's a heck of a lot of money, you might think. But then, polio is a hell of a disease. It is debilitating, crippling. It traumatises you for a very, very long time.

I should know. I am polio-afflicted. Have been since 1956.

I was a normal, healthy and hyperactive nine-year-old then. No one could have imagined that the virus would strike down some 85 children from our area in just five days.

Doctors were totally unprepared for the disease, which struck in varying ways. There was no specific pattern. And they had no strategy to counter it.

Each one experimented with a combination of very expensive injections and antibiotics. Infantile poliomyelitis was the name it went by, but it was shrouded in obscurity, ignorance and misconceptions.

People hesitated to visit us victims because they were scared of carrying the germs home to their children. Terror filled the minds of parents, especially after a number of children died.

My doctor conveyed to my mother the pessimistic diagnosis: "Your daughter will never be able to stand."

"You are not God," I remember my mother telling him fiercely. "I will see that she walks!"

And she did. Had it not been for her faith and untiring efforts, who knows what my state would have been.

Yes, the government is doing a great deal to contain polio. But I sincerely wish that people knew about the late effects of polio or the Post Polio Syndrome, as the condition is commonly known.

I wish there were support groups, like they have in foreign countries, to make PPS sufferers know that they are not alone. I wish the patients knew what to expect instead of feeling confused and scared.

PPS, as I learnt, affects polio victims some 30 years after the initial acute attack. You find you cannot do the things you could easily do before. Like boarding buses or getting down. You find you cannot lift your feet easily, that you lose your balance.

I found it necessary to use a walking stick. A friend I met in Australia told me I could be in the PPS stage. I was given literature about the dos and don'ts. Later, I got more literature from the WHO.

I met a few PPS sufferers and exchanged notes. Some had to leave their jobs because of their progressively weakening muscles and nerves. It is a very frightening feeling. What's happening, you ask yourself. You slow down gradually. You cannot stand for long.

You need reassurance from an authority. You go to an orthopaedic surgeon. He laughs at you and say you are "imagining" things! There is still such lack of knowledge among even medical professionals.

I showed my doctor the books and literature I had. He found those "interesting". That's not very comforting to one who is worried, confused, totally frightened about the days ahead. You don't know whether you will be able to withstand the strain of working. And if you need to work from sheer necessity it becomes more scary.

What a PPS person needs to do is manage his energy. You will tire easily. Accept that. You have to stretch out your energy account. Relax when you are tired. Use energy saving equipment as far as possible. Use a highchair while working in the kitchen or while bathing.

If you are overweight you need to reduce. Your muscles are weak as it is, don't punish them further. Exercise is a must to keep up muscle strength. If you can't stand and exercise try sitting and exercising your limbs. You may suffer from cramps or muscle twitching. You may need to go to an orthopaedic surgeon for medication, especially for nerve pain. You could approach a dietician too.

You could get depressed very easily. Don't go to pieces; tell yourself you are only readjusting your lifestyle. Go to a counsellor if need be.

Travelling is the toughest part for a working post-polio person. It can be very expensive if you can't use public transport. Yes, our government offers conveyance allowance to the handicapped -- a measly Rs 100 a month! I spend Rs 850 every month to go to work. And that's a big chunk of my salary. I wonder how others manage.

I truly hope that the government would do something to make our lives easier. I hope, instead of concentrating only on immunisation, something would be done for the victims: guidance, help centres...

Life is a big challenge for the physically challenged. Can we expect a better deal someday not too far in the future?

The full text of the article can be found at http://www.rediff.com/news/2000/sep/28diary.htm

28 September 2000: Groups make 'final' push against polio.

In the Atlanta Journal-Constitution (http://www.accessatlanta.com/) M.A.J. McKenna, Staff Reporter, writes from New York:

Polio is being passed from person to person only in the poorest and least stable of the world's countries, but remains a health problem for the entire world, political and public health leaders said at a "polio summit" here Wednesday. [See NewsBites 27th September 2000]

Delegates from the World Health Organization, the Atlanta-based Centers for Disease Control and Prevention and the service organization Rotary International joined representatives of governments from the United States to the Ivory Coast at the United Nations to refocus attention on the global effort to eradicate polio by 2005.

Since the worldwide campaign began, the annual count of cases has dropped from 350,000 in 1988 to about 20,000 last year. The disease, which can be prevented by immunization, persists in parts of Africa and South Asia, and campaigners fear that attention and funding will lapse before the job of eradication is complete. If the campaign were not completed, polio could rebound --- or at the least continue to exact its current global price tag of $1.5 billion each year.

"Today, the story enters what we must make its final chapter," Kofi Annan, secretary-general of the U.N., told the group of 500 in a keynote speech. "We cannot risk being complacent: Every child on this earth must be immunized against polio, so that we can free the world together from the grip of this dreadful disease."

According to WHO's strategic plan, outlined by Director-General Gro Harlem Brundtland, eradicating polio requires multiple steps: intensifying immunization and surveillance to see where it crops up; identifying and destroying, or securely locking away, any remaining lab stocks of the virus; and figuring out when to scale down, or stop, polio immunizations.

But experts said the initiative continues to face multiple challenges.

One is securing enough funding from public and private sources to complete the campaign. The effort is expected to require an additional $1 billion over the next five years. The coalition fighting polio has identified sources for about half of that, and fears it will face a $450 million shortfall.

Ted Turner, whose United Nations Foundation recently gave $28 million to the polio campaign, was on hand to urge major companies and well-off individuals to pony up more money to combat the disease.

"I would like to call on the private sector --- those who have been blessed with more wealth than they need --- to make their contributions to this cause," he said, "and to share the joy and the triumph that we're going to have when polio joins smallpox as one of the two diseases that have been eradicated."

The other major obstacles to polio's defeat are getting access to all the children who still need vaccine, and garnering political support for vaccination campaigns, twin goals that are emerging as the greatest remaining hurdle.

Areas in some African countries, as well as in parts of Asia, are closed to immunization campaigns by small-scale wars.

Others are overwhelmed by refugees, fleeing conflicts and natural disasters, who move so quickly and unpredictably that they are difficult to monitor and immunize.

Local political support, combined with strong international censure, could make a difference, the polio campaigners believe. But those contributions have been slow in coming.

"I don't think that 10 years ago, or even five years ago, we quite realized the obstacle that access would be," Carol Bellamy, executive director of UNICEF, said after the meeting. "Money, of course, is still an obstacle. But we need a greater understanding worldwide that access is a significant problem, because that could possibly lead to greater pressure being placed on some of these problematic places."

Much of the summit seemed devoted to raising the profile of the international battle --- it began with the triggering of a "Countdown Clock" that will tick off the seconds until 2005 and the remaining lab-confirmed cases down to zero --- and to honoring the major organizations carrying out the fight.

Until this year, the WHO and other groups had set a goal of eradicating the disease by the year 2000. But over the summer, the coalition said political and scientific hurdles would push achieving that goal back by several years.

Technical planning and fund-raising were being carried out behind the scenes. But the upfront, high-luster public relations of the summit, according to one participant, was in itself a policy goal.

The full text of the article can be found at http://www.accessatlanta.com/
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28 September 2000: U.N. resets target date for ending polio epoch.

The Orange County Register (http://www.ocregister.com/) carried the following report from the United Nations:

World health officials conceded Wednesday that they would not meet their goal of eradicating the polio virus everywhere on Earth by the end of this year - the target date set by the World Health Organization in 1988 when it kicked off a global immunization drive.

But the officials, who pointed to a steep decline in reported polio cases over the past decade, said they were making progress and would wipe out the virus within 24 months and be able to declare the world polio-free by 2005.

The three-year lag time between stopping transmission of the virus and certifying eradication is for scientists to verify -- through lab tests of stool samples in every geographic region of the world -- that no more polio virus is circulating in the human population.

Polio is expected to be the second infectious disease to be eradicated. The first was smallpox, which was wiped out in 1979.

"Our race to reach the last child is a race against time," said Kofi Annan, United Nations secretary-general, during a two-hour polio "summit" at UN headquarters in New York.

"If we do not seize the chance now, the virus will regain its grip and the opportunity will elude us forever."

About 20 countries - most in sub-Saharan Africa and on the Indian subcontinent - still have periodic outbreaks of polio.

Last year, 7,094 cases of polio were reported to public health officials, but they believe that there were actually about 20,000 infections.

The full text of the article can be found at http://www.ocregister.com/health/krpoliocci.shtml

28 September 2000: A UN clock is started for eradication of polio.

In the Boston Globe (http://www.boston.com/) John Donnelly, Globe Staff, reported from the United Nations:

Starting a clock to count down what is hoped to be the last few years of polio on Earth, global health leaders said yesterday that the job to eradicate the virus depended upon political will, access to children trapped in war - and $1 billion.

At the global summit on polio, leaders applauded efforts that have shrunk the annual number of victims from an estimated 350,000 in 1988 to 20,000 last year. But the organizers said the truly difficult task lay ahead.

At the end of this year, it is estimated, polio will be transmitted in only 20 countries, 16 in Africa and four in Asia. In several African nations and Afghanistan, war hinders vaccinations.

But health leaders were careful not to point fingers at problem countries. That time may come, UNICEF's executive director, Carol Bellamy, said in an interview. "I do think eventually we have to identify those places that are the most difficult," she said. "I think access is shaping up to be the toughest issue."

Paul Goa Zoumanigui, a representative for Guinea at the UN, told the leaders that they should begin pressuring UNITA, the Angolan rebel group, to allow immunizations. "When you think about armed groups there, with no access to children, you really need a follow-up program to this summit," he said.

The summit was full of recognition of what Bellamy termed "an undertaking of truly Olympian proportions" - vaccinating every child under age 5 worldwide. But all speakers said efforts must now be stepped up. One major need was $450 million in new funds over five years, toward a $1 billion goal.

UN Secretary General Kofi Annan reminded participants that the "last phase of polio eradication is a race to reach the last child," an effort that is expected to take until 2005, or 166,624,816 minutes, according to the 11½-foot-high clock started yesterday.

Try to picture that child, Annan said: "He or she is probably under 5, probably living in Africa, possibly in ... hunger, poverty or armed conflict. Our race to reach this child is a race against time. If we do not seize the chance now, the virus will regain its grip."

Polio, an ancient disease, caused panic in the United States in the 1940s and 1950s, spreading through feces in water or by the hands of a carrier.

But with the introduction of two vaccines, the disease began to die out, country by country, Cuba being the first to report eradication in 1961. The United States recorded its last case in 1979, and it was declared eliminated from the Americas in 1991.

Polio still flourishes in many developing countries. At the summit, though, participants spoke of upcoming initiatives, such as national immunization days for 17 West African countries for one week in October and one week in November. Planners hope to vaccinate 70 million children in that campaign.

Then there was the savvy of Marie-Irene Richmond Ahoua, a Rotary International aide in the Ivory Coast. Rotary International, with the World Health Organization, the US Centers for Disease Control and UNICEF, are the major partners in polio eradication.

In January, a coup toppled the Ivory Coast government, and one of the effects was the cancellation of immunization that month. About 20 Rotarians from Massachusetts and New Hampshire had planned to attend.

Ahoua approached the health minister, Bamba Norifere, about setting a new date, but "he told us he had other priorities." So she decided to visit the new first lady, Rose Doudou Guei, wife of the military leader, General Robert Guei.

"We told her, 'First Lady, you are a wife, you are a mother, you know how essential it is to organize this.' That night, she talked to her husband - and it was organized the next day," Ahoua said.

In February, the Ivory Coast held the immunization days, and Guei helped to vaccinate children.

"All this shows you that will is key," Ahoua said. "Tremendous progress has been made in ... Africa ... But where there's armed conflicts, it's essential that the combatants put down their arms and allow us to vaccinate the children."

The full text of the article can be found at http://www.boston.com/
dailyglobe2/272/nation/
A_UN_clock_is_started_for_eradication_of_polio+.shtml

28 September 2000: UN plans a world without polio by 2005.

The Detroit Free Press (http://www.freep.com/) carried the following report by Danile Bases of Reuters from the United Nations:

Polio topped the list of priorities Wednesday at the United Nations as humanitarian agencies and business leaders laid plans and established a countdown for eradicating the virus by 2005.

The World Health Organization says it has raised $550 million of the $1 billion it will take to carry out the final phase of the eradication plan, first unveiled by the World Health Assembly in 1988.

The WHO and UNICEF, the UN's children's fund, expect the number of countries where the polio virus is transmitted to drop from 30 countries to 20 by the end of the year.

Among the remaining countries where transmissions are taking place, 16 are in Africa, many in armed conflict zones, and four are in Asia.

Confined to a wheelchair because of the virus, Thaddeus Farrow, son of actress and UN children's fund special representative Mia Farrow, was helped by Secretary-General Kofi Annan to start a specially designed countdown clock that will track the number of reported cases through 2005.

The number of confirmed cases in 1999 dropped to 7,000, a 95-percent decline since 1988. There are slightly fewer than 1,200 confirmed cases so far this year.

The effort to eradicate the virus, along with the certification that the world is polio-free, is being led by the WHO and includes several UN agencies and the U.S. Centers for Disease Control, as well as fund-raising efforts by Rotary International and business leaders.

The full text of the article can be found at http://www.freep.com/news/health/polio28_20000928.htm

28 September 2000: Bill Gates "We can eradicate polio from the face of the planet."

In the Seattle Times, Bill Gates, Guest columnist, writes:

Not so many years ago, it was fairly common to see young children in wheelchairs or with crutches and massive metal braces on their legs - victims of polio, one of the world's most dreaded diseases. No more. Thanks to widespread availability of the polio vaccine, the last reported case of wild polio in the Western Hemisphere was in 1991.

It would be easy to stop there, and perhaps in the past we might have thought that wiping out the disease in the U.S. and the rest of the Western Hemisphere would be a noble achievement. But today we live in a different age, a global age, where international travel, trade, communications and the Internet have torn down borders and made us all neighbors.

What happens in India, Somalia or Kosovo is as important today as what might have happened yesterday to our neighbors down the street. From that perspective, we still have a way to go to make polio a thing of the past.

Earlier this month, I was at a clinic in New Delhi and saw a 6-year-old girl named Puja wait in line for a vaccine that could save her life. Puja's mother had brought her here to the heart of India's capital to have her immunized. When I met with Puja's mother I asked her how she had learned about polio and the vaccine that prevents it. Simple, she said: One of her neighbors was forever crippled by it.

Puja is one of millions of Indian children who will be immunized this year in the final push to stamp out polio from the face of the earth. We are almost there. Like the Olympic marathoners we admire so much, the last mile in this journey is the most daunting.

This week, the United Nations, World Health Organization and UNICEF, along with Rotary International, are convening in New York to prepare for this last mile. If necessary resources and political will are devoted to eradicating polio, the world can claim victory over this killer by the end of this year and certify the planet Earth as polio free by 2005.

World health officials have made tremendous strides in eradicating this menace from the face of the earth. As recently as 1988, there were 350,000 cases worldwide. At the end of 1999, there were only 6,000 reported cases in 30 countries, mostly in Africa and South Asia.

That means we are within striking distance of completely eliminating this disease. Unlike most other diseases, polio cannot survive outside the human body. If we can control the existing cases and prevent its spread, we can look forward to a day when no child will be its victim.

That's why my wife, Melinda, and I decided to make polio eradication one of the primary goals of the Bill & Melinda Gates Foundation. And once polio has been wiped out, just as smallpox was eradicated in 1977, we want to move forward to reduce or eliminate other diseases.

To achieve this goal, we have made a $750 million commitment to the Global Fund for Children's Vaccines and have joined forces with UNICEF, the World Health Organization, the United Nations, Ted Turner and many other organizations and governments who have already made remarkable strides in this direction. In the 1970s, only 5 percent of the world's children could expect to be fully immunized. Today, the global community is vaccinating as many as 70 percent of those children.

Some of the money will go to purchasing vaccines. At $15 per child, vaccines are one of the most cost-effective ways to prevent so many deadly and destructive diseases.

Some of the money will go to continued scientific research. Our hope is for vaccines against AIDS, malaria and tuberculosis, which together are responsible for a third of the world's deaths.

Conquering these and other diseases will be a scientific and administrative challenge. Nearly 1 million people die each year from the Hepatitis B virus - yet a vaccine for the disease is available. New vaccines must be created, manufactured and tested, then distributed and administered to those most in need. It is a daunting but achievable goal.

In my lifetime, I have had the privilege of watching two unfolding miracles: information technology and medical advancements. I am pleased and humbled to have played a role in one of those miracles; Melinda and I now hope we can do our part in advancing the other miracle.

Of all the things that wealthy, industrialized nations can do for poor, developing countries, nothing is more important than the gift of health. Reducing or eliminating many of the preventable diseases will give those countries' children the chance to grow and become productive members of society. A vaccinated world is the first step to a more prosperous world.

And it is the first step to a world in which the only exposure children have to polio will be in a history book.

Bill Gates is the chief executive officer of Microsoft and a co-founder of the Bill & Melinda Gates Foundation.

The full text of the article can be found at http://seattletimes.nwsource.com/
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1 October 2000: Plan to wipe out polio worldwide thwarted.

In the Star Tribune (http://www2.startribune.com/) John Donnelly of the Boston Globe reports from Luanda, Angola:

The young man dragged himself on cracked knees and raw palms along a dirt path, past snarling dogs, past naked children, past drunkards standing around vats of crudely made moonshine, toward a highway where he begs. His twin brother crawled alongside him, two lives reduced by a virus. Polio.

Marcou Ossi and his brother Joaquim are so poor that their home is a bare concrete slab. They must share one pair of crutches -- and one crutch has rubbed the skin off the back of Joaquim's left hand, opening a festering wound. On his left ankle, blood drips from another sore.

This is surviving with polio in Angola. In this place, the Great Crippler not only lives but thrives. For now.

More than 40 years after the last big summertime epidemic of poliomyelitis swept through the United States, spreading hysteria across the nation, a global effort to eliminate polio is in its final stages -- soon to be down to the last 20 countries where children still catch the virus.

The effort is at the hardest stage. Last week, the United Nations held a polio summit, where world leaders and public health specialists pledged to stop transmission of the virus in a little more than 15 months, with the goal of being able to certify its demise by 2005. If that happens, polio would be only the second disease afflicting humans ever to be eradicated, following smallpox's elimination in 1977.

Setbacks have put the timetable in doubt. The barriers include war, the logistics of immunizing millions of unvaccinated children and all but nonexistent national vaccine programs in several African nations.

Trouble also resides inside the four large agencies that are trying to defeat the disease. The partners have often bickered over credit in the march toward the historic feat and over assuming the difficult leadership roles in war-torn countries.

The intensive effort on polio comes at a time of much larger health care crises around the globe, including the killer pandemics of HIV/AIDS, tuberculosis and malaria, which account for a quarter of all deaths worldwide. But the chance to eliminate polio for good, its supporters say, offers multiple benefits, including a $1.5 billion annual savings on vaccinations and the chance for basic health services for the most vulnerable in the poorest of nations.

New victims.

Then there's the humanitarian factor.

The urgency of ridding the world of polio is acutely felt in Angola, where new victims arrive daily at the Pediatric Hospital of Luanda. One day this past summer, nine toddlers were flat on their backs in cribs, their mournful mothers and fathers standing next to them.

The children, all under age 3, had been walking only a few days before. Now none could. Twenty-month-old Madalena Bernard, listless in crib No. 295 in the isolation ward, was just learning to run, her mother said.

"She started a fever and she stopped walking -- just two days ago," said Georgina Pedro, 26, her eyes wide with disbelief. "She had a vaccination. Why did she catch it?"

The answer for her daughter, and for children in much of Asia and Africa, is that the virus circulates in places of squalor where children do not have basic health services. It lies in wait for those who have not had the full cycle of vaccinations.

Polio harks back to ancient times. An Egyptian drawing dated 1380 BC depicts a priest with a withered leg, supported by a staff, suggesting that the virus has infected humans for thousands of years.

Highly contagious, the virus passes through infected feces, entering through a person's mouth either by drinking contaminated water, on the hands of someone with the disease, or from unclean utensils.

The 60-sided virus -- it is among the smallest in the galaxy of microbes -- settles in the throat and then the intestinal tract. Most people have few or no symptoms. But if the virus enters the brain, it can paralyze the muscles used in swallowing and breathing. And if it invades the nerves of the spinal cord, it can paralyze the arms, legs or chest.

In 1916, the first modern major epidemic swept through the Western world, paralyzing 9,000 people and killing 3,000 more in New York City alone. In the 1940s and early 1950s, summertime outbreaks in the industrialized world disabled hundreds of thousands of people, who were rushed to hospitals and encased inside iron lungs -- metal tubes that aided in breathing.

Scientists raced to halt its spread. In 1954, Dr. Jonas Salk introduced his injectable vaccine; seven years later, Dr. Albert Sabin's oral vaccine entered the market.

The same year, 1961, Cuba used the Salk vaccine to become the first nation to eradicate the disease. The oral vaccine made the job easier as it required only two drops into the mouths of children.

Stage was set.

By 1988, after years of reluctance by the World Health Organization (WHO) to attack polio on a global scale -- it was seen as diverting funds from other causes -- the stage was set for an ambitious push. In the Americas, a major effort had shown that eradication of polio could be accomplished even in nations embroiled in civil wars or hampered by dismal health services. And Rotary International, a group sometimes unfairly stereotyped as men interested only in making business deals over lunch, had fervently embraced the idea of eliminating polio, raising more than $246 million for the effort in the preceding three years.

Thus prodded, the World Health Assembly, WHO's governing body, that year called for the eradication of polio by the end of 2000. In 1988, 125 countries in five continents were still reporting new cases.

If all had gone according to plan, Madalena Bernard, the 20-month-old girl in Angola, would have been among the last children in the world to contract polio.

But she won't be.

With great fanfare on Jan. 6, the WHO leader, Gro Harlem Brundtland, and the U.N. Children's Fund executive director, Carol Bellamy, declared that transmission of polio would cease by the year's end.

Brundtland said: "In the year 2000 -- the target year for polio eradication -- we have a window of opportunity to defeat this disease forever."

Ten days after Brundtland's speech, WHO specialists told her there was no way to eliminate polio this year, according to a participant. The reasons centered on the vastness of the work and the difficulties of reaching children in war. But UNICEF and WHO analysts also had erred in estimating the amount of vaccine needed for the final push.

It was not until May that Brundtland and Bellamy announced that the goal would be pushed back to the end of 2002, with eradication to be certified for 2005.

"What happened wasn't that people didn't do the job, but other things intervened -- conflicts, HIV/AIDS, debilitated health systems," Bellamy said in an interview. "If we look ahead, to 2005, there's potential in virtually every place to stop it."

But even that pushed-back goal seems optimistic, despite significant gains.

The full text of the article can be found at http://www2.startribune.com/
stOnLine/cgi-bin/article?thisStory=82629360

5 October 2000: Polio effort is personal for Farrow.

In a USA Today (http://www.usatoday.com/) Jeannie Williams writes:

Mia Farrow lay in a polio isolation ward for three weeks when she was 9 years old, spending three days in an iron lung.

She recovered fully from her mild case, and many fans may not even know about this illness from her past. Now 54, she believes it helped her, as a child of Hollywood, to become aware of the suffering of others, and she is joining a United Nations drive to eradicate this disease from the planet by 2005.

"It was a lastingly traumatic episode," the actress recalls. "But it was the beginning of my awareness of other people, that there were people suffering.

"And I have a son, Thaddeus, who is a paraplegic as a result of polio," she says. "It's the very personal and powerful wish of both Thaddeus and me that we see the end of polio, and soon."

Farrow, a UNICEF special rep, and Thaddeus, 11, took part in last week's U.N. conference on the initiative. She hopes to go to Africa, where UNICEF, Rotary International, the World Health Organization, and the U.S. Centers for Disease Control and Prevention soon will begin major inoculation programs, despite difficulties caused by civil wars in many countries.

It's possible Farrow may face future problems with what's called post-polio syndrome. "You get weak, aches and pains, you can't walk so well, even people with mild cases like myself. I've not felt that yet. We'll see."

Farrow was delighted that Thaddeus, whom she adopted from India and who uses a wheelchair and braces, was recognized at the conference. He took part in a previous event for the initiative.

"He said a few words. He was so proud to be there. He felt he was doing something to fight this disease that has been so devastating to him. He just can't stop talking about it. He's a brave little guy with a really sweet disposition."

(For donations or polio information, call 800-FOR-KIDS, or visit www.unicefusa.org.)

Farrow, a still girlish-looking grandmother of three, has several of her 13 children at her Connecticut home (one child, Tam, died earlier this year at 17 of a heart ailment). Her acting career continues. Last year she was in Coming Soon. She's in talks to start a fall movie and has made a Showtime mini-series for next year, It's a Girl Thing, with a major female cast including Stockard Channing, Lynn Whitfield and Kate Capshaw.

The full text of the article can be found at http://www.usatoday.com/usatonline/20001005/2722813s.htm

For Polio eradication and vaccine related resources see our directory Polio Virus, Vaccine and Eradication