The InterDependent

Polio is a highly contagious viral disease that has been virtually wiped off the map since Unicef, the Rotary Club and the World Health Organization began a campaign in 1988 to tackle the problem comprehensively. Now, with the disease endemic in only four countries – Nigeria, India, Pakistan and Afghanistan -- a partnership started in 2009 with the US the State Department and the Organization of the Islamic Conference has become the latest joint effort to eradicate polio once and for all.

But there is a major problem: to continue to fight the disease, the partnership needs $800 million. This gap exists despite commitments by the US government, the Islamic Conference, the Islamic Development Bank and organizations like the Bill and Melinda Gates Foundation.

India, which is not a member of the Organization of the Islamic Conference, received $521 million in financing from the World Bank in 2008 to fight infectious diseases, including polio. The financing has measures in place to prevent fraud and graft in the program, which had marred previous public-health projects. Nevertheless, the fraud continues. The World Bank announced yesterday that it debarred four companies and two individuals for fraud in relation to food and health projects under its purview in Afghanistan and India.

Jawad Jalali/UN Photo

A health volunteer vaccinates a 1-year-old in a nationwide campaign in Afghanistan to reach children under 5.

As Saad Houry, deputy executive director of Unicef, said at a conference on Sept. 27 at its headquarters in New York on the subject of stamping out polio, “We may lose all previous investments if we do not reach the goal” of total eradication.

Houry added that to stop now would be like “the Apollo 11 astronauts getting 99 percent of the way to the moon but deciding to come home instead.” He emphasized that this moment is a special opportunity for the world to completely eliminate a deadly disease -- only the second time in history since full eradication was achieved with another fatal disease, smallpox.

From the audience, John Lange, a retired US ambassador who works for global health program of the Gates Foundation, spoke up to ask the panel where the $800 million would come from and when. Dauda Malle, the representative from the Islamic Development Bank, said he would dig deeper for new donors and continue to pressure old donors to fill the gap.

Rashad Hussain, the US special envoy to the Organization of the Islamic Conference, of which Nigeria, Pakistan and Afghanistan are members, said at the Unicef meeting that the US government planned to remain focused on the issue and that “for the Obama administration, polio eradication continues to be a foreign policy priority.”

In fact, the partnership with the Islamic Conference was one tangible outcome of the Obama administration’s new policy of engagement with the Muslim world, a strategy that got its impetus from a speech Obama made in Cairo on June 4, 2009, in which he pledged “to seek a new beginning between the United States and Muslims around the world.”

At the Unicef gathering, Alhaji Sama ’la Mera, the emir of his Northern Nigerian community, Argungu, emphasized the need to engage traditional leaders to reach people in certain regions of the world, particularly in areas where fundamental Muslim sects, like the Islahuddeen, refuse vaccines because of traditional and religious beliefs.

Mera explained that since traditional leaders actually encouraged vaccinations in Northern Nigeria, incidences of polio have decreased from 300,000 cases a year to only 7 so far in 2010.

Ekmeleddin Ihsanoglu, secretary-general of the Islamic Conference, also supported the idea of reaching out to religious and community leaders for help toward polio eradication, particularly in the polio-infected regions on the Afghan-Pakistani border, where tribal sects control the local government. Dr. Ihsanoglu also mentioned the need for “indigenous production of vaccines,” saying that dependence on foreign financing may bring negative consequences to Islamic Conference members.

Chris Maher, head of country operations for polio eradication at the World Health Organization, praised India and Nigeria for greatly reducing the number of cases while increasing vaccination coverage -- putting the countries on track to become polio free by 2011.

Challenges remain: a recent outbreak in the Central Asian nation of Tajikistan, a nonendemic country, demonstrated that efforts to eliminate polio must push on. The outbreak represented 75 percent of the world’s polio cases for 2010, or 458 cases so far this year -- and according to Maher, the new cases were most likely generated from increased interaction between India and Tajikistan. Currently, Unicef is carrying out immunization campaigns in the country to stop the spread of the disease.

In Angola, the polio virus has led to 24 cases this year in a country that had been polio free for six years until an outbreak in 2007. The Democratic Republic of the Congo has reported 15 cases this year after counting 3 cases in all of 2009, according to the World Health Organization.

Sierra Ortega contributed reporting to this article.