• by Armin Rosen (united nations)
• Tuesday, April 20, 2010
• Inter Press Service

Only one disease has ever been totally eradicated by human beings: smallpox, the last natural instance of which was reported in 1975. Two doctors are now making the case for adding a second disease to the list.

There are only 1,600 polio cases left around the world, and Drs. Claudia Emerson and Peter Singer of the McLaughlin-Rotman Centre for Global Health in Toronto are arguing that the international community has an ethical obligation to put an end to the disease at last.

In the latest issue of the respected medical journal the Lancet, they write that eradication could prevent over four million children from contracting the disease over the next 20 years.

Polio, a virus that affects the central nervous system and can lead to paralysis and physical deformity, was widespread in the early 20th century. The disease was all but eliminated by a vaccine developed by the virologist Jonas Salk in the 1950s, and by a worldwide vaccination campaign that had the number of polio victims down to less than 350,000 by the end of the 1980s.

Today, there are less than 2,000 polio victims worldwide. While there is no existing cure for polio, Singer says that the goal of eradicating the disease for good is a realistic one.

Singer says that polio is now contained to just a few countries, with Nigeria, Afghanistan, India and Pakistan having the highest number of cases.

'The debate is over whether or not we should push for the last effort on polio eradication,' says Singer, who says that polio eradication will be discussed at next month's World Health Assembly, the World Health Organisation's annual meeting of the world's health ministers.

Singer believes that the issue should be examined from an ethical perspective. 'Polio eradication is a bit like walking down the bank of a river and seeing someone drowning,' he says. 'They're within reach and you can reach and pull them out. You can't just let them drown.'

He says that the medical community has a responsibility to rescue people that they are capable of rescuing, and that the only barriers to polio eradication are 'social and ethical' rather than 'technological and scientific'. With a polio vaccine available, the only obstacle to eradication is doubt as to whether a disease that affects so few people is actually worth eradicating.

'The main barrier at this point is whether or not we have the will to make the final push,' says Singer. 'That's fundamentally a question of motivation and will, which is why the ethical arguments are actually important here.'

He notes that eradicating polio will be difficult, and will mean overcoming political and cultural obstacles in places where access to the vaccine is scarce, or where there are ingrained cultural fears of vaccinations. The fact that many polio cases are in Afghanistan and Pakistan means that regional conflict will be another obstacle to eradication.

However, he says that polio and one other relatively-easily eradicable disease, Guinea worm, present humanity with the opportunity to do something it has only done once before. And when polio is eradicated, the benefits will be permanent.

'Once the disease is eradicated it's like an annuity that keeps on paying,' Singer says. 'Every year a disease isn't on the earth it's a year that people aren't suffering from that disease.'

Polio eradication might not be that easy of a sell to next month's World Health Assembly. Singer concedes that he became interested in the ethical dimensions of polio eradication partly because he had heard the ethics-based argument against eradication made more often.

But with so few cases left, the article helps prove that the world is near the end of a marathon that could be worth finishing, even if it means diverting resources and attention from other problems.

© Inter Press Service (2010) — All Rights Reserved. Original source: Inter Press Service

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