To support the global campaign against poliomyelitis (polio) -- a contagious virus that paralyzes and sometimes kills young children -- the Bill & Melinda Gates Foundation awarded two challenge grants (the most recent in January for $255 million) to the service organization Rotary International. Together, the two grants total $355 million and must be matched by new donations of $200 million over the next three years.

The grants support the Global Polio Eradication Initiative (GPEI), a partnership launched in 1988 by the World Health Organization (WHO), Rotary International, the U.S. Centers for Disease Control and Prevention (CDC) and UNICEF, working together with national governments. For this initiative, the U.S. government has contributed approximately $1.3 billion since 1991. There also have been donations from private U.S. organizations and individuals, including contributions from U.S. Rotary Clubs of almost $204 million.

"Rotarians, government leaders and health professionals have made a phenomenal commitment, so polio [currently] afflicts only a small number of the world's children," Bill Gates, co-chair of the Gates Foundation, said in announcing the new grant in January. "However, complete elimination of the polio virus is difficult and will continue to be difficult for a number of years. Rotary in particular has inspired my own personal commitment to get deeply involved in achieving eradication."

"The contribution by the Gates Foundation and matching funds from Rotary come at a very strategic moment, providing additional momentum to get across the finish line to complete the worldwide eradication of polio," Dr. Steve Cochi, senior adviser on polio eradication at CDC's Global Immunization Division, told America.gov.

In January, the United Kingdom announced a contribution of $150 million to the GPEI, and Germany gave $130 million. Other countries, including Canada and Russia, also have made significant donations.

"Since 1988, the GPEI has been very successful in reducing polio cases by over 99 percent," Cochi said. "Polio has been eliminated from more than 200 countries by proven strategies, and we are very close to victory globally, but are stalled at the threshold of success by difficulties in the four remaining polio-endemic countries-- Nigeria, Afghanistan, India and Pakistan -- where polio has never been completely eradicated."

Polio is a highly infectious, potentially fatal disease that invades the nervous system and causes muscle paralysis in a matter of hours. Polio has no cure but can be prevented through multiple vaccinations. "People can be infected with polio and silently transmit the virus to others without displaying symptoms, which can pose a challenge to controlling the epidemic spread of the virus," Cochi said.

TOP PRIORITIES

"The key issue now is stopping the spread of polio through people infected in the polio-endemic countries who might travel anywhere in the world," Cochi said. "For example, over 20 countries in Africa had previously eliminated polio, only to become re-infected by importation of the virus from Nigeria, and had to work hard to eliminate polio a second time, and in some cases several times, as a result of numerous importations from Nigeria."

"[Therefore] the whole world remains vulnerable to the threat of polio, and vaccinations must continue everywhere to keep the barrier in place," he added.

Godwin Atiah, left, and Busuyi Onabolu, center, of Nigeria PolioPlus join officials in Kano, Nigeria, for Immunization Plus Days.

"The Gates challenge grant will focus on efforts in the polio-endemic countries, and other high-risk countries, including Sudan, Chad and Ethiopia," Carol Pandak, manager of Rotary's PolioPlus program, told America.gov. In the polio-endemic countries, issues to be resolved include low vaccine effectiveness (northern India), low vaccination coverage rates (Nigeria), and access problems due to conflict and insecurity (Afghanistan and Pakistan), she added.

ROTARY POLIO PREVENTION ACTIVITIES

"Local Rotarians on PolioPlus committees in those four countries are our main focal points to [connect] with WHO, CDC and UNICEF at the country level, and to motivate their own governments' immunization activities," said Pandak.

For example, in Nigeria, she said, "Nigerian Rotarians are engaging local leaders at state and local government levels to dialogue and to enhance accountability at the lowest level of government, to support high quality polio immunization activities."

Bill Gates visited Nigeria in January to learn more. In Abuja, Gates commended the renewed resolve he saw firsthand, and expressed optimism that leaders at all levels of the country will help create a movement to protect Nigerian children from polio and other vaccine-preventable diseases.

Rotary International has contributed nearly $850 million to date and countless volunteer hours to immunize more than 2 billion children in 122 countries.

U.S. Rotarians travel to help with polio immunization campaigns. Polio-survivor Ann Lee Hussey of Maine has participated in immunization day activities 12 times, most recently going to Kaduna, Nigeria in March. In February, Noelle Galperin of Florida led a group of 45 to India with a three-day effort to distribute live polio vaccines to nearly 80,000 children.

HOPEFUL SIGNS

Since 1988, more than 2 billion children in 125 countries have been vaccinated. In 2008 alone, campaigns in 36 countries provided 2.46 billion vaccine doses to 340 million children.

In 2008, some 1,659 cases of polio occurred worldwide, a reduction of mire than 99 percent from 1988 levels. In 2009, some 169 cases had occurred as of March 25.

"The key [to polio eradication] is political will, good management and high quality implementation of proven strategies to prevent the disease," Cochi said.

"We have demonstrated that polio can be eliminated in the most difficult places in the world," Pandak said. "It is definitely possible."