RI General Secretary John Hewko’s Address to the World Vaccine Congress – 12 April 2012 Washington, DCIt is my honor and privilege to be here at the WorldVaccine Congress and to proudly represent the 1.2million men and women of RotaryAnd on behalf of the 34,000 Rotary clubs worldwide,let me also express my sincerest gratitude to everyperson in this room. Because if it weren’t for you —the professionals who fund and conduct vaccineresearch — who develop, produce, and distribute
these lifesaving agents — we at Rotary could not dowhat we do.And what do we do?As you saw in the video: We eradicate polio.We do other things too, of course. Rotary clubssupport literacy and education. We promotematernal and child health. We improve access toclean water and sanitation.But Rotary’s highest priority is the eradication ofpolio.
This crippling childhood disease has been Rotary’ssworn enemy for more than three decades, and youprovide us and our partners with the weapons — thevaccines — that have carried us to the threshold ofvictory. Thanks to vaccines, humanity was able toconquer smallpox. And now we are poised to makehistory a second time by eradicating polio.But before I talk in more detail about how close wetruly are to a polio-free world, I want to share a littlestory about the polio vaccine. Call it a pop-culturetidbit that perhaps illustrates just how much a part of
our lives vaccines have become — in ways that wedon’t always expect.A few weeks ago, I came across a news story abouta gentleman named Robert Sherman, who had justpassed away at the age of 86.His obituary indicated that he was an award-winningcomposer who did a great deal of work for DisneyStudios. One of his assignments was to write thesongs for the 1964 musical, Mary Poppins, a verypopular movie that I certainly remember, and Iimagine many of you do too.
One day, Mr. Sherman found himself struggling withthe lyrics for one of the film’s most important songs.He needed a catchy phrase around which to buildthe song — to anchor it. Something memorable. Buttry as he might, nothing seemed to work.Then his 8-year-old son came home from school.The father asked the age-old question: “So how wasschool?”“Great, we got the polio vaccine today,” came theresponse.
Mr. Sherman assumed it was delivered by injection.“Did it hurt?”“Nah,” the boy said. “They just stuck the medicine ona lump of sugar.”A light bulb popped above the father’s head, and aninstant classic was born.“A Spoon Full of Sugar Helps the Medicine GoDown.”Yes, the same vaccine that has saved millions ofchildren from a lifetime of disability also inspired one
of the most memorable songs in Hollywood history,a song that helped Mr. Sherman win an AcademyAward for Best Original Score that year.I would say that’s a great example of creative, off-label use.Now let me shift gears and take a look at howRotary and our partners in the Global PolioEradication Initiative have put the oral polio vaccineto its intended use.And to great effect, I must say.
Rotary officially took on polio eradication as ournumber one priority when we started our PolioPlusProgram in 1985. We were the first NGO to addressthe problem.In 1988, Rotary was joined by the World HealthOrganization, UNICEF, and the US Centers forDisease Control and Prevention to launch the GlobalPolio Eradication Initiative. And more recently, theBill & Melinda Gates Foundation has joined thecause.
Rotary’s chief responsibilities are fundraising,advocacy, and mobilizing volunteers — and we do avery good job at all three.In fact, to date Rotarians have contributed more than$1.2 billion to the polio eradication effort.Many consider the polio eradication initiative to bethe most ambitious and successful public-privatepartnership ever forged. And I want to get back tothe private sector part of the equation in a fewminutes, because it’s very important and it speaksdirectly to many of us here today — as private sectorprofessionals.
But first, let’s look at what this partnership hasaccomplished so far.Since the initiative began its work to immunize theworld’s children against polio, the incidence of poliohas dropped by more than 99 percent — from350,000 cases a year to fewer than 700 for all of2011. This year, we’ve had 36 cases worldwide asof April 1, well below the case-count at the samepoint in 2011.Think about these numbers.
We have reached more than two-and-a-halfBILLION children with the oral polio vaccine. Polioeradication activities have reached more familiesthan any other public health initiative in history –introducing millions of parents to the basic conceptsof preventive health care.In doing so, we have prevented more than 5MILLION cases of childhood paralysis and hundredsof thousands of pediatric deaths.Already this year, we have celebrated the long-anticipated milestone of seeing India removed fromthe list of polio-endemic countries, leaving only
Afghanistan, Nigeria, and Pakistan as nations wherethe wild poliovirus has never been stopped.And because this is such an important milestone,let’s look a little more closely at India, a country ofmore than a billion people and a host of challenges— among them poverty, pollution, and poorsanitation — challenges that until recently madeIndia an epicenter of polio.When the eradication initiative began, India wasexperiencing about 75,000 new polio cases a year.
And if you have spent any time at all in India, youhave seen the ravages of polio for yourself —children and adults permanently disabled, unable towalk — the so-called crawlers of the streets — andmost of them with little hope of receiving anymeaningful treatment or rehabilitation.However, defeating polio in India didn’t “just happen.”Instead, India’s progress demonstrates — perfectly— how determination, persistence, and planning willultimately win the day.Year after year, thousands of health workers andvolunteers — many of them Rotarians — have
methodically carried out massive immunizationrounds — called National Immunization Days — inan effort to reach every Indian child under age fivewith the oral polio vaccine.This means going door-to-door — from the remotestvillages to the teeming urban slums — to make sureno child is missed.Public awareness rallies drive home the importanceof vaccinations.Parental misgivings and cultural misconceptions areidentified and addressed.
Detailed records are kept. Home addresses arelogged.Even the children themselves become living medicalrecords — their pinky fingers dyed purple to showthey have received the vaccine.Over and over again these immunization roundstake place — vaccinating more than 170 millionchildren each time. Then come the mop-up rounds,targeting communities where children may havebeen missed or where risk is particularly high.
And sure enough, over time, India’s polio infectionrate began to drop. By 2009, new cases totaled justover 700. In 2010, only 42 cases were reported. In2011, there was only one case — a young girl inWest Bengal — recorded on January 13 of that year.And that was it.On January 13, 2012, India celebrated a full yearwithout one new case of polio. India’s removal fromthe endemic list was announced in February duringa Polio Summit in New Delhi — a meeting convenedjointly by Rotary and the Indian Health Ministry.
Ladies and gentlemen, if polio can be beaten inIndia, it can be beaten anywhere.Of course, the vaccine industry has been vital to ourprogress.In India, for example, it was very likely that theintroduction of the new bivalent vaccine — whichtargets poliovirus types 1 and 3 — contributedsubstantially to the steep case-count reductions wesaw in 2010 and 2011.The swift production and deployment of the bivalentvaccine resulted from an extraordinary collaboration
between WHO, UNICEF, government regulatoryagencies and — of course — the vaccine companies.Throughout the history of the polio eradicationinitiative, the vaccine industry has been amazing inits ability to continually and quickly reconfigure thepolio vaccines to make sure we have the rightweapons at the right time to use against thistenacious disease.Polio vaccine producers have been incrediblygenerous in negotiating prices to help makevaccines affordable to developing countries, even
donating vaccine supplies for use in emergencyresponses to sudden outbreaks.When such emergencies occur, we know we canrely on our pharmaceutical industry allies to deploythe right vaccine in the quantities needed to respondswiftly and effectively.Trivalent. Monovalent. Bivalent. Each type of oralpolio vaccine has proven indispensable to our effort.And as we approach the end game with polio, it isalmost certain that injectable, inactivated poliovaccine — IPV — will be introduced into the mix to
help in the final stages of eradication and ourtransition into the post-eradication era.Yes, I said post-eradication era, but let us not getahead of ourselves. There is still much to do — andserious challenges to overcome — before we reachthat point.The Global Polio Eradication Initiative retains anIndependent Monitoring Board that issues quarterlyreports that take a very critical look at our strategiesand practices.
These reports provide a valuable reality check thatkeeps us from becoming too giddy over oursuccesses – even India’s milestone, as wonderfuland important as that is.While acknowledging India’s success, the board inits most recent report said we simply have to do abetter job on-the-ground – at the local level – toreach every child with the vaccine in the remainingpolio-affected countries.This means giving the vaccinators the resources andtools they need to get the job done — better training,
fair compensation, creative incentives, adequatesupport, continuous motivation.We have to make sure that the changes andimprovements we make at the organizational levelare put into practice at the community level, where itcounts.The Independent Monitoring Board reminds us thatbeyond the three endemic countries, so-called “re-established polio” has become persistent in Angola,Chad, and the Democratic Republic of Congo.
And 20 additional countries have had smaller poliooutbreaks since the start of 2010. Again, these arecountries where the poliovirus had once beenstopped.This is alarming, to be sure. And it demonstrateswhy it is so critically important to stop thetransmission of the poliovirus in the three endemiccountries, which are the reservoir that enables thedisease to re-establish itself elsewhere.For example, in 2011, polio cases in non-endemiccountries totaled 310, almost as many as the 340cases in the endemic countries.
To me, one of the most surprising outbreaks lastyear occurred in China, which had been polio-freefor more than a decade. The 21 cases there weregenetically linked to the same strain of the type 1poliovirus circulating in neighboring Pakistan – onceagain, proof that we must stop polio in the endemiccounties at all costs.And speaking of costs.As you would expect, funding remains the singlebiggest challenge to the Global Polio EradicationInitiative.
To date, the world has spent more than $8 billion onpolio eradication. Yet, the initiative right now faces afunding gap of more than $1 billion in order to carryout immunization activities through 2012-2013.Believe me — we are working hard to close that gap.In January of this year, we at Rotary announced thatour membership had succeeded in raising more than$200 million in new money for polio eradication. Andwhen you think about the state of the globaleconomy during the past few years, it makes whatour members did even more impressive.
This fundraising effort was in response to a $355million Challenge Grant from the Bill & MelindaGates Foundation, which has added another $50million to the total to recognize Rotary’s commitment.To date, Rotary and the Gates Foundation each hascontributed more than $1 billion to polio eradication.In addition to raising funds for polio eradication,Rotary advocates as a global organization toencourage the world’s governments to commit publicresources to a cause that benefits all families, nomatter where they live. Because Rotary is present in
more than 200 countries and regions, this hasproven to be a very effective tactic.As I mentioned earlier, you can see how importantthe private sector is to polio eradication.Without the leadership, participation, support, andcooperation of the private sector — vaccinemanufacturers, foundations, the professional andcommunity leaders in Rotary clubs — polioeradication would still be a pipe-dream, not a globalhealth initiative that is 99 percent of the way toachieving its goal.
In fact, for the purposes of polio eradication, wecould reverse the order, and call it a PRIVATE-publicpartnership, because the private sector was therefirst, leading the way.It was the private sector — Rotary — that proved tothe World Health Assembly that polio eradicationwas even feasible.In 1979, the same year that smallpox was declarederadicated, Rotary committed $750,000 through itsown grant program to buy polio vaccine to immunize6.3 million children in the Philippines, which at thetime had the highest polio rate in the West Pacific.
By 1982, the incidence of polio in the Philippineshad dropped by 68 percent. Using the Philippineexperience as a model, Rotary launched successfulpolio immunization projects in several other Asian,African, and South American countries over the nextfew years.Rotary’s early successes in these countriesdemonstrated that millions of children could besystematically immunized against polio.Rotary then mobilized its worldwide membership toraise an initial war chest of $247 million to vaccinate
all of the world’s children, easily doubling its originalgoal of $120 million. And as I said earlier, weestablished our PolioPlus Program in 1985.With such solid groundwork in place, in 1988 theWorld Health Assembly adopted the historicresolution that formally targeted polio for eradication,thus creating the Global Polio Eradication Initiative,the wonderful partnership we’ve been talking about.And I must add that a key vaccine researcher waswith us from the beginning. Dr. Albert Sabin was astaunch ally of Rotary and spoke at two RotaryInternational conventions, in 1980 and 1985, to
encourage Rotary to embrace polio eradication asour global cause.Dr. Sabin was a visionary. He could see the history-making potential of his oral polio vaccine, deliveredto the world’s children through the resources ofRotary, an organization of everyday business andprofessional people committed to the goal of a polio-free world.Yes, it has become increasingly clear to me thatprivate sector leadership is one of the keycomponents to any valid solution to community
problems the world over — and polio historically hasbeen a major one.The continuing support of the world’s governmentsis by all means crucial to our success – of course itis — but governments alone cannot eradicate polio.But by working together, as a team — leveraging thestrengths of both the public and private sectors —WE CAN eradicate polio. And we will.So what will be our legacy when polio is finally gonefor good?
For one thing, the world’s $8 billion investment willbe protected. In fact, eradication will result in netbenefits estimated at $40 billion to $50 billion overthe next two decades.Most of the benefits will accrue in developingcountries, as per capita production goes up andhealth care costs drop after the burden of polio islifted.Another tangible benefit is the solid public healthinfrastructure that polio eradication will leave inplace — systems that can be used for the delivery ofother vital health services.
For example, active disease-surveillance networkshave been established in all of these countries,assets that can be readily repurposed to addressother diseases, such as measles, malaria, and HIV.Once achieved, polio eradication will set the stage –and provide the inspiration — for the next greatglobal health initiative.But the most important legacy, of course, will be ourcollective gift to children everywhere: a polio-freeworld.
This realization hit me hard — and in a veryemotional way — last November in Mumbai, wheremy wife and I had our first opportunity to vaccinatechildren as part of a Subnational Immunization Day.The first child I immunized that day was a little girl. Ican honestly say that the feeling of joy and pride thatI felt as I placed the vaccine drops into her mouthwill live with me forever.Two small drops and a lifetime of misery isprevented.
There are few certainties in life, but at least herparents can be certain — as I am certain — thatpolio will not rob that child of her future.What more can I say?It was a truly humbling experience, and I thank youfor enabling me — and the thousands of my fellowRotarians who have devoted countless hours toimmunize the world’s children — to have such aprofound and powerful impact on another human’slife.
And I also invite YOU to become personally involvedin our cause.Use your voices. After you leave the World VaccineCongress and return to your homes and to your jobs,tell your families and colleagues how the poliovaccines that you develop — that you manufacture,distribute, and regulate — are helping us to makehistory.Together, we WILL End.Polio.Now.Thank you.