Political Paralysis
How many children will we need to paralyze to eradicate polio forever? Increasingly, as we approach the ultimate goal of eliminating a crippling disease once and for all from the planet, we must confront this grim calculation. Until the turn of this new century, the naturally-occurring—or wild—polio virus was the primary way for the disease to reach its human hosts, causing illness, debilitation, partial or total paralysis, even death, usually of children, almost always in remote villages ill-served by health agencies. But since the certified eradication of Type 2 polio, and the near elimination of Types 1 and 3, the primary way polio infects its hosts is, I hesitate to say it, through our own inoculation campaigns.
The twentieth-century eradication of smallpox must have emboldened us to imagine that ridding the world of polio would be a matter of course. After all, according to Donald Henderson’s “The Eradication of Smallpox—An Overview,” smallpox had killed 300 million people in the 20th century alone, “more than twice the death toll of all the military wars of that century.” Compared to that massive, almost always deadly scourge, polio, which paralyzed children but killed few and was almost never contracted by adults, must have seemed like an easy target for elimination.
But polio turned out to be a different case altogether: less deadly but sneakier, more resistant to both serums and human effort.
First of all, smallpox is easy to spot. As Henderson again notes, this time in “Countering the Posteradication Threat of Smallpox and Polio,” smallpox is readily visible. Sufferers are covered over most of their body with distinctive purulent poxes. Unlike polio, which can hide in the body for years while its bearers infect others, smallpox advertises its presence and makes intervention much more likely. Imagine trying to rid the world of a disease that has more than 200 asymptomatic carriers for every paralyzed patient.
Second, polio vaccines need to be administered several times, on a schedule, to be effective. Whereas for smallpox, again according to Henderson, a single dose of vaccine immunizes nearly 100% effectively, polio requires at least three doses of Oral Polio Vaccine (OPV). And fewer than six doses might not achieve a 90% protection against the predominant strains: types I and III. In stable communities with the enthusiastic support of the local population and health agencies, inoculating every child under five with six doses of anything on a scheduled basis would be seemingly indomitable. But, add to that the social and environmental instability of the areas where polio is endemic (Afghanistan, Pakistan, North and West India, and Nigeria), where flood, famine, and warfare shred the social fabric, and the job seems beyond human capability.
Finally, the vaccines themselves can infect patients with the virus. This is the most insidious and infuriating frustration of the fight against polio. What at the start of the campaign was an almost negligible nuisance factor (if lifelong paralysis can be discounted) of 1 case per 3 million doses of vaccine, has become—tragically and ironically—a much more significant drawback of the seemingly endless effort to finally eradicate polio.
Aylward and Tangermann relate the confident enthusiasm of the polio eradication campaign of the early 1980s, fueled by a strong start and rapid success.
By the year 2000, the incidence of polio globally had decreased by 99%. . . . By 2002 . . . the Americas, Western Pacific and European Regions had been certified polio-free. By 2005, . . . wild poliovirus (WPV) had been interrupted in all but 4 ‘endemic’ countries: India, Nigeria, Pakistan and Afghanistan, where eradication efforts effectively stalled.
Momentum is everything in eradication campaigns. The effort is global and requires the cooperation of entire continents. Adversaries in everything else need to put aside their differences—sometimes even calling cease-fires on battlefields—to cooperate in delivering preventive measures to diverse populations regardless of their race or nationality. What had occurred so naturally in the eradication of smallpox needed to occur again if polio was to be eliminated. Henderson described it this way:
The scope of the smallpox program was unprecedented. It required the cooperation of all countries throughout the world and the active participation of more than 50. It was a universal effort unlike any that had ever been undertaken. Most countries eventually proved to be readily responsive but strong persuasion was necessary for some. National antipathies were generally set aside.
In both efforts, the vast majority of the population in endemic countries were inoculated in the early years. And in both cases complications of population movement, natural disasters, maddening bureaucracy, and dislocations of regional conflicts and civil wars frustrated the mass inoculations. But the polio campaign has not yet overcome the elemental differences of the two diseases that make the ultimate elimination of polio so much less likely.
Like the smallpox campaign, the effort to eradicate polio scored impressive early successes. According to Aylward and Tangermann, “By the year 2000, the incidence of polio globally had decreased by 99% compared with the estimated number of cases in 1988 . . . and the last case of polio due to wild poliovirus type 2 transmission anywhere in the world was recorded in Uttar Pradesh, India in 1999.” And then the effort stalled.
Polio is not smallpox: obvious, defenseless, stable. It’s nefarious, invisible until it strikes, and mutable. The 1% of cases that persisted after 2005 began to mutate. The world had failed to wipe out the last of the last viruses. Some children had only mucosal immunity while the virus thrived in their intestines. The carriers looked healthy but passed the virus to others undetected, especially in the toughest places, the remote villages and refugee camps where sanitation was crude at best and healthcare nonexistent.
And while the agencies assigned to eradication tried to counter the mutations with customized variations of the Oral Polio Vaccine to meet local conditions, mounting resistance to an intrusive, expensive, and seemingly endless global eradication effort weakened the support needed to force the effort past the last 1%. According to Taylor, Cutts, and Taylor, in the American Journal of Public Health, “Negative effects were greatest in poor countries with many other diseases of public health importance.” It’s not hard to imagine the reluctance of villagers in India, for example, whose children routinely die of diarrhea, objecting to the massive effort to eliminate polio, which many have never seen, and which does not kill.
There was blessed, magnificent, altogether positive enthusiasm at the UN, at the WHO, at Rotary International, in the 1980s, that the world could once again achieve with polio the triumph of man over disease that had been accomplished against smallpox. But similar efforts achieve similar results only when conditions are similar, and smallpox and polio are too different for the same formulas to work.
References
Aylward, B., & Tangermann, R. (2012, April 06). The global polio eradication initiative: Lessons learned and prospects for success. Retrieved February 12, 2018, from https://www.sciencedirect.com/science/article/pii/S0264410X11015994?via%3Dihub
Henderson, D. A. (2002, January 01). Countering the Posteradication Threat of Smallpox and Polio | Clinical Infectious Diseases | Oxford Academic. Retrieved February 12, 2018, from https://academic.oup.com/cid/article/34/1/79/312029
Questions for You
Answer with a Reply below.
- How is this a Definition Essay? It doesn’t define polio, smallpox, or eradication.
- What is the clearest and briefest statement of the thesis of this argument?
- What differences between polio and smallpox make it less likely that polio can be eradicated?
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Counterintuitive 
-It is a definition essay because it reveals the severity of the diseases. It doesn’t give a dictionary definition of polio, smallpox or eradication, but it gives a clear indication of what they are and how important/severe they are.
-The clearest and briefest statement of the thesis is that “smallpox and polio are too different for the same formula to work”.
-Polio is not detectable until the infection has taken place- as the text says, “Polio is mutable until it strikes”. This makes it extremely difficult to know who has polio, therefore we cannot give someone treatment if we do not know if they have polio.
1. It is considered a definition essay because it, “technically”, defines polio and smallpox by explaining how they effect people, the death rates of them, and simple compare/contrast analysis. The essay also explains eradication by using statistics and describing how polio had almost been completely gone, but that it had broken out again and had never achieved 10 years of no cases (the definition of eradication). This enables the reader to understand what the terms mean without using a dictionary definition.
2. The main argument of the thesis is that polio and smallpox have received different support for being eradicated, and that they are different diseases. Therefore, polio and smallpox require different strategies when attempting to eradicate them. (smallpox has already been eradicated, of course)
3. Polio is invisible until it strikes, as well as mutable, more resistant to serums, and it is not as deadly as smallpox. Meanwhile, symptoms of smallpox are very visible, and it is a very deadly disease. For these reasons, the diseases are very different, and due to their differences the momentum and effort to eradicate polio is less involved than it was for smallpox.
1. It is considered a definition essay because the paper describes how polio affects human hosts by causing illness, debilitation, partial or total paralysis, even death, usually of children,and almost always in remote villages ill-served by health agencies. The paper also explains the inoculation campaign methods as well as using statistics to highlight the death and mutation rates and the number of cases. Lastly the paper mentions countries where the polio epidemic occurs. Although the essay doesn’t give a dictonary defintion of polio, by using statistics, facts and other information conducted from reserach studies, this makes the essay considered to be a “defintion essay”.
2. The clearest and briefest statement of the thesis is that smallpox and polio require different medical technqiues for eraditcation
3. Polio requires different medical techniques than smallpox becuase the dieases is readily visible (Sufferers are covered over most of their body with distinctive purulent poxes), polio on the other hand can hide in the body for years while its hosts infect others. Polio is also mutable and more resistant to oral vaccinations. Also polio has shown to have higher death rates than smallpox. Polio can only be detectable when the host shows symptoms which makes the disease harder to treat.
The main difference is the control and eradtication stratgies for both dieases**.
1. It would be considered a definition essay because it talks about what the diseases do to people and how to recognize them without giving a textbook definition, but still giving readers a sense of what the diseases are.
2. The clearest statement of the thesis would be “smallpox and polio are too different for the same formulas to work.
3. Polio is harder to detect. Someone doesn’t know that they have it until it comes about, so it is hard to completely destroy.
1. Even though the medical definition of the disease was not given, the essay still describes important factors of the disease, the effects it has on people, and the long history it has.
`2. ” as we approach the ultimate goal of eliminating a crippling disease once and for all from the planet, we must confront this grim calculation”
3. Polio cannot be directly seen on the skin like smallpox does, and it can lie dormant in the body for a long period of time while continuing to spread to other individuals. Polio is also very resistant to serums and human efforts.
1. It is a definition essay even though it doesn’t straight up state the definition, but because it says the affects and expresses the severity of the disease. It tells possible outcomes of having the disease and indicates the severity of it.
2. The clearest statement I see in the thesis is…smallpox and polio are too different for the same formulas to work.
3.Polio is something that can’t be tracked until someone is diagnosed and has it. Its untraceable till your diagnosed with it. Therefore, its much harder to eliminate since you can’t do anything till someone already has the disease.
1. It is a definition essay because throughout the essay it defines what the disease is capable of doing and who it will greatly affect.
2. The clearest and briefest statement is that polio and smallpox are two completely different diseases that won’t allow the for the same formula to work.
3. Smallpox can be visible to the human eye and polio cannot which means polio is much harder to be diagnosed without being tested for.
This is a definition essay because it describes how polio and smallpox’s affects people. It doesn’t just come out and say the textbook definition of polio but it tells the tragic affects and indicates what these sicknesses can do to the people that contracts it.
The clearest and briefest statement of this thesis is that polio and smallpox are very different illnesses that wont allow for the same formula to work.
The differences between polio and smallpox that make it less likely that polio is eradicated is because polio can’t be detected until the person contracts it, which makes the medical treatments very difficult and very different for that of smallpox’s. This also means that it is much harder to get rid of is they only time you can try to fight it is when you find out the person has it.
1. This is a definition essay because of the way that it portrays polio and smallpox. The essay explains how these illnesses affect people. Although there isn’t a specific definition the essay explains the topic in other ways.
2. The clear & brief statement of this essay is polio and smallpox are very different and use different methods to treat them.
3. There are many differences between polio and smallpox. Smallpox can be visibly seen on a person whereas polio is harder to detect.
1. This is considered a definition essay because the essay describes what polio does to people who get the disease without giving an actual dictionary definition.
2. For me personally, the clearest and most brief statement of the essay is polio and smallpox are very different and use different methods to treat them.
3. Smallpox can be seen on people while Polio is not visible and is harder to find.
How is this a Definition Essay? It doesn’t define polio, smallpox, or eradication.
What is the clearest and briefest statement of the thesis of this argument?
What differences between polio and smallpox make it less likely that polio can be eradicated?
1. This is a definition essay as it defines characteristics of polio and the attempts to eradicate it and uses a comparison with smallpox to better characterize it.
2. The most concise statement of the essay was the final summarizing statement.
3. Some differences that make polio more difficult to eradicate include: the disease’s ability to remain undetected within a host, the strict scheduling requirements of the vaccine, and socioeconomic disorder in the affected regions.
1. This is a definition essay because it doesn’t give the reader a dictionary definition but goes on length about what polio is and the affects of it.
2. The clearest and briefest statement of the thesis is that polio and smallpox are two different things and should be treated in two different ways.
3. The difference between polio and smallpox makes it less likely that polio can be eradicated is that smallpox is easy enough to be seen. When you have smallpox you can see bumps on your skin, but polio is not physical a child can have it and you wouldn’t be able to tell by looking at them.