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Bill Gates expanded the campaign to eradicate polio during a frontline visit to India yesterday. The new strategy: lift health beyond polio's reach. The largest remaining pockets of the disease are the Indian states of Bihar, site of Gates' visit, and neighboring Uttar Pradesh. Over 240 million people live in the region. Fertility rates are high with more than 500,000 children born monthly in Uttar Pradesh. The new births are accompanied--and perhaps driven by--the highest child mortality rate in India. Waves of vaccination campaigns have failed to eliminate the disease from the two states. Disconcertingly, even multiple doses of the oral vaccine don't guarantee immunity here, a failure usually explained by widespread unhygienic conditions, undernutrition and illness. By improving broader health conditions, the chain of circumstances favorable to polio could be broken. The World Health Organization recently began investigating the biology underlying the vaccine failure. Meanwhile, however, Bill Gates signed an agreement with the state of Bihar to "to improve and increase the availability, quality and utilisation of health-care facilities and services," according to the Economic Times. For all its assets, however, the Gates Foundation cannot fund better health care at Bihar and Uttar Pradesh scale. The memorandum between Bihar and the Foundation might represent a quid pro quo. Polio affects very few, even in India which experienced just 741 cases in 2009. The benefits of eradication accrue to the entire world but India must do the actual work at least to the partial exclusion of more pressing priorities such as child mortality. A few weeks ago, the Wall Street Journal speculated that Gates might shift away from eradication toward strengthening health systems. Instead Gates added improving health infrastructure to his still-relentless campaign for eradication. --------------------------------- Related: Gates Seeks to Close Out Polio in Nigeria (June 7, 2010) Wall Street Journal: Pulling the plug on polio eradication? (April 26, 2010) Polio Eradication: Harder Than it Looks (April 14, 2010) |
