Finishing the Global Fight Against Polio

I want to acknowledge my dear friend, Senator Tim Wirth—who was one of my predecessors in the post I now hold—for his long-term, unwavering commitment to polio eradication. Many of you here today have devoted much time and effort to improving health around the world, and specifically to combating polio. In particular, I would like to recognize the steadfast dedication of Rotary International. We deeply appreciate your work, and that of your colleagues and the organizations you represent. Without your contributions, we would not be as close as we are to eliminating polio. I would like to express my thanks to George Washington University 's Elliott School and especially Dean Michael Brown, together with the School of Public Health and Health Services, for hosting this event. I want to recognize in particular Dr. Kristin Lord, who rendered distinguished service at the State Department on global issues and who has recently returned to the Elliott School. And finally, I congratulate the Elliott School on launching its Distinguished Women in International Affairs lectures and thank Mr. Jack Cumming whose generous sponsorship has brought the series to life. It is an honor to be your inaugural speaker.

Role of Health in Foreign Policy

Secretary of State Condoleezza Rice has emphasized that Transformational Diplomacy is a key component of U.S. foreign policy, through which we work with partners around the world to build and sustain democratic, well-governed states that respond to the needs of their people and conduct themselves responsibly in the international system. The United States is employing its diplomatic strength to assist foreign citizens in bettering their lives, building their nations, and transforming their own futures.

Promoting greater public health around the world is a top priority of the Bush administration. Working to prevent disease when possible, and treat it when necessary, is a moral imperative. Helping to protect the vulnerable from suffering, respects and preserves the inherent dignity and worth of every person -- man or woman, child or adult, rich or poor. Fostering improved public health around the world is also a crucial aspect of transformational diplomacy. Healthy and safe citizens are a prerequisite for any country to develop and flourish economically, and to sustain civil society. As a result, we work both directly with the people and with governments to improve health conditions and services. And we know, from experience and study, that global health issues have consequences that affect not only the people of developing nations but also directly affect the interests of American citizens. By working with our many partners to advance public health around the world, and thereby helping to change people's lives, alleviate poverty, and create the conditions for stable and well-governed states, we enhance our security and manifest our inherent compassion.

There are many examples of how the United States has shown its fundamental decency, and embraced its global role, through international efforts to promote public health.

• The United States is a leading participant in the Stop TB Partnership, a network of international organizations, national governments, and private-sector donors dedicated to fighting tuberculosis. We are contributing about $90 million this year to TB programs in over 35 countries, as well as approximately $184 million on TB research.
• Last year, President Bush challenged the world to increase dramatically efforts to fight malaria, which is a major cause of death of children in Sub-Saharan Africa. The President pledged to increase funding of malaria prevention and treatment by more than $1.2 billion over five years. This initiative has already reached 5 million people in Angola, Tanzania, and Uganda, and next year, the effort will expand to Malawi, Mozambique, Rwanda, and Senegal.
• HIV/AIDS hampers the development and threatens the stability of many countries. Under the President's Emergency Plan for AIDS Relief, the United States is committing $15 billion over five years to combat HIV/AIDS. We are working closely with the Global Fund, UN agencies, and affected nations in undertaking this critical initiative.
• The SARS outbreak of three years ago vividly illustrates that the social, economic, and political impacts of a virulent flu pandemic could be far more devastating. In recognition of that danger, and with the clear intention of helping not just the United States, but the entire world, become better prepared, President Bush announced the International Partnership on Avian and Pandemic Influenza last year at the UN General Assembly. The United States has committed $392 million to help the developing world prepare and respond to this threat.

Together with much of the international community, we are engaged in long-term fights against those diseases. We are also, in cooperation with partners here and around the globe, vigorously combating polio. In that effort, we have come far, and the eradication of the disease lies within sight.

Progress in the Fight against Polio

For thousands of years, polio has been endemic. Many of you remember polio epidemics in the U.S., when fear of the crippling virus closed schools and swimming pools. Only in 1955, when Dr. Jonas Salk developed the first vaccine against polio, was the world able to imagine a future without the dreaded disease. Dr. Albert Sabin's oral polio vaccine, produced five years later, gave us a second weapon against the disease, and opened a door to eradication. In the United States, the last case of polio caused by a wild poliovirus was reported in the late 1970s.

Thanks to the leadership and generosity of private organizations, international institutions, and numerous national governments, we have achieved considerable success in combating polio around the world. In 1985, Rotary International unveiled a campaign to fight polio and their efforts helped catalyze an international response. In 1988, the World Health Assembly voted to launch the Global Polio Eradication Initiative (GPEI). At the time, wild poliovirus was endemic in more than 125 countries on five continents, paralyzing more than 1,000 children every day.

Since the late 1980s, the Global Polio Eradication Initiative, which is a unique public-private partnership involving national governments, WHO, Rotary International, the U.S. Centers for Disease Control and Prevention, and UNICEF, has grown into one of the largest public health initiatives the world has known.

The UN Foundation has also been actively engaged in trying to ensure all financial resources are in place to eliminate polio, and has contributed many millions of dollars of its own funds to the cause.

All these efforts have made remarkable progress. While the Global Polio Eradication Initiative's target of 2005 was not achieved, some two billion children around the world have been immunized against polio, and last year, there were fewer than 2000 new cases. Health experts continue to make strides with cutting-edge technologies and approaches, including use of vaccines at birth, genetic tracking of the virus, and better-targeted vaccines. We have never been closer to the goal of eradicating polio.

Challenges Remaining

Yet, challenges remain. Today, polio is endemic in four nations— Afghanistan, India, Nigeria, and Pakistan. The populations affected by polio in those countries are among the poorest and most difficult to reach through public health tools, such as vaccines, communication campaigns, or trained health workers. Existing conflict, dire poverty, and religious and social tensions have compounded the problems.

Setbacks have resulted in the exportation of polio infections from affected areas to countries where wild polio had been eliminated, threatening to turn back the progress we have made.

Completing the task of eliminating polio requires commitment, cooperation, and community involvement. Diplomatic initiatives must complement and reinforce public health actions.

First, the international community must renew and strengthen its commitment. We must fight what may be fatigue, waning enthusiasm, and decreased financial support among some donors. To achieve these objectives, we use bilateral and multilateral fora to continue to highlight the importance of polio eradication, including exchanges such as the G-8 Summit where we strive to ensure the support of world leaders. We urge other groups, such as the Organization of Islamic Conference, to do the same, and they have. And we are actively working with leaders in polio-endemic countries and with international and regional organizations to encourage sustained action in polio-affected regions.

U.S. financial support—both from private donors and from the government—remains strong. Yet, vaccination campaigns and emergency operations in outbreak areas continue to face funding gaps. While many nations have given generously, other potential donors have yet to fulfill their pledges, or have not given at all. This Administration will work with our partners to ensure that resources become available. As Dr. Salk himself said, “you cannot achieve anything altogether on your own.... [W]hatever we do has to be part of a team, part of a community.” This spirit underpins our commitment and efforts.

Vaccinating children where polio is endemic also requires enhanced cooperation. In some cases, the remaining polio-endemic regions are also buffeted by strife and conflict. Enabling public health workers to gain access to these areas requires the parties to encourage safe passage for immunization campaigns.

Health workers operating in conflict zones—sometimes under extremely threatening conditions—should be commended for their courage and determination. These medical heroes have our respect, admiration, and our steadfast support. They deserve protection by all. Through diplomatic overtures, both public and private, we will continue to ensure access for these health workers.

Success in eradicating polio also requires greater community involvement. Local political and religious figures have a crucial role to play in disseminating helpful information, dispelling myths, and instilling confidence regarding immunization. National and world leaders, both secular and religious, must reach out to the communities affected by polio and urge local leaders to support vaccination efforts.

We are also working to enhance the involvement of women in efforts to eliminate polio. Especially in areas where cultural practices prohibit male non-family members from entering homes to vaccinate or monitor, well-trained women are vital to immunize newborns or infants and conduct accurate post-campaign assessments.

And through our diplomatic initiatives and outreach, we are encouraging greater sharing of expertise among developing nations themselves and across countries of similar religion. Technical support and advice from officials from similar circumstances can sometimes more effectively build confidence and competency in those who are struggling with challenges at local levels.

Conclusion

For the Bush Administration, the eradication of polio is a key foreign policy objective and one of our highest international public health priorities. We will continue to provide strong public support and diplomatic leadership to strengthen international commitment, enhance regional cooperation, and expand community involvement.

The struggle against polio has been long, and though never easy, the work is now progressively harder. The easy route would be to feel satisfied by the successes to date, to say that we have come far, and then to relent in the face of obstacles. The more difficult route, the moral one, the strategically important one, is to push on, to persevere, to see the fight through to its very end.

An historic opportunity lies within the grasp of the global community to rid the world of this dreaded disease. Let us move forward together, and finish the job. Once again, it is an honor to speak to those who have been working tirelessly, some for the last two decades, on this most critical issue. Thank you.