Polio Eradication
Tuesday, 11 October 2011
Senator MOORE (Queensland) (20:08): I seek leave to speak for up to 20 minutes.
Leave granted.
Senator MOORE: I join with Senator Louise Pratt this evening in a discussion around the very important issues of polio in our world. This month of October-and we are running out of months for awareness of particular issues-is, amongst other things, Polio Awareness Month. I think it is really important that people in this place play a part in raising awareness of this condition. We are heading towards 24 October, which is World Polio Day. A number of activities will be going on so that we can share in learning more about this condition, working with people to finally eradicate it from this world.
Polio is a disease that is almost forgotten in Australia except by those whose families have been affected. In my family, one of my cousins was part of the large postwar epidemic in Queensland, on the Darling Downs. We grew up knowing what had happened to her and learning more about polio. But, by and large, I think in Australia we mostly forget about this condition.
The word 'polio' is actually an abbreviation of poliomyelitis, or infantile paralysis. It is an awful disease and is rarely encountered in Australia today by our health professionals. It is a devastating disease that historically affected thousands of people across the globe. We know that people of all ages can contract polio, but it mainly attacks young children under the age of five. Many people experience symptoms that go undetected, but sometimes these people go on to become carriers of the disease. In contrast, the people we see and know as people who have suffered from polio display common symptoms such as fatigue, fever and headaches-all those things we associate with being unwell. In some cases, though, infections can lead to irreversible paralysis, and this often happens in the legs. The virus spreads through the central nervous system and destroys nerves responsible for our muscles. Without the activation of these muscles, the limbs become limp and almost useless. In extreme cases, paralysis can result in quadriplegia. So this is a very serious condition.
Many of the medical advances we now take for granted in the Western world were implemented out of the need to take action earlier in Australia's history. We can be proud of the way Australia led the world in the 1950s and 1960s. In fact, simple things such as the way our intensive care wards operate had their origins in fighting polio. Before the 1950s, hospitals had little capacity for respiratory assistance for patients. The very first respiratory centre opened to treat severe cases of polio, leading to the first intensive care unit opening in Copenhagen in 1953, followed soon afterwards by Australia.
As we know, today we take intensive care units for granted. When we were attacked by this awful epidemic in the 1950s, one of the things that happened across communities was that the grass roots of medical philanthropy began. Local fundraising committees were formed to help care for those who had caught polio, mainly kids. We learnt more about rehabilitation programs to help survivors. Polio survivor support groups have been instrumental to this day, as we heard from Senator Pratt, in advocating for disability rights.
Clearly, this is a disease that has changed not only the lives of those affected and their families but also, to a large extent, our culture. We heard about the development of the marvellous miracle-engaging vaccine in the 1950s, which has reduced the number of polio cases in the Western world from hundreds of thousands a year to just handfuls-but all those handfuls are important to note. The last case of polio in Australia that we know of was in 2007, when an Australian student on holiday in Pakistan contracted the disease. With that identification, the raising of awareness of the illness in Australia continued. However, as we have heard, tens of thousands of Australians who survived polio must still manage the often debilitating effects-the legacy that polio has on their daily lives.
Polio clearly demonstrates that in an age of globalisation of air travel, there is absolutely nowhere that is completely safe. We have to be always vigilant on these contagious diseases. Leading up to World Polio Day, we can reflect on the successes of strategies employed to reduce the spread of the disease and to very, very nearly eradicate it. We can also reflect on the legacy of polio on Australian survivors and look forward to celebrating its ultimate eradication worldwide through the Global Polio Eradication Initiative. This initiative seeks to make sure that no child ever again experiences the crippling and fatal effects of polio.
At the 41st World Health Assembly in 1998-a while ago now-a resolution passed by delegates from 160 member states launched the Global Polio Eradication Initiative. This initiative was spearheaded by the World Health Organisation, the wonderful Rotary International, the US Centres for Disease Control and Prevention and UNICEF. Since then the Global Poverty Project, in conjunction with Rotary International, UNICEF, the World Health Organisation and the wonderful Gates Foundation, have continued to work on the initiative and are calling on the Australian government to place polio eradication on the agenda for the upcoming Commonwealth Heads of Government Meeting. As we heard from Senator Pratt, there will be a major public engagement concert with a whole lot of bands-which, I have to admit, I had not heard of very well-getting together to entertain and raise awareness, and that is important. With a quarter of the world's leaders travelling to Perth for that meeting, Australia has a unique opportunity to focus global attention on this monumental and essential eradication opportunity.
Michael Sheldrick is the Australian campaign manager for the Global Poverty Project, an education and advocacy organisation focusing on ensuring that both the public and private sectors in OECD nations take action to contribute to the end of extreme poverty. Only last week he met with the Prime Minister, Julia Gillard, to discuss the Global Poverty Project's call to make the eradication of polio a priority issue. Mr Sheldrick was able to hand the Prime Minister a letter signed by over 700 Australians, outlining why Australia should step up its efforts to eradicate this disease. In his blog Michael said 'the eradication of polio-a cause which has been making considerable progress since Australian Rotarians commenced their global eradication push in 1979' must continue.
Collaboration globally between governments, local communities and NGOs has successfully reduced incidence of polio by 99 per cent-so near. That last one per cent globally is the most difficult and expensive to immunise. There are serious challenges facing health and aid workers: geographic isolation, armed conflict-because many of the nations which are still facing this awful disease are involved in horrific conflicts within their own nations as well-and ongoing cultural barriers. But the challenges are not there to stop us; they actually should encourage us to do better.
Currently the initiative faces a worldwide shortage of money of about US$590 million for the full implementation of its 2010-12 polio eradication and strategic plan. Failure to meet the financial requirements of eradication is really a failure to protect future generations from polio. In the next 40 years more than 10 million children will be paralysed if the world does not capitalise on its US$5 billion global investment in eradication.
In the last sitting week there was a special event hosted here in parliament by the Parliamentary Group on Population and Development. It had as its goal the end of polio. At the event were many members of parliament, diplomatic representatives from Commonwealth member states, and members of the Global Poverty Project, Rotary International, the Burnet Institute and UNICEF. The 2011 Australian of the Year, Simon McKeon, talked to us about how he felt the project should continue:
… we've dropped the ball in relation to going on beyond smallpox and dealing with other conditions, particularly polio … We've done 99 per cent of the work. We've actually done the majority of the hard work. It's just a matter of getting serious for once, putting the final nail in the coffin of this condition and dealing with those last four countries in which it's still endemic.
Mr McKeon said:
I'm looking forward to a positive announcement by the Australian government which says very plainly that we're part of this global effort to rid the world of this disease once and for all
This year saw some impressive contributions made to the Global Polio Eradication Initiative. One that I think is well worth noting is that earlier this year the Crown Prince of Abu Dhabi, His Royal Highness Sheikh Mohammed, together with the Gates Foundation, committed a total of US$100 million to the global health partners the GAVI Alliance, WHO and UNICEF. The British Prime Minister, David Cameron, announced a matching grant a few days later. With this grant the UK doubled its contribution to the eradication of polio.
I need to pay particular attention to the wonderful work of Rotary International. Over the years, Rotary have donated more than $1.2 billion to the eradication of polio, and we need to keep working on this goal. Rotary across the world have been fighting polio for 23 years, and through their network of over 33,000 clubs in 200 countries they keep this item clearly on the agenda and mobilise a marvellous volunteer army. The volunteers are working at a local level providing support at clinics and mobilising communities for polio eradication actions and immunisations-not just fundraising but visitations to countries and working on the ground, and then bringing back their knowledge and talking about these issues in our local community.
There are so many reasons for Australia to support the Global Polio Eradication Initiative. The first is humanitarian, the second is economic and the third is because we can do it. All Commonwealth countries, including Australia, have a stake in the elimination of the disease, and our opportunity to end suffering has never been greater. A study published in the Lancet in 2007 showed that the cost of eradicating polio once and for all is billions of dollars less than the cost of merely keeping infection levels where they are now. The economic benefits over the next five years more than make up for the cost of eradication. A study in the journal Vaccine in December 2010, a cost-benefit analysis of this project entitled, catchingly, 'Economic analysis of the Global Polio Eradication Initiative', assessed investments made since the formation of the GPEI-the initiative-in 1988 and those predicted until 2035. It is estimated that the efforts will prevent more than eight million cases of polio in children, which saves so many dollars-you cannot even count the billions-in reduced treatment costs and productivity gains. The lead author of the study, Dr Tebbens of Kid Risk Inc., said:
The GPEI prevents devastating paralysis and death in children and also allows developing countries and the world to realize meaningful financial benefits.
We have had success. In 1994 the World Health Organisation was able to declare that the 36 countries that make up the region of the Americas were polio free. In 2000 the Western Pacific region, of 37 countries, was also declared polio free, and the incidence of polio has decreased so much since 1988, from an estimated 350,000 cases worldwide to just 1,600 reported cases in 2009.
One of the more fascinating issues is a story that has been documented on the web about the one case of polio that has been documented in India this year. I will go through that case. It is a little girl named Rukhsar. The Global Polio Eradication Initiative is striving to make sure that she is the last person to suffer from this condition in India. They talk about her family. She is the only one of her siblings not to be vaccinated against polio, because she was a sickly little girl and was often ill before she contracted polio. Because she had been unwell, her parents were reluctant to vaccinate her. This made a major difference. Her mother said that she did not even know what polio was. They thought that the polio drops were for general good health. Her father said:
I made a mistake by not giving her polio drops. I would beg every parent to vaccinate their child and not make the same mistake.
Now Rukhsar is the face of the need to eradicate polio on our planet. She is actually developing quite well, according to the website. Her condition is improving, but the physiotherapists working with her do not know whether she will ever be able to walk freely again. Compounding the loss of control of her legs, Rukhsar's parents worry about her prospects for schooling and employment and about her future. This shows us what the impact is.
That leads on to what I want to discuss in the last few minutes. Senator Pratt mentioned that we have many polio survivors in our country, people who were children when they caught this disease, just like Rukhsar in India. They have lived on and now polio survivors in Australia form the largest single disability group identified in the country. Between the 1930s and 1960s, more than 40,000 Australians contracted paralytic polio. The Australian experience of polio has shown that, as people age, they may develop new symptoms known as the late effects of polio. The symptoms are not infectious, but they are serious, debilitating and painful.
One of the consequences of Australia's success in eradicating polio is that many survivors who experience late effects find it difficult to obtain accurate diagnosis and treatment from health professionals, who often confuse the symptoms with the effects of just getting older. These late effects of polio will become a serious health issue in Australia as our population ages. We need to be aware of this and to be in a position to provide effective services.
The need for Australia to intervene on the late effects of polio was recognised by the federal member for Ballarat, Catherine King, who moved on the 17 August 2009:
That the House recognises that:
… the needs of polio survivors have been largely neglected since vaccination against the disease became a reality, and as they age with chronic disabilities this neglect must be addressed as a matter of urgency.
We heard from Senator Pratt about how the President of Polio Australia, Gillian Thomas, herself a survivor of polio, said:
The onset of the late effects is a cruel blow to polio survivors who fought hard to overcome their original disability. As we now increasingly lose mobility, function and independence, knowledgeable health care professionals who understand our unique issues are critical to maintaining our quality of life and our ability to continue as valued, contributing members of society. This is why Polio Australia's strategies for nationally consistent information and education programs are so essential.
Gillian's story is a clear example of the personal impact of this disease. We need to listen to and learn from her and other survivors about what we can do, as a nation, to help her and others.
Simon Moss from the Global Poverty Project recounted a story about his mother. He said:
When I was a kid, I never understood why my Mum walked funny, and always needed to rest.
I remember walking to school with her once-I would have been eight or nine. I ran off ahead, and she shouted after me to stop. I didn't- I thought it was funny. She tried to run after me, but couldn't. She seemed really upset, so I came walking back.
He went on to tell a deeply moving story about how he related to his mother, a polio survivor. This is an important way to understand.
We have had amazing success with our medical science in developing responses to a whole range of diseases. We saw, through the eradication of smallpox and the development of vaccines, that we can make a real difference. In 1998 at that world health assembly, Professor Fenner, who was instrumental in the eradication of smallpox in Australia, said:
By eradicating smallpox we no longer have to vaccinate young children, and as someone who myself received the smallpox vaccine as a young boy, when we were travelling to Indonesia, I can attest that it was a pretty painful vaccination to receive.
But it made a difference.
What we can do, during this month when we are talking about raising awareness of poliomyelitis and polio across our community, is learn from the successes of the past. We have been able to eradicate smallpox from the globe. As we know, we have eradicated 99 per cent of polio. There are two challenges for us. The first is to deal with that last one per cent across the nations of the globe, to ensure that people do have vaccination and support so that we have no more cases like that of little Rukhsar in India. The second is to understand the number of people living in our community-our neighbours, our friends, our family-who have survived polio but are now suffering the ageing conditions linked to that. We have a double responsibility and we can make a real difference. It is so important during this month-not only at the CHOGM but through community activities across our country-for us to maintain this message and to ensure that we understand and are part of the solution to this world curse.
