Washington — A more than 50-year relationship that has survived the Cold War and the dissolution of the Soviet Union remains strong, vibrant and still vital in the global effort to eradicate polio and combat other health threats.
At the G8 summit in France in late May, leaders from Russian and U.S. science and health institutions signed an agreement to sustain their scientific cooperation in the fight to eradicate polio.
“It’s not just a diplomatic piece of paper that was renewed recently,” said Dr. Stephen Cochi, a senior adviser in the Global Immunization Division at the Centers for Disease Control and Prevention in Atlanta, Georgia. “It’s a living, breathing collaboration.”
A 2010 polio outbreak that began in Tajikistan provides a keen example of the importance of the Russian role in an international collaboration against this paralyzing disease, says CDC epidemiologist Steven Wassilak. He was a member of a multinational, emergency team sent to Central Asia when the first cases of polio began to appear in March and April 2010. With a still developing medical infrastructure, Tajikistan relies on laboratories in Moscow to process specimens, but the need for accurate and speedy analysis is imperative when a contagious and fatal disease is suddenly striking children and adults alike. Wassilak says the University of Moscow and the Chumakov Institute for Poliomyelitis really delivered.
The laboratories “were working under incredible pressure,” Wassilak said in an interview. “The importance of the work they did can’t be overstated.”
Tajikistan had been considered polio free since 2002, but ultimately, almost 500 cases were detected and a handful of cases appeared in the neighboring Central Asian countries. Launching a major immunization campaign is the proper reaction to an outbreak, and Wassilak says a “well-executed international response” came together within two weeks. Because of an urgent need for vaccine on very short notice, international partners helped rush vaccine to where it was needed.
“CDC provided vaccine to all five of the Central Asian republics, totaling about $8 million,” Cochi said.
HISTORY OF COLLABORATION
Medicine’s progress against polio and U.S.-Russian collaboration in health issues have moved on parallel tracks through the last half of the 20th century to today. The oral polio vaccine developed by Polish-American Albert Sabin was field-tested in the Soviet Union in the late 1950s. That collaboration “was the stepping-stone to that vaccine becoming licensed in the United States in 1961, and then elsewhere in the world,” Cochi said.
Effective vaccines and large-scale immunization campaigns have yielded dramatic reductions in polio cases in recent decades. The disease appeared in 125 countries when the international eradication effort began in the late 1980s. Now the disease occurs in nature — is endemic, in medical terms — in pockets of only four nations: India, Pakistan, Afghanistan and Nigeria.
The 2010 outbreak in Tajikistan, the first in the region since 2002, was a warning, said Cochi. The virus was genetically linked to an endemic virus strain found elsewhere, proving that “every country is a plane ride away from the virus being imported,” he said.
The 23-year old Global Polio Eradication Initiative (GPEI), involving an array of international partners including the CDC and the World Health Organization (WHO), has been enormously effective in bringing the caseload down from more than 300,000 per year in the late 1980s to 1,600 cases in 2009.
The collaborative effort has had a broad impact on health systems internationally, according to a WHO fact sheet. The GPEI has “expanded the capacity to tackle other infectious diseases, such as avian influenza or Ebola, by building effective disease-reporting and surveillance systems, training local epidemiologists and establishing a global laboratory network,” WHO says.
Despite the successes of the GPEI, eradication still has not been achieved; 2012 has become the target year. At the May meeting, the leaders of the G8 industrialized nations reaffirmed their ongoing support to make the final push against the disease. “Our past support has contributed to the 99 percent decrease of polio cases in the developing countries,” the leaders said in a unanimous statement. “We flag the need for a special focus on this issue and renewed momentum.”
The WHO estimates that more than 5 million people who would otherwise have been paralyzed are walking today because they have been immunized against polio since GPEI began in 1988.