Polio: The Odyssey of Eradication

by Thomas Abraham

In 1988, the World Health Organization launched a twelve-year campaign to wipe out polio. Thirty years and several billion dollars over budget later, the campaign grinds on, vaccinating millions of children and hoping that each new year might see an end to the disease. But success remains elusive, against a surprisingly resilient virus, an unexpectedly weak vaccine and the vagaries of global politics, meeting with indifference from governments and populations alike.
How did an innocuous campaign to rid the world of a crippling disease become a hostage of geopolitics? Why do parents refuse to vaccinate their children against polio? And why have poorly paid door-to-door healthworkers been assassinated? Thomas Abraham reports on the ground in search of answers.

Genres: Nonfiction, History, Medicine, Science, Medical

320 pages, Hardcover

Published October 1, 2018

Reviews

[Prakhar Sachdeo · Rating 5 out of 5]

Polio The Odyssey of Eradication by Thomas Abraham delves into humanity's long quest to eradicate poliovirus.

The book is penned by a journalist. The writer in the Author's Note says, "Books about disease, and the efforts of men and women to protect humanity, tend to be written by epidemiologists, medical practitioners or historians of medicine. I belong to none of the professions." Hence in the three parts of the book (Part I: The Virus, The Vaccines and A Crippled President, Part II: The Road to Eradication, and Part III: The Long Endgame), the author gives an all-round view of the disease. The author sheds light on the history, the science, the politics, and the humanitarian aspect of the virus and the human race's prolonged tussle with it. To the author's credit, he has maintained a perfect balance between all the subjects. Hence there is just the right dose of science jargon, historical dates, and critical commentary. The research that has the author has put in exceptional and writing sharp.

It is fascinating to know the biologics of the virus, the fierce competition that drives the scientist to develop a vaccine against an infectious disease, why some disease draws the world's attention while other malaises are forgotten, and the geo-politics of a disease.

Honestly, reading the book during the 21st century's deadliest pandemic makes a lot of sense. As the author writes: "Disease is one of the many mirrors we use to understand ourselves and the societies we live in." After all, one of the oldest virus afflicting the human race can tell us a lot about the newest virus tormenting the human population.

[Steve · Rating 5 out of 5]

Excellent look at the microbiology, health policies, and politics of polio eradication

I enjoyed this book. Thomas Abraham created a great story about the ongoing attempt to eradicate polio. He gives a lot of background in polio and vaccines but in a non-technical, very conversational way. The book isn’t so much about polio itself; it’s about the way that the World Health Organization, other multinational health organizations, and different governments collaborated in the effort. It’s also about resistance to the program on the part of many of the countries that had larger local health issues than polio. It all makes for fascinating reading that incorporates microbiology, health policy, and politics. It is well worth the read and I strongly recommend it. If you liked Smallpox: The Death of a Disease: The Inside Story of Eradicating a Worldwide Killer by D. A. Henderson, I think you will like Abraham’s effort.
Disclosure: I received a complimentary copy of this book via Edelweiss for review purposes.

[Alexander Telfar · Rating 3 out of 5]

Interesting book. Ended up skimming the last few chapters.
The most interesting questions covered IMO were;

> Given that there are more deadly diseases, why are we spending so much effort to eradicate polio?

The answer seems to be (vastly simplified); because of FDR. His illness (possibly not even polio, but at the time everyone though it was) lead to massive campaigns by the NFIP. Later, Americans generously footed the bill via the Rotaries, who spent billions on the eradication attempts.

> Is eradication even a good idea?

It is possible to synthetically build polio in the lab. So even if we eradicate the disease, there is no guarantee it is gone forever. The release of polio in a population with no resistance would be devastating.
It also seems a more than a little disingenuous to claim that the disease might be eradicated, while a close relative (that has consistently mutated into the polio virus) is still at large (the weakened Sabin virus).

Otherwise, I was surprised by the gung-ho/reckless testing of the vaccines (e.g. on mentally ill kids) and the morbidity of the source of the vaccine (powdered chimp spinal cords). Many kids were infected with polio via both the dead and live vaccines (although on the whole more were saved). The cheap and easy to distribute vaccine was chosen (Sabin's vaccine), rather than the safe and effective vaccine (Salk's vaccine).
In hindsight I shouldnt have been so surprised, it was a classic story of pride and arrogance amongst men.

I was also interested to learn that a/the reason the UN added it to their agenda (rather than focusing on horizontal health care via better infratstructure and health services) was and is that other are willing to pay for it (Rotary, Bill and Melinda Gates, ...).

I am still interested about some of the IP and commercial issues around the production of the vaccines. Who pays, how much profit is made, who does it go to? But the book didnt really cover those issues.

I do have to say that I am deeply impressed by the amount of coordination and the scale that is being worked at. Millions of children receiving vaccinations in coordination across different countries.

Now that I am an expert in polio eradication, my opinion is that the effort has failed, we/the UN should consider more targeted approaches to aiding developing countries.

[Gregory · Rating 3 out of 5]

This was a very interesting book. Certainly has been helpful to me as I begin my new job. It needs to be better edited. There were quick a few typos or repeated words. He repeats spelled out acronyms and peoples names and positions frequently which initially I found annoying, but I soon found it to be helpful. I do think he spend to much time rehashing material from other chapters when it was pertinent to the current discussion. Maybe I would feel differently if I had not read it so fast, but I think the writing should be tightened up. Lastly, I free anti-vaccine proponents will misuse the information in this book.

[AMAN SUBAIDA · Rating 5 out of 5]

exceptional unbiased read through the history of the biggest eradication in the history of mankind and its incomplete journey through bureaucracy, internal politics, ethical conflicts and sloppy calculated guesses. as a person whose interested in public health, it sure gave me spiraling goosebumps in every chapter. this is a must read.

[Donna · Rating 2 out of 5]

The prologue and first chapter of this book should be required reading for everyone concerned with global health. After that, the details are a bit of a slog. Worth reading if you are in the field, but not really aimed at the layman.

[Shreejana Bhattarai · Rating 5 out of 5]

Great story of the journey of polio eradication program from vaccine development to the players of global health programs, the complications of implementing global scale program, difficulties in developing countries etc. Simple words so easy to understand. Was captivating at times.

[Tamil Vetri]

Authors perspection may be biased, but still an interesting read