Polio eradication
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Maputo, 29/9/97
The American Journal of Public Health (Vol 87, No 6) published in
July an article by Carl Taylor, Felicity Cutts and Mary Taylor, ti-
tled "Ethical Dilemmas in Current Planning for Polio Eradication". In
this article, the authors raise concern about of intensification of
World-wide efforts, in particular of organising National Immunisa-
tionDays (NIDs).
The major argument for eradication of polio is the high benefit-cost
ratio. Globally the benefits will exceed the costs by 2007, with cu-
mulative savings of US $ 13.6 billion by 2040 (Bart et al. Bulletin
of the WHO / 74, 35-45). However financial benefits are greatest for
rich countries.
According to the article, two evaluations have reported both positive
and negative effects on sustainability of Primary Health Care.
The article raises in its introduction a number of highly relevant
questions, related to a basic policy question how global goals and
local priorities can be balanced and what the ethical implications of
current choices are.
Most important is to my opinion the following specific question:
Should poor countries with many health problems, that could be
controlled, divert their limited resources for a global goal,
that has low priority for their own children?"
A controversial but highly interesting question, which brings us also
to e.g. the following underlying questions.
- Can an individual country afford not to participate?
- What does an individual poor country benefit from NIDs ?
- What are the direct costs (both human and monetary) ?
- What are the negative effects of NIDs on sustainability of PHC ?
- Can these be minimised and how ?
Considering the fact, that NIDs have been / will be organised this
year in almost all sub-Saharan African countries, please react to
above. Include in particular your own experiences and personal ideas.
Regards,
Bert Schreuder
mailto:bert@schreud.uem.mz
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