Successes

The Process of Saving Lives: What is Possible?

In the beginning there were small pox vaccination campaigns. Smallpox was eradicated in 1981. About that time a Rotarian from Australia happened to sit down in a plane next to an official of the World Health Organization (WHO). They got talking. The Rotarian asked the WHO official, what's next after smallpox? The official answered, if you're serious, Polio. The Rotarian interested his friends, who in turn enlisted their Rotary Clubs and Districts to provide vaccine for whole countries, starting with the Philippines .

Then the project spread like wildfire through Rotary.

In 1984-85, Rotary International picked a cause. That cause was raising the money to buy enough polio vaccine to provide to any country (asking for it) for free, for forever. Period. Then, Rotarians raised the money (twice the amount WHO said was needed), and they handed the donations to the WHO.

With The Rotary Model we can lower child mortality by 50% within the decade. Public health efforts can drop child mortality by 5 million lives per year by 2010.

When Rotarians raised the money for PolioPlus, the money was to provide free vaccine for any country that asked for it. After Polio had been totally controlled in various countries, it become officially eradicable. Rotarians were about to leave when various partners suggested that Rotarians may have some other roles to play in the campaign. Rotarians stayed. Their contributions are now legion and legendary, including arranging over 100,000 volunteers to participate in vaccinating over 100 million children in one 24-hour period. Taken from, http://www.who.int/whr/2003/overview/en/index3.html , the Global Health Report, the WHO states,

Global Polio Eradication Initiative, one of the largest public health efforts in history, the number of children paralysed by this devastating disease every year has fallen from over 350 000 in 1988 to about 1900 in 2003; the number of countries in which the disease is endemic has fallen from over 125 to seven…. The vision of a polio-free world is within reach, although formidable obstacles remain.

The successes to date are the result of a unique partnership forged between governments, international agencies, humanitarian organizations and the private sector. Through this partnership, over 10 million volunteers immunized 575 million children against polio in nearly 100 of the lowest-income countries in the world in the year 2001 alone. The most visible element of the polio eradication initiative has been the National Immunization Days, which require immunizing every child under five years of age (nearly 20% of a country's population) over a period of 1--3 days, several times a year for a number of years in a row. In many countries, the scale and logistic complexity of these activities were even greater than those of campaigns undertaken during the height of the smallpox eradication effort.

While Rotarians have many ways to contribute, we do NOT suggest malaria, measles, or any other disease as the successor to PolioPlus. The true successor to PolioPlus is a method, a model of implementing good works. The Rotary Model. With The Rotary Model we can lower child mortality by 50% within the decade. Public health efforts can drop child mortality by 5 million lives per year by 2010.

Measles is on the fast track to eradication, thanks to The Rotary Model. When working on the Polio Campaign, officials from the Centers for Disease Control and Prevention (CDC) in Atlanta noticed two things. First, they noticed that Rotarians had broken National Immunization Days into 3 components:

• Mass Social Mobilization – getting huge numbers of people to come to vaccination stations.
• Logistics – creating a cold chain to keep millions of doses of Polio vaccine cold until being delivered, and managing the millions of people the vaccine was delivered to.
• Surveillance -- ongoing monitoring of symptoms that look like Polio in the general populace to make sure Polio is gone. If Polio is not completely gone, it can come back. The only way you can tell if Polio is gone is through DNA testing. Rotarians set up and equipped dozens of laboratories across the world for testing. The idea -- always thinking ahead – was to leave the labs for later efforts.

The Rotary Model delivers essential goods and builds the capacity of the health care system to deal with the local problems and address opportunities. The vaccines and medicines save lives and improve health immediately. The Surveillance Clinics provide bricks and mortar laboratories and trained personnel who can readily apply their skills to new challenges. The Rotary Model creates progress in the most fundamental way, by showing and training the local professionals and volunteers how to deal with their own issues. Furthermore, with PolioPlus, anytime vaccinators go out, they deliver several vaccines and often medicines. The idea of 'Several inputs in one carry' lowers costs for all parties and changes the outlook.

Second, the CDC guys noticed that the model would work on measles. They tested the methods from ‘Proof of Concept', ‘Scale up', through full country rollout. The results surpassed their most optimistic expectations. In a few short years, indigenous measles has been controlled, totally contained, in the Americas . The last step, Surveillance by DNA phyllotype testing, has confirmed that the only measles in the western hemisphere is imported. Monitoring and mop up campaigns makes sure the disease does not escape its containment.

Measles

There are many partners using the Rotary Model for mass vaccinations. Meet the Measles Initiative comprised of:

• American Red Cross
• International Federation of Red Cross and Red Crescent Societies
• United Nations Foundation
• Centers for Disease Control and Prevention (CDC)
• World Health Organization (WHO)
• United Nations Children's Fund (UNICEF).

At http://www.measlesinitiative.org/mip2.asp , they describe their structure as: "The mechanism for the Initiative is an American Red Cross-led partnership with operational support to African National Societies. The partnership has adopted the highly successful Rotary-led global polio eradication initiative as a model. "

No deaths from measles have occurred in 13 of the 14 countries covered by the campaigns.

It goes on to describe the value of partnership:

In the battle to reduce mortality from measles, partnership is crucial because each player brings a different strength and talent to bear. WHO designs the policies and health guidelines for each country to ensure proper, safe steps are taken during immunization campaigns. UNICEF is the only organization allowed to import the vaccine into Africa and has a sophisticated logistics capacity as well as great stature in the country. CDC provides funding and the technical and scientific basis for the policies and advises countries on program planning. The UN Foundation provides a substantial amount of funding as well as the financial mechanisms necessary to move funds between agencies and to countries. American Red Cross provides funding and has the network of branches around the world and the volunteers to do social mobilization, ensuring each child has a chance to be immunized.

The Measles Initiative improved the Rotary Model. To it, they added near total transparency and emphasized local empowerment. The results of the Measles Campaign are far beyond expectations. The initial goal was to halve the death toll from measles. No deaths from measles have occurred in 13 of the 14 countries covered by the campaigns. The results far surpass what was thought possible. Measles Partnership Fosters Resolve for Elimination states, "Already, the Initiative has vaccinated more than 68 million children in Africa and prevented the loss of an estimated 100,000 lives." More than a million lives will be saved by the Measles campaign in a few short years.

last updated 25 May 2006