Global Ethics Corner: Health Dollars and Polio

Polio is a deadly and crippling disease and could be eradicated. Are the costs worth the price?

Bill Gates made polio eradication his focus, estimating costs of one billion dollars a year for the next two years to achieve the goal

The Carnegie Council's Evan O'Neil explains Gates' rationale. First, we are close to eradication. Last year there were about 1,000 cases globally, concentrated in four countries: Nigeria, India, Pakistan, and Afghanistan. Next, eradication permanently frees resources for other health programs. Third, economic productivity of the afflicted regions improves. Finally, eradication would be a motivational victory, driving hope and investment. In addition, polio vaccination can be a gateway leading to routine immunization for common diseases.

However, both timeframe and dollars are disputed, and there are opportunity costs. Polio is difficult to kill. There are many strains; the vaccine is not 100 percent effective; parents refuse because one child in every two millions dollars is infected; and only one in 200 carriers show symptoms. Also, infrastructure is lacking.

Critics like Dr. D. A. Henderson, who led the successful smallpox campaign, felt that dumping billions into polio eradication was a misallocation.

Medical journal editor Richard Horton states, "Bill Gates' obsession with polio is distorting priorities…"

Gates responds, "If you don't keep up the pressure on polio, you're accepting 100,000 to 200,000 crippled or dead children a year."

What would you do? Push ahead with polio eradication? Settle for control? And, with a current shortfall of 700 million dollars a year, where would you find the money?

By William Vocke, adapted from Evan O'Neil

For more information see:

Evan O'Neil, "Drops Not Drones, Vaccines Not Marines," Policy Innovations, March 7, 2011.

Donald G. McNeil, Jr. "Gates Calls for a Final Push to Eradicate Polio" The New York Times, January 31, 2011.

Bill Gates, "2011 Annual Letter from Bill Gates."