In these difficult and ill-starred days it is always good to have something genuine to celebrate, and the announcement earlier this week that wild poliovirus has been eradicated from Africa is definitely an event worthy of celebration. On the face of it, this leaves just Pakistan and Afghanistan to go before the global eradication of polio can be announced. However, it is not quite that simple, because the fact that wild polioviruses have been eradicated from Africa does not mean that all polioviruses have been expunged from the continent.
Originally the aim of the WHO was to achieve the global eradication of poliovirus by Year 2000, but a number of factors, including global unrest, civil wars and what appears to have been a rather confused eradication strategy, have caused a series of delays and disappointments. From what I hear from a number of virologists, the eradication campaign sometimes failed to get the balance right between using oral polio vaccines (or OPVs) and inactivated polio vaccines (or IPVs). OPVs are cheaper and easier to administer, but because they contain living (albeit weakened) viruses they are still capable of mutating to a virulent form and then re-emerging months later as new cases of “vaccine-derived poliovirus” among previously uninfected people. By contrast IPVs are more expensive and difiicult to administer (and less long-lasting), but they are incapable of causing further local spread of the poliovirus.
In mopping-up operations, the use of IPV seems to be crucial. The fact that in 2019 Africa still saw 320 cases of vaccine-derived poliovirus (up from 68 in 2018) shows that sadly, there is still some way to go before poliovirus is entirely removed from the continent.
However, the important polio eradication effort also has an unpleasant back-story, for men such as Hilary Koprowski and Stanley Plotkin, who were both deeply involved with the mass OPV campaign in the Belgian Congo and Ruanda-Urundi in 1957-60 in which nearly a million Africans were given experimental OPVs, have tried to blame my book, The River, for allegedly disrupting the polio eradication programme in countries such as Kenya and Nigeria. Naturally I was concerned and upset by such allegations, but when I investigated further I found that the alleged links to me and my book had been fabricated.
In 2004 I flew to Kenya, where I went through the archives of The Daily Nation newspaper and found that the article which Koprowski claimed had reported that the Catholic Church had “advised mothers not to take their children for polio vaccination as it was contaminated with HIV” did not exist. After making his false claim, Koprowski had written: “So one of the greatest efforts by numerous institutions throughout the world to completely eradicate a deadly disease may now be compromised because of The River.” [See Koprowski’s claims in his article from the Royal Society meeting, “Hypotheses and facts”; Phil. Trans. R. Soc. London B; 2001; 356; 831-833, available on this site.]
While in Kenya, I also interviewed Omu Onzala, the Kenyan AIDS vaccine researcher who, according to Science journalist Jon Cohen, had said that “ripples from The River have ’caused many problems’ in Kenya”. (This claim featured in Cohen’s article, “The Hunt for the Origin of AIDS”, published in The Atlantic Monthly in October 2000.) Dr Onzala acknowledged having been interviewed by Cohen, but staunchly denied ever having made such a statement about either me or my book.
Later I followed up on similar claims linking The River to polio vaccine refusal in Nigeria, which had been promulgated by both Hilary Koprowski and Stanley Plotkin in early 2004, shortly after the release of the film documentary, “The Origins of AIDS”, which had raised cogent questions about the safety of their 1957-60 central African vaccination campaign. Further details of the Nigerian episode are well-reported in an article by Maryam Yahya, “Polio Vaccines – ‘No Thankyou!’ Barriers to Polio Eradication in Northern Nigeria”; African Affairs; 2007; 106/423; 185-204, which is available on-line. This reports that in 2003 the four northern states of Nigeria (Kano, Zamfara, Bauchi and Niger), which are predominantly Islamic, were advised by the chairman of the Supreme Council for Sharia in Nigeria, Dr Datti Ahmed, that “modern-day Hitlers have deliberately adulterated the oral polio vaccines with anti fertility drugs and contaminated it with viruses that are known to cause HIV and AIDS”. By 1996 the population in the north of Nigeria was already sensitised to the more negative aspects of US-led drug trials by an incident in which an experimental anti-meningitis drug had been tested in children from Kano and had allegedly led to 20 of them becoming disabled, which resulted in a a US federal law-suit against Pfizer Inc. Intriguingly, the African Affairs article mentions that “In 1996, Uganda also experienced a boycott of polio vaccines with fears of contamination with the HIV virus and anti-fertility agents.” In short, rumours that polio vaccines were contaminated with fertility-reducing drugs and with HIV were already abroad in Africa in 1996, which was three years before The River was published.
I have always encouraged people to take polio vaccines when advised to do so, and after The River was published I stressed that my warnings about the experimental CHAT oral polio vaccine that was used in central Africa in the 1950s did not apply to modern polio vaccines which, as far as was known, were safe. [For further details, see my article titled “As far as is known, modern polio vaccines are safe”, available on this site, which was posted on line on March 3rd 2004, which was before my trip to Kenya.] It is shameful that men like Koprowski (now dead) and Plotkin thought that it was acceptable to use the rejection of polio vaccines in Africa as a device to try to discredit me, and to divert attention from their own careless practices with regard to the OPV campaign in the Congo in the 1950s. But that is exactly how they decided to respond to The River from the first…by cynically using falsehoods and spin. More will follow in due course.
But let’s leave that ugly business aside, and instead doff our caps to a successful and important step on the road to the global conquest of polio.
Here is a link to the article by Ruth Maclean in the New York Times which announces the latest development.
Ed Hooper. August 27th, 2020.