Transcript for CDC Press Conference: Can polio be eradicated despite recent setbacks?
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Press Briefing Transcript
Monday, October 24, 2016, at 12:00 P.M. EST
Please Note: This transcript is lightly edited and may contain errors.
MICHELLE BONDS: Good afternoon. Welcome to the CDC media briefing to mark World Polio Day. I am Michelle Bonds, director of Division of Public Affairs at CDC. CDC works around the clock and around the globe to protect people from health threats. Before I introduce our speakers, I would like to welcome those of you in the room and those joining us by phone. I would especially like to welcome the international media who are joining us through live web cast. Today our speakers will highlight historic progress towards eradicating polio and outline what is needed to achieve a polio-free world. Following brief remarks from our first speakers, we will take questions on the topic from media in the room and on the phone. When acknowledged please wait until you’re acknowledged by the moderator and state your name and affiliation before asking the question. The briefing will conclude with an opportunity for media here on site to get an opportunity to get a first look at the Rotary and UNICEF virtual reality showcase on polio. And now to introduce our speakers, we have Dr. Tom Frieden, the director of Centers for Disease Control and Prevention, Mr. John Germ, the 2016-2017 president of Rotary International. Mr. Reza Hossaini, Director of polio eradication UNICEF, and our special guest today Dennis Ogbe, para-Olympic athlete and polio survivor. Dr. Frieden:
Dr. Frieden: Thank you all for joining us. This is World Polio Day and it’s an important one because we are on the brink of eradication of polio. We are closer than ever. All too often in public health, only bad news is news. But today, we do have good news. I want to give you four numbers. Behind each of these numbers there are so many stories. In 1988, when the world committed to eradicating polio, there were an estimated 350,000 children disabled by polio. That is nearly 1,000 every day of the year. So far this year, there have been 27 diagnosed cases of polio. 350,000 to 27. Now two other numbers. In this period, 2.5 billion children have been vaccinated against polio and if it were not for this effort, an estimated 15 million more children would be disabled. 15 million people who don’t have to struggle with a disability. It isn’t so long ago, that polio was common in this country and elsewhere. When I did my medical training we still had the iron lung on the floor where we treated patients and one of my colleagues in medical school was struggling with post-polio syndrome. Today, we have learned also of two more funding announcements. Generous contributions from the Global Affairs Canada as well as former mayor Michael Bloomberg, $25 million commitment adding to his prior $100 million commitment and Ray Dalio, chairman and co-chief investment officer at Bridgewater Associates is donating $30 million and an anonymous donor $15 million all to overcome setbacks. Every year polio eradication is delayed the incremental cost is about $800 million. So it’s urgent to protect children and to be able to get over the finish line that we get additional resources. The event that Rotary International is having here tonight, along with CDC, will raise more awareness. The global polio eradication initiative is made up of five partners, Rotary International, CDC, World Health Organization, UNICEF and Bill and Melinda Gates Foundation. Eradication of polio is a CDC priority. In fact, for nearly five years we have had our emergency operation center activated so that all resources of CDC are available to help get over the finish line. There are four areas of action that we need to get over the finish line. First, the new cases in Nigeria highlight the need to improve tracking of the disease, particularly anywhere there may be insecurity. It is now clear that the disease was spreading in inaccessible, insecure areas of Borno for approximately five years before it was detected. That means that all over the world where there are areas that we don’t have access to, we need to make sure that polio is not lurking. Second, we have to redouble our efforts to get over the finish line in Pakistan and Afghanistan. Despite big obstacles, both countries are making substantial progress. Third, while focusing on interrupting the virus where it is still spreading, we have to transition the polio services and polio programs so that they protect the lives and health of children and others around the world. This is being done in areas which we are confident are polio-free we continue to track the polio but use resources to do other things that will also save lives. Fourth, we have to ensure that any remaining polio virus in laboratories around the world is contained, so that once eradication is achieved the virus doesn’t get out and become a problem again. The last mile of the journey is often the hardest. So it has been with polio. But it’s been a long journey, and we can see the end in sight. And that end lifts our spirits and our hearts and reminds us that we will get to a day when polio is history. It will be the ultimate in both sustainability and equity because it will be forever and for everyone. Thank you very much. I will turn it to John Germ, our wonderful partner from Rotary International.
John germ: Thank you Dr. Frieden. It’s a very exciting time to be a Rotary member because when Rotary first started this program in 1979, and then the partnership came we have been committed to this and we will remain committed until the end. Dr. Frieden said we are closer than before. It is also an issue to which I am personally committed to. My own father was struck with polio as an adult. The doctor said he would never walk again. My father was determined that, yes, he would walk again. So he did exercises just like you will hear from Dennis shortly. He and my mother tied an iron to his leg where the rope would never touch the ground and he lifted his leg little by little every day until he could walk again. He did walk again. He walked with a limp. He didn’t give up and I don’t give up. And Rotary does not give up. That is why this year as president of Rotary International I am more determined than ever that we will, in fact, keep up our efforts to eradicate polio until the job is done. That means that we have to double our efforts in Afghanistan, Nigeria, Pakistan. That means we have to have increased surveillance. It means strong immunization systems. It means vaccinating as many children as possible even in areas that are incredibly difficult for us to reach. We know what we need to do. It’s a matter of doing it in order to eradicate polio. We know how much it is going to cost. It’s going to cost us additional $1.5 billion in order to reach our goal of eradication. What happens if we don’t make the $1.5 billion? Polio will spread again. If it does it will cost us billions of dollars and it’s going to cost us hundreds of thousands of lives a year for those vulnerable children that we must protect against this virus. It can cost us a dream of a polio-free world. You heard the comments from Dr. Frieden about the recent contributions we got today. Rotary would like to thank those individuals for their contributions but we would also like to thank the Bill and Melinda Gates Foundation who have agreed to match Rotary $2 for $1 for up to $35 million that Rotary commits on an annualized basis to eradicate polio. I have been with Rotary a long time. I have seen us conquer polio in the Americas, the western Pacific areas, Southeast Asia. I have seen us donate $1.6 billion to immunize more than 2.5 billion children. Rotary started this, as I said a few minutes ago, more than 30 years ago. We have stayed with it and we will continue to stay with it. The polio virus is persistent. But Rotary is more persistent. We will, in fact, win this battle. And when we do all of us will have made good on a promise we made over 30 years ago, to leave our children, their children and your children in a world that is polio free. Thank you.
Reza hossaini: Thank you very much Dr. Frieden. It’s a pleasure to be among you. 27 cases. 27 cases as Dr. Frieden said. That is what it comes down to. After threatening, as you heard earlier on, the lives of millions and millions of children, polio is almost defeated. After countless frontline workers and vaccinations reaching to the remotest corners of the world, often in a very, very dangerous circumstances and to immunize countless number of children. We are talking about 2.5 billion children since it started. Polio is almost defeated. And, of course, after the massive global movement led by the government but the valued partnership that we heard earlier on, The Centers for Disease Control and Prevention, Rotary International, the World Health Organization, UNICEF and Bill and Melinda Gates Foundation and of course the generous support of the donors as you heard earlier on, polio is almost defeated. I say almost because the recent cases of polio viruses in Nigeria is a sharp reminder that almost is not good enough. It was for all of us a wake-up call that the work is not done unless it is totally done. We cannot afford to let go right now. We have to reach every single child no matter where whether it is an isolated areas of Myanmar or areas of Borno where we have not been able to reach children because of the inaccessibility. Just last week, after the military operation in northeast of Nigeria was able to create corridors and liberate areas for people to come out, they have about 2 million people who have come out previously inaccessible areas. Last week we had massive campaign, targeting 41 million children, not only in Nigeria but also because of the spread in the Lake Chad region covering five countries. It was the third round of five rounds of mass campaign in all those countries. And it was in order to prevent the wild virus circulation to neighboring countries because of the porous border and people moving back and forth. Yet we have had four cases so far, but we have to keep it in context. We are talking about 2 million people who had not received any vaccination for nearly three years. They have had four cases. That shows the resilience of the system to pick up the cases and second, to be able to control it over there. So the rapid response in Nigeria, the recent that we have all had in India, Somalia, the outbreak in Syria and the various strong progress that we have seen in Pakistan and Afghanistan is a testament to what we have built together and what we have been able to achieve. I believe that what we have done in places is a blueprint for doing even better from improving as Dr. Frieden mentioned before, to developing a base to reaching children we have not reached before. Today, Rotary and UNICEF are launching two new virtual reality videos that will clearly show how we have been able to achieve what we have achieved today. What we need to do is we need to finish the job because places like Nigeria, where there is wild virus, they put the countries like Kenya that have been freed for a while, at risk of importation. And once polio outbreak happens, it happens once and everywhere. So we cannot rest, and we will not rest, until we reach every last child with a polio vaccination. Thank you very much.
DENNIS OGBE: Thank you. It’s an awesome privilege to come here, Dr. Frieden, John, Reza. I’m really like a true story. Most of this they are talking about theoretical, so I’m the living example. I’m going to give you a snapshot of my life to see that polio is still real and the work you are committing here is going to go a long, long way. My name is Dennis, Dennis Ogbe. I’m from Nigeria. I was born in a village. When I was 3 years old I contracted malaria. I was taken to the hospital. While in the hospital bed I contracted the polio virus. As a young two year old lad, to have so much life and enthusiasm to see what the future holds for me I was paralyzed from my waist down. And then there are two things like back home in Nigeria either put you out to beg on the street or my dad, with his seventh grade education, knew that education was going to be my saving grace. So now that I’m paralyzed what do I do as a kid? I want you to imagine your own kid, some of you have kids here. A lot of kids in my neighborhood would taunt me, kids will always be kids. Back home in Nigeria our number one sport is soccer. We call it football over there. When I want to play soccer with my peers when they see me coming in my old raunchy wheelchair, mind you the areas are not as paved as we have here. So I need someone to actually help me. When the kids see me coming they go to higher grounds. And when they go to higher ground, it is impossible for me to get there. Somehow, due to my stubbornness too, I try to go on my crutches and then try to like hop and stay with them. So the sense of belonging that I’m playing with my peers. I kept doing it. So, when they see me, some of those kids say, “Dennis is coming.” Now they can’t push me away, they seize my crutches, they say take one step and then you can play. Next time they say, take two steps, you can play with us. While I’m doing that fall down with bruises here and there. A doctor told me that was a 50/50 chance to hurt myself even more. Low and behold, God was so kind, I overcame it and when I walk I walk with a big limp. My left leg is still paralyzed. Looking at that my dad told me — I told you earlier it is not how you — when it happened most times when the kids reject me, I can’t play, I go and cry. I cry really, really hard. Most times my mom comes and joins me. My dad or siblings join me. That’s how painful I want you guys to paint the picture. I will fast forward. So, it’s not left for me. What am I going to do? God is so kind, My dad told me it’s not how you [inaudible]– it is how you finish. He took me to go to school at an early age. Our schools, the road is not paved. There is no access to people with disabilities. It was really tough. It was really, really tough. Hopefully you guys will see the pictures later and you see how the kind of pain that we go through. But with God’s grace, I went to school and then I started competing in sports as you all know. But to cut a long story short, I got into sports in a very unique way. In the village where I grew up most of the opportunities are not always there but somehow I got involved with sports and through sports I tried to like lift myself up from where I was. And Mr. John talked about, your dad right? I did a lot of exercise on my own like, I had to improvise. There is no gym to work out and nobody to help me. I have to do a lot of things myself based on what I have heard and seen. So I lift weights, work on my legs. If you see how I coordinate my paralyzed left leg with my hip and upper body, the doctor says it is unimaginable what I do. That is through sport. I competed in shotput, discus and javelin, I tried all kinds of sports mind you, not just soccer. Basketball was [inaudible] and because I can’t run up and down the court, and it’s very physical, I try to do what works for me. In soccer guess what I did. Anybody here? What position I played? I was the goalkeeper. So most times when those kids try to kick it that way I have extra time to perfect diving time. Right now they don’t know what to do with Dennis. [Inaudible] I kind of try to stop it. Low and behold I cannot find people with disability to compete with myself like I am. When I went to Lagos for the first time to compete nationally, because there were only four sports, track and field, wheelchair racing, shotput discus and javelin. Those were all we had then. I thought shotput, discus and javelin was what I could do because I can use my hands. God gave me hands and talent that he gave me. So I started competing and to fast forward, I competed locally, I won. Nationally I won and I represented my country then. That was when I met Jim [inaudible] the head coach for Belmont University here in the U.S. He saw me, and saw how I was networking, and the way I throw. In Paralympics I have a special chair, I didn’t have one made for me and my country is sending me to international competition without enough tools. But with God given talent and what I have education, I have to network among the other athletes. I had to borrow a chair, and mind you, this is custom made. I borrowed a chair to compete. And when I compete I beat them with their own chair. So normally it’s supposed to be three throws. You have to throw the first three and then select others for the final. Most times when I beat them when I come back most of them refuse to give me that. I have to lobby again. While I was doing that, this coach was watching behind the scenes. Outside the competition he met me and spoke to me and gave me the opportunity to come to Belmont and told me I would be a good addition to the track and field program. This is where I am. Cut the long story short, I have my degree in business, and I have my MBA. I was competing with everybody out there. So while doing that, I am getting my citizenship in 2010. I compete locally, nationally and internationally, too. I was so fortunate to represent America in the Paralympic games in London 2012. I got married in the U.S. and have two kids. So I’m so blessed if you look at it if you try to follow my trend. And then looking at where I am today there is something in my heart that still burns, something that pains there. People that contracted polio will be there forever. To tell you the truth, there are times that even at home, when I don’t have my balance, well, I still fall. My little one says, “Daddy are you okay?” That is something that is hard for any parent to see and don’t wish it for his own kids for their own self. My plight to you all today is really crucial that whatever you say out there is really crucial. We have fought this fight, my colleague has talked about, a long time. But as a sportsman this is the toughest competition anybody can do. But we can do it. And we have been trying all along. And as we said we’re almost 99 percent so that yes, we can eradicate polio. With help, with organizations like Rotary International, UNICEF and other organizations and individuals — this is the time. Look at me. Look at my life. Look at what I have done. I have survived this. I am lucky but there are a lot of people that didn’t make it and died before 5 years old. There are many still suffering today. Some are very dependent and people have to help them do one thing or the other. Just with a drop, we can save lives. So without further ado, I want to thank you all so much for coming here. Thank you so much. It’s a privilege. [applause]
Dr. Frieden: Thank you sharing your story and for your story of triumph and determination and for reminding us that we are really at our best. We see the lives and the faces behind the numbers — because each one of those one thousand kids who didn’t get paralyzed from polio is a life story that has been changed. Each of those 15 million kids that hasn’t been paralyzed by polio over the past decade is a life changed forever. We don’t know their names but we know they exist. They are out there, as are the millions of children to be born in the future who we hope will be born into a world without polio. We are on the brink of eradication. The opportunity is the best it’s ever been. We have stronger childhood immunity, stronger surveillance. But we need to reach every last child including in areas of insecurity. Eradicating polio is achievable and it reminds us that health can be a bridge, something that everyone in the world can agree to, that we can work together on as a global community with common goals against a common enemy. The enemy is not other people. It’s a virus. Today, we renew our dedication and commitment to get to polio zero. Thank you.
MICHELLE BONDS: Thank you, Dr. Frieden. We are ready to take questions. For those in the room please raise your hand. Remember to state your name and affiliation before your question. Do we have any questions on the phone?
OPERATOR: At this time there are no questions.
JEFFREY KLUGER: I was just wondering we’re focusing so much, and rightly so, on Nigeria this year. The numbers out of Pakistan and Afghanistan are very encouraging but they haven’t reached polio zero yet. What progress has been made this year in those two other endemic countries?
TOM FRIEDEN: I will make some comments and then Reza or John will want to make more. We have seen really encouraging progress in Pakistan where there is much more accountable system, they’re reaching kids who weren’t reached before. There are areas of the country where vaccination could not be done in the past and is now being done. Surveillance indicators are strong and community vaccination initiatives have been highly effective and UNICEF has done a terrific job hiring thousands of women who live in communities and can provide vaccination even in areas where security may not be as we would wish. In Afghanistan we have seen progress in some areas but the security situation does make it challenging. And for that reason the travel between the two countries is particularly important. And we have been strengthening systems to vaccinate children as they move from one country to the next or within countries. Afghanistan has a more sparsely populated environment and that makes it less hospitable for the polio virus. However, there are parts of Afghanistan as in parts of Borno, Nigeria where vaccination can’t get securely reached. And really for any place in the world where we can’t get vaccines in and surveillance done we are concerned, given the lesson of Borno of Nigeria, that we need to intensify supervision, intensify surveillance so that we know for a fact, for sure and confidently that there is no polio there. There are parts of the world particularly in secure parts but we need to double down on that surveillance. Reza, would you like to add?
REZA: If I can just make the comment. You are right that we see tremendous progress in both Afghanistan and Pakistan. Look at Pakistan, they have had – the diversity of the virus has narrowed down. It’s the smallest that we have had. So that is a reduction. If we look at the data that we are getting out of the campaign there was a time that we used to have 9% of the children who had been vaccinated that were zero-dosed, that means they have not received any vaccination before. That has reached zero actually — the last round we didn’t have a single child that had not received a dose before. And then we look at the data in both in Pakistan and Afghanistan. We see the sharp decline on resistance. Another way of looking at it we look at the map of the polio virus 2015 and 2016 the virus is actually cornered in few areas both in Pakistan and Afghanistan. The Afghanistan one is an interesting one because as Dr. Frieden said we do have problems in some areas that are inaccessible, although we do the local negotiations, they are inaccessible. But you have four cases coming from a single village that has been with ISIS and we have not been able to negotiate access. But the virus was contained over there, so there is a wall of resistance that is built around that. That is part of the strategy. We do have right now because I’m sure you might have heard because of the population movement, because of the change of policies going back and that is where we have to keep our guard high up and make sure that the virus does not spread across the border.
MICHELLE BONDS: I would like to take a call from the phone.
OPERATOR: First question comes from Mike Stobbe with the Associated Press. Your line is open.
MIKE STOBBE: Thank you for taking my call. I had two questions. First, the gentleman from Rotary I believe said $1.5 billion needed to reach the goal of eradication. Could you all tell me who came up with that estimate and as detailed a manner as possible how that money would be spent, what you need to do with it in order to achieve that goal? And the second question is can you just say a little more about what the objective of today’s program is? Are you hoping it will attract more funding? Thank you.
JOHN GERM: I will start. The budget has been developed by a group of individuals that are professionals that are led by actually the Bill and Melinda Gates Foundation is working with us on our financial objectives. A budget has been put together and has been agreed to by the partnership as to what it will take in order to finish the job. Let us say that also that it takes three years after the last case for us to be able to declare that the world would be polio-free. During that same period of time while we may have 27 cases we are still having to provide vaccine and vaccinate about 400 million children a year. We are also providing surveillance in about 72 different countries. It costs a lot of money. Until each of these children, until there are no more cases we have to continue to vaccinate all the children in the world in order to protect them in case of wild polio virus does show up. So it is a very expensive thing and one that has been well thought out. I think that we are going to get that money. Today we are trying to make the public more aware. We have a lot of people in this world that don’t believe polio exists. Polio, in fact, does exist. So we have to get the word out there that polio is there. We have to continue our fight to that. It’s an expensive fight. Yes, it’s going to take a lot of money. We can get you a detailed budget if you would like to have a detailed budget. We can certainly provide that for you. There are no secrets in our game. We are open to everything and every suggestion and we’ll be happy to take any contribution we can get, too.
TOM FRIEDEN: Thank you, John. I think John said it well. We have this coalition of five organizations that I listed earlier, Global Polio Eradication Initiative. We looked carefully at the budgetary needs, those have been reviewed not only by the individual organizations and by a group looking very specifically at what is needed. And as I’ve mentioned, the problem is for each year that eradication slips into the future you have to continue the efforts for one more year. And when we open a new front as with Nigeria there are additional expenses to vaccinate more children not only in Nigeria but as Reza mentioned, in a five-country region where children are at risk and continuously improve surveillance so we can have confidence that there isn’t polio lurking anywhere else. Today’s event we hope draws attention to progress being made and to what is needed additionally not only in terms of resources but in terms of effort. Polio is almost defeated but almost isn’t good enough. And we want to get over the finish line.
REZA HOSSAINI: Just to respond to your question, maybe following what John – you mentioned we have to do the immunization. The 50% of the additional cost will go for making sure that there is a high level of immunity among the children. The other 50% it goes for sustaining the gain after we have interrupted the wild virus as it was mentioned, you’ve got to have a strong surveillance system. Eventually, our aim is to remove the oral polio vaccines. In 2016, I’ll just take an opportunity to say that, we had one of the largest public health globally that it happened in April 2016. 154 countries within two weeks to remove one of the OPV vaccines, one of the P2 – what you call the TOPV to make into the BOPP. We have to do the same again. Once we have made sure that there is no wild polio virus circulation and that requires the funding.
DENNIS OGBE: After all is said and done we have to keep that awareness going. And I guess that requires money, too. Because that education is very, very key. When my kid was born the hospital had all the immunizations and inoculations that needed to be done. Not all parts of the world do that. So we need to push that out in order to sustain it. So after a child is born and after the polio vaccine is given, that is not all I think that requires a lot of funding too, to keep it going for some time.
MICHELLE BONDS: Thank you. Thank you to our speakers today and for those of you in the room and joining us via phone or on web cast. We encourage everyone to participate in World Polio Day live stream event tonight at 6:00 p.m. eastern time by going to www.endpolio.org. This concludes our media briefing. I invite the media in the room to join us in the lobby to engage in the virtual reality experience. Media with questions about today’s topic can call the media line at 404-639-3286 or e-mail email@example.com. A transcript will be available at CDC.gov/media. Thank you.
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