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It's also a hopeful sign that the leaders of all three endemic countries have put their prestige on the line. Nigerian President Goodluck Jonathan pledges that polio will be wiped out in his country by 2015. Afghanistan's Hamid Karzai signed a polio-eradication plan in September and made a show of personally administering drops to children. But it's Pakistani President Asif Ali Zardari who has the most to gain--and lose--in the polio campaign. His daughter Asifa Bhutto Zardari is a leading spokeswoman for the eradication effort, recalling in speeches that her mother--the late Prime Minister Benazir Bhutto, who was assassinated in 2007--administered the vaccine to her when she was a child. President Zardari speaks of "my martyred wife," who dreamed of a world free of disease.
Pakistan is putting institutional power behind the sentimental appeals. After the December shootings, the government temporarily suspended the inoculation program, but Prime Minister Raja Pervez Ashraf quickly issued a statement confirming the country's commitment to the campaign. He called for an inquiry into the attacks, promised the safety of polio workers and pledged to proceed with plans to deploy 250,000 health workers to vaccinate 34 million children in 2013. Polio teams will continue to work at toll plazas, boarding buses and looking for children who don't have blue ink staining a finger--a mark applied by field workers after a vaccine has been administered. When they find an unmarked child, they vaccinate on the spot.
Appeals to religion and reason are being deployed as well. Health workers in tribal areas cite Koran verses that encourage the care of children and reach out to local religious leaders for support. If the mullah in Mohib Banda had endorsed the vaccine, says Saiful Islam, father of the paralyzed 6-month-old girl, "100% of the village would have accepted it." And how to answer those rumors of vaccine-related sterility? Tahira Yasmin, a polio worker for UNICEF, has a way: "I tell them I am married and young. If I were worried, I would not take it," she says. Then she downs a few drops. "They laugh and they let their children take it."
Rotary, WHO and the other groups had hoped to have halted transmission in all three endemic countries by the end of 2012. Now they acknowledge they will have to continue intensively vaccinating in 2013, especially during the comparatively cool months when the virus is at its weakest. "You pound the disease through the low season," says Aylward. "Then you need 12 months of no cases before you could say that we did it. You're not going to open the champagne at least until 2014."
When that does happen--when polio joins smallpox in the supermax lockdown of the lab--it will be an existential as much as a medical victory. Viruses and bacteria have had their way with humans since the dawn of history--a species-vs.-species war we have too often lost. We are on the brink of wiping out a virus that richly deserves extinction. The war may be slow, but there is no tonic like a big victory over a disease to ensure there will be more victories to come.