Introduction to Global Alliance

SVEA CLOSSER: The Global Polio Eradication Initiative is a partnership of a number of different organizations– U.N., government, and foundation– and it has been that way for the entirety of its existence. And it’s very, very helpful to think about the history of this and to understand the history in order to think about what lessons can be taken from this for other health initiatives. So we’re going to start today with the story of how Europe ended polio through Operation of MECACAR. So as you watch this video think about the kinds of collaboration that had to happen to make this possible both between U.N. agencies and also across political actors and governments.

NARRATOR: From his home in St. Petersburg, George Oblapenko remembers a meeting in 1991 where new laboratory information explained why Europe was facing up to 300 new polio cases every year.

GEORGE OBLAPENKO: All outbreaks, all cases in Europe it was a result of the importation of polio viruses from India, Pakistan, and Afghanistan.

NARRATOR: The smallpox veteran had a $20,000 budget to end polio in 41 countries. As the Soviet Union collapsed, another dozen countries became his responsibility.

GEORGE OBLAPENKO: I had to prepare a plan of action because it was no plan of action for polio eradication in the region. And then suddenly what I’d drafted in 1990 started to be useless in 1991.

NARRATOR: Polio from outside Europe continued to cause outbreaks. By 1994, George needed a new plan. He and a colleague at WHO’s eastern Mediterranean region had an idea. Why not coordinate polio campaigns across the regions? After all, polio knew no boundaries. He raised the idea with experts and they liked it.

GEORGE OBLAPENKO: You know, George, it looks a very sexy project. This may work. When I started to count what I might need, and definitely vaccine was the first, I was shocked because the figure was $5 million US.

NARRATOR: George took the idea to Rotary International. They were willing to help fund it if countries were also on board. So he presented to country immunization leaders and they also agreed. Operation MECACAR was launched on World Health Day in April 1995. About 55 million kids would be vaccinated in the same week. But would it work? George was encouraged when he found a lone vaccinator carrying a bucket of ice in a remote area of Kazakhstan.

GEORGE OBLAPENKO: She said that it’s a great day because today 18 countries or for the region and our neighbors join efforts to vaccinate kids and to protect them from poliomyelitis. And it will come one day that there will be no Polio anymore.

NARRATOR: Operation MECACAR grew as Russia joined. Funds continued to flow. Partners showed full support. The results in Europe were especially impressive.

GEORGE OBLAPENKO: After ‘97 it was outbreak of cluster of polio cases in Turkey and then it was over.

NARRATOR: In November 1998, Melik Minas of eastern Turkey was the last child paralyzed by indigenous polio in the European region. George remembers many lessons from Operation MECACAR. The need for clear plans of action, trained and motivated health staff who understood why they were working so hard, partners who were indispensable, and one can add George having a huge vision. He thanks the people he worked with.

GEORGE OBLAPENKO: There were many teams which understood, that worked together for a great purpose to solve big problem. It’s very good satisfaction.

SVEA CLOSSER: So the story of how polio was eliminated from Europe is one story. But there are more stories about different regions of the world, and all of them involve some of the same actors and some different ones. And understanding those trajectories is really useful in understanding what’s happening with polio today. So today we’re going to talk about the history of the global Alliance. We’ll start with the Americas, and then we’ll talk about how that alliance has shifted and developed in other regions of the world. We’ll talk about the key actors from U.N. organizations, to bilateral donors, to governments who are implementing polio eradication activities, to foundations.

We’ll talk about some of the challenges involved in that complex collection of actors, and how the program has been reorganized in attempts to make it more efficient. And then we’ll talk about how the current polio program is organized and why.