In the New York City double town house where President Franklin Delano Roosevelt recuperated from polio in the summer of 1921, billionaire Bill Gates on Monday began the latest chapter in his campaign to rout the disease from its last global strongholds.
"Let us pave the way for a future where children, no matter where they live, are not at risk of polio," Gates said. "We owe it not only to the children of today but the generations of people who made the progress that we have."
Gates, co-chairman and trustee of the Bill and Melinda Gates Foundation, the world's largest philanthropy, reiterated his commitment to global elimination of polio at a high-profile event a day after the 129th anniversary of Roosevelt's birth. Gates used the occasion to release his third Annual Letter, a blueprint of his philanthropic goals, at Roosevelt House on New York's Upper East Side, once a wedding present from Sara Roosevelt to her son Franklin and daughter-in-law Eleanor, the current home of the Public Policy Institute at Hunter College.
Polio is Gates' No. 1 health priority for 2011. Half his 21-page compilation of goals focuses on eliminating polio and protecting youngsters from other vaccine-preventable diseases such as measles, pneumonia and tetanus.
Gates pegged the cost of fighting polio for the next two years at $2 billion. Of that sum, $700 million "still has to be raised," he told an auditorium packed with foreign policy and health dignitaries. "Polio eradication is going to take amazing work. There's no guarantees, but I truly believe we can succeed."
Gates was introduced by ABC News anchor Diane Sawyer, who called him "the man who has given us the conviction that you can turn enormous pain into enormous purpose."
Sawyer shared how polio had touched her family in Louisville, Ky.
"I grew up in terror of polio," she said, recalling how parents and children helplessly watched suddenly stricken friends and playmates disappear, leaving behind empty seats in school rooms. "My aunt had polio. She was in a long leather brace, and in her 80s still limps and still reminds us of a time when there was a random terror in our world."
Worldwide, new cases of the potentially paralyzing and sometimes fatal childhood illness have been cut 99 percent since governments of the United States, Great Britain and India, along with the United Nations Children's Fund, Rotary International and Gates Foundation, launched the Global Polio Eradication Initiative in 1988. But while polio may not be on the radar screen among residents of developed nations, the disease remains endemic in Nigeria, India, Pakistan and Afghanistan, and there have been outbreaks in more than a dozen other nations. In 2010, outbreaks in countries that once had vanquished polio sickened hundreds, including 458 in Tajikistan; 93 in the Congo and 323 in Angola. There has been one reported case this year in Pakistan.
Speaker after speaker on Monday made the point that polio remains everyone's problem, because if the international community lets up the pressure to quash it, polio could make a comeback in the developed world.
"Polio is kind of like fire, where you've got to damp it down, and if you don't … succeed in doing that, it will flare up in places, and that's where most of our cases are now," Gates said. "You see a lot of deaths, a lot of paralyzed children. It's a terrible thing."
In a morning heavy on symbolism, Gates assumed the polio prevention mantle borne by FDR and inventors of vaccines to stop the mid-20th century scourge that left children weakened, paralyzed and sometimes confined to iron lungs. The event, titled, "Polio Eradication and the Power of Vaccines," began with a welcome from James Roosevelt Jr., a grandson of the 32nd president, who serves as CEO and president of Tufts Health Plan. "Of all of FDR's legacies, the one that resonates the most strongly for me is his commitment to health equity," Roosevelt said. He called the campaign to see every child vaccinated against preventable illnesses "another great chapter of health equity."
In the second row sat Dr. Peter Salk of San Diego, a son of Dr. Jonas Salk, inventor of the first polio vaccine, an injectable inoculation that used dead polio virus. The younger Salk, scientific director of the Jonas Salk Foundation, spent much of his medical career researching cancer, autoimmune diseases and HIV vaccines with his father. He feels an imperative to finish the job his father started in the 1950s, and to which his father rededicated himself in 1977. "We have to understand that every problem in the world today is our problem also," Salk told ABCNews.com. He described the continued existence of polio as "a sore" that won't heal. But if it finally heals through a concerted international effort, he predicted that milestone would fuel other public health successes.
Seated next to Salk were Debbe Sabin, a registered nurse, and Amy Sabin Horn, who represented their father, Dr. Albert Sabin, inventor of the oral polio vaccine made from live, weakened polio virus. The Sabin vaccine has protected millions of American children and others overseas from polio, although it carries a tiny risk of infection. They sat by Cathy Hively, whose grandfather. Basil O'Connor, FDR's law partner, helped launch the March of Dimes campaign through which Depression-era Americans and Americans today continue to make modest contributions that collectively have provided millions of dollars to stop polio's spread.
Both the Salk and Sabin vaccines are used today and have a role to play in the worldwide push to eradicate polio, those gathered Monday said.
The roster of speakers in a panel discussion that Sawyer moderated included Dr. David Oshinsky, a 2006 Pulitzer Prize winner for his book "Polio: An American Story;" Dr. Helen Rees of the University of Witwatersrand in South Africa and chairwoman of the World Health Organization's Strategic Advisory Group of Experts on Immunization; Dr. Ciro de Quadros, executive vice president of the Sabin Vaccine Institute; and Ahmed Ghani, governor of Pakistan's Khyber Pakhtunkhwa district and federally administered tribal areas.
De Quadros, who believes polio can be beaten, said it has resurged in regions with scant resources, where "we are not having sufficient funds to apply the tools we do have." Rees said one of the major obstacles to further reducing the number of cases worldwide has been "the quality of our health services in our poorest countries," where there aren't enough people on the ground to provide needed vaccinations.
Ghani said 30 years of conflict have prevented access for 25 percent of people in those regions. He said he had discussed with Pakistan's army the idea of having soldiers distribute vaccines in hard-to-reach areas. Although vaccination refusals in the regions have dropped from 3 percent to 0.6 percent this year, they remain a significant hurdle.
Last Friday at the World Economic Forum in Davos, Switzerland, British Prime Minister David Cameron pledged to double the United Kingdom's contribution to fighting polio in the next two years, but that gift is conditional on other governments matching it 5-to-1, Gates said. The increase would enable 45 million more children to be fully vaccinated, advancing the goal of providing life-saving immunizations to every child who needs them.
But whether polio, like smallpox, can be driven from the planet remains to be seen. The World Health Organization sought to banish polio by 2000; other organizations set the goal for 2005. Those dates came and went, due largely to the hardiness of the poliovirus, which can survive several months in water and in human waste; the vulnerability of vaccines to temperature extremes; and the lack of sophisticated health services in countries where polio continues to spread.
But Gates, who has been a cheerleader for polio-fighting, came to New York to trumpet some successes. He noted that polio cases in Nigeria declined from 388 in 2009 to 19 last year, and in India from 741 cases in 2009 to 41 last year.
Perhaps the most emotional moment of the morning came when Sawyer invited world-renowned violinist Itzhak Perlman, who contracted polio at the age of 4 and uses crutches today, to provide his perspective on how to sell the public on finishing the job started by FDR, Sabin, Salk and O'Connor.
"Two letters: PR," the Emmy- and Grammy-winning soloist and conductor said from the back row. "There's a kind of PR with intensity that's needed," Perlman said, pointing out how athletes and celebrity spokespersons have raised awareness of many diseases.
"We should take the fruits of science and technology and say this is a problem we can fix," Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases at the federal Centers for Disease Control and Prevention, who flew in for the occasion, told ABC News. "We're so close."