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May 02, 2010

USAID Polio Eradication Director Says Goal in Sight

by Rosanne Skirble

Long fight to end disease strengthens health systems in poor countries

In the early 1950s a worldwide epidemic of polio was in full swing. In the United States alone, 58,000 cases of this highly infectious and crippling disease were reported in 1952. Vaccines - which can prevent, but not cure polio - halted its spread in the U.S. and much of the world.  

Since the Global Polio Eradication Initiative was launched more than 20 years ago, cases of the highly infectious and crippling disease have decreased by 99 percent.  It was at about that time that Ellyn Odgen entered the field of public health with the Peace Corps in Papua New Guinea.

Getting started

For two years she ran a provincial disease control program for 80,000 people, managing on a limited budget, with scarce medical supplies and drugs. 

"I ended up trying to work around some of those obstacles and reach out to women in particular through non-governmental groups, through smaller women's clubs and try to provide information in a more sensitive way that would bring them in for services without setting them up to be ostracized by their community," says Ogden.  

The experience taught her "to be flexible, to learn to live with ambiguity and to keep an open mind."

After leaving the Peace Corps, Odgen continued to work on international public health projects.

In 1997, she took the reins of the U.S. Agency for International Development (USAID) polio program, coordinating U.S. efforts with health institutions, governments, community-based groups and donors around the world.

Odgen says great strides have been made since 1988, when the World Health Assembly targeted polio for eradication. The disease then was endemic in 125 countries. "Now we are only in four countries that have never stopped polio: India, Nigeria, Pakistan and Afghanistan, and a 99 percent reduction in cases and a huge restriction geographically of where the virus is located," she says.  

On the road

Ellyn Odgen spends a lot time abroad.

So much so that sometimes her husband and their two sons go with her. She manages large grants, attends mass immunizations, visits laboratories and supervises work in many countries.

She says war is no excuse to stop immunization and uses well-honed diplomatic skills and technical know-how to forge ahead. In 2009, Odgen was honored with the USAID Award for Heroism.

"I was seen as a credible emissary to negotiate the Days of Tranquility in the eastern Congo among the main warring factions. I had been discussing ceasefires with some of the key forces in Angola when Jonas Savimbi was still there. And, even today, I have an opportunity in Afghanistan to see where we can allow safe access and the vaccinators safe passage even thought there is ongoing conflict."

The vaccinators

Odgen works in remote areas, in crowded urban centers and slums. Her first question, like the one she asked of textile workers at a dye pit in Nigeria, is always whether their children have been vaccinated. "And they said, 'No,'" she says. "There's never been a vaccination team here. And this is after almost 10 years of [vaccination] campaigns."  The children in this forgotten slum were vaccinated the next day.

So far in 2010, 71 polio cases have been confirmed compared to 155 over the same period last year. But for each of those cases, Odgen says as many as 1,000 children carry the virus, but show no symptoms and can infect others.

Ogden cautions that the failure to eradicate polio would be detrimental to public health, not only in communities where polio still exists, but worldwide. "Because if we can't get this simple 13-cent vaccine to all of the children in the world, how are we going to bring the more difficult things to them."

Odgen says the fight to eradicate polio is one children of the world deserve. "It would rescue four million lives over the next 20 years," she says, "and It is our moral obligation to do so."