World Health Organization
JHUMUNC 2017
1 World Health Organization
Topic A: The Prevention of Communicable Diseases
Topic B: Response to the Polio Epidemic
with the opportunity to rewrite history Thirteenth World Health during the committee sessions. To encourage the achievement of novel results Assembly: Committee rather than the summary of predetermined Overview outcomes in committee, delegates will limit their knowledge of information to the The World Health Organization historical time period leading up to the (WHO) was established on April 7, 1948. Thirteenth World Health Assembly (1960). The WHO is responsible for directing and Increasing polio epidemics in the coordinating international health within the early 20th century quickly became a major United Nations. The WHO engages in topic of concern as they left communities partnerships and provides leadership where handicapped and paralyzed. Advancements joint action is necessary on matters essential in medicine were not able to catch up to the to health. It also shapes the research agenda, devastating effects of polio. Delegates will sets norms and standards of health, provides focus on addressing the aftermath of the technical support, and monitors the health epidemics and developing resolutions that situation in the world. The Committee emphasize rehabilitation strategies and addresses important health issues such as the tactical responses to the outbreaks. eradication of polio, the health effects of air Continuing the spirit of tackling pollution, strengthening care for epilepsy, communicable diseases, delegates will also and monitoring global nutrition. Currently, explore the topic of preventative measures in the majority of the WHO’s budget is aimed terms of facing outbreaks of malaria, towards communicable diseases; to reduce tuberculosis, cholera, and other diseases. the health, social and economic burden of Preventative measures such as surveillance, those diseases in general; and to combat clean water, and containment are essential in HIV/AIDS, polio, malaria and tuberculosis the control of communicable diseases and in particular. will be the focus of the second topic In 2017, delegates will be exploring discussed in committee. two important issues relating to communicable diseases that the world faced in 1960: response and prevention. In order to encourage more thorough and specific resolutions, delegates will be asked to focus on the response and the prevention, respectively, in regard to the topics presented in committee. The historical aspect of the WHO will provide delegates
2 Topic A: The Prevention of the World Health Report released by the WHO stated that recent trends and Communicable Diseases developments in world health point to the fact that countries are promoting health due Introduction to its essential contribution to industrial, agricultural, social and economic Diseases, throughout history, have swept advancement.5 through the world bringing down empires, It is important to keep in mind that destroying economies, and completely with the rapid development of new 1 altering the course of mankind. In order to technologies and methods of transportation, ensure a safer future for humanity, various diseases cease to recognize the limits of organizations, such as the International expansion, especially diseases that spread by Sanitary Conference, were founded. contagion. During the time when the WHO However, due to political differences, was established, international travel committees found it difficult to accomplish occurred via ships and news made its way to cooperation for disease prevention and different nations by telegram.6 Although control. Finally, following the end of World various epidemics such as cholera, plague, War II, the United Nations established the smallpox, and yellow fever were of concern, th World Health Organization on April 7 , the lack of high traffic between countries 1948 with the most fundamental goal of made the diseases fairly “quarantinable”.7 2 preventing the spread of infectious disease. Today, any infection in the world is In 1951, the WHO issued the first less than a day away. Air travel, which set of regulations aimed at avoiding the transports over 2 billion people annually, initial spread of communicable disease provides the perfect opportunity for diseases 3 epidemics. That year marked an to incubate in the aircraft carrier and then undeniable movement towards “world health propagate in new land. In addition, mass consciousness” and the concept of the right population movements due to free trade and 4 of health has been initiated. In the 1951, labor agreements between nations provide diseases with the ideal epidemic carriers.8 1 Hays, J. N. Epidemics and Pandemics: The disease situation in the world today is Their Impacts on Human History. Santa far from stable. Rapid urbanization, Barbara, CA: ABC-CLIO, 2005. Print. population growth, expansion into new 2 McCarthy, Michael. "A Brief History of territories, pollution, poor farming practices, the World Health Organization." The Lancet and the misuse of antibiotics have all 360 (2002): 1111. Print. contributed to the imbalance of the 3 “The World Health Report 2007, A Safer Future” WHO. World Health Organization, n.d. Web. 17 July 2016. 5 Ibid.
3 microbial world.9 In 2017, the primary area or season.”11 You will often see the method in combating epidemics is words “epidemic” and “pandemic” used emergency response. However, in 1960, an throughout this guide. The definitions of alternative strategy to protect public health both of those terms are vague, but for our security exists – stopping a disease at its purposes, epidemic will refer to a disease source and preventing the outbreak before it outbreak of increased frequency and becomes an international threat.10 severity.12 Pandemic will refer to an In our historical committee, you will epidemic affecting a massive area, perhaps be responsible for proposing various plans even worldwide.13 Keep those definitions in that could be put in motion to halt the initial mind as you read about the account of some start of disease. After the Thirteenth World of the worst epidemics and pandemics in Health Assembly, which met in 1960, history, prior to the founding of the WHO. epidemics and pandemics kept affecting the Note the various methods that have been world. In our committee, you have the used in the past to prevent the spread of opportunity to create a resolution that could disease as well as the cause of the spread in have potential put a stop to the cholera, aids, the first place. Only by studying the origins malaria, and Ebola epidemics that followed. of diseases and their means of transmission Throughout this background guide you will can delegates begin to tackle the problem of find information about various epidemics infectious diseases at the core. that occurred in history as well as the causes and nature of their occurrence. This will Historical Background give you insight about the different preventative strategies that could be Plague implemented, such as educating medical One of the world's first recorded professionals, increasing surveillance, clean epidemics, traditionally known as the water initiatives, food control, and focusing “Plague of Athens,” struck in the summer of on research and development to ensure that 430 B.C.E. Thucydides, an Athenian antibiotic resistance does not become a historian who himself suffered from the deadly issue. With this in mind, delegates disease, documented the start of the should reflect the views of their nation and epidemic. According to him, the disease propose solutions that closely resemble their spread to Athens from the adjacent port of country’s point of view. Piraeus during the start of the Peloponnesian War, a tremendous conflict between Athens The World Health Organization 14 defines a disease outbreak as “the and Sparta, which began in 431 B.C.E. occurrence of a disease in larger quantities The city was vulnerable due to the ongoing than what would normally be expected to warfare, which undoubtedly contributed to see in a defined community, geographical 11 "Disease Outbreaks." WHO. World Health Organization, n.d. Web. 20 July 2016.
4 large political criticism. Prospects of weakness that was generally contagion amplified when the leader, fatal.16 Pericles, began relocating people that lived Ongoing warfare and mass in the countryside of Attica to inside the city migrations into the city contributed to a of Athens. With an elevated amount of mass hysteria in the Athens – people movement in terms of military forces and gathered around public fountains seeking Athenian rural population, an estimated 25 relief from the water. Thousands lay dead in to 35 percent of the Athenian population the street and labor shortages from both the died in this widespread epidemic. Because war and epidemic made proper burials an the disease came on suddenly during a year issue so much so that burial customs were that was otherwise healthy, some Athenians completely disregarded.17 believed that the Spartans were to blame. Another major epidemic, the “Plague Others believed that the gods were simply of the Antonines”, affected the ancient displeased with the Athenians.15 The world in 165 C.E. and shook the Roman historian Thucydides, wrote Empire. One ancient account of disease comprehensively about the epidemic: claimed that malicious spirits were to blame. People in good health were Another account interpreted the disease as all of a sudden attacked by an imbalance in the “humors” – phlegm, violent heats in the head, and blood, yellow bile, and black bile – that, redness and inflammation in according to Greco-Roman medicine, were the eyes, the inward parts, supposed to influence the body and such as the throat or tongue, emotions.18 In reality, the excessive trade becoming bloody… followed between the Mediterranean states that the by sneezing and hoarseness, Roman Empire was able to unify facilitated after which the pain soon the diffusion of the disease. 19 Furthermore, reached the chest, and the majority of the population lived in close produced a hard cough. quarters in large, overcrowded cities. The Externally the body was not living situation and frequent trade very hot to the touch… but contributed to the spread of other diseases as reddish, livid, and breaking well, such as smallpox, measles, and out into small pustules and tuberculosis. Galen, a Greco-Roman ulcers. Internally it burned so physician, described the disease as a “rash of that the patient could not bear black pustules, diarrhea, black stools, fever, to have on him clothing… and fetid breath”.20 Like the Athenians, the throw themselves into cold people of Antonines experienced a severe water… miserable feeling, pressure for burial space. The state made it not being able to rest or sleep… disease descended further into the bowels, 16 Thucydides, Richard Crawley, and T. E. inducing violent ulceration Wick. The Peloponnesian War. New York: there accompanied by severe Modern Library, 1982. Print. diarrhea… brought on 17 Hays, J. N. Epidemics and Pandemics: Their Impacts on Human History. Santa Barbara, CA: ABC-CLIO, 2005. Print. 18 Ibid. 19 Ibid. 15 Ibid. 20 Ibid.
5 illegal for people to construct tombs for the also contributed to the great wave of plague. dead and instead, public burials were The first recorded attempts of prevention ordered. included careful attention to diet, rest, and The first actual confirmed plague bathing. pandemic occurred in 541 C.E. in Pelusium, The most prominent pandemic of which is located at the eastern edge of the plague was the bubonic plague, Black Nile delta of Egypt and last two hundred Death, recorded in the medieval ages. years.21 The plague, also known as the Starting in 1346 and spreading until 1844, “Plague of Justinian” was then reported to the disease claimed 50 to 60 percent of the have spread to Alexandria and Palestine, and population.25 The disease originated in as far west as Italy and Tunisia, and then to southern Russia near the Crimea, where it England, Ireland, Persia, and South Asia.22 It spread along the main trade routes toward struck suddenly and was described to be Western Europe and the Middle East. In this characterized by high fever, buboes that area, marmots were specifically hunted for appeared in the groin, armpits, behind the their fur and sold to traders along the ears or thighs, black spots on the skin, aforementioned routes. Marmots that were followed by a coma and then death.23 sick, dying, and infested with fleas were The first of three plagues, the especially easy to trap and skin. Fur Justinian Plague, occurred during a time of containing carrier fleas of the bubonic great commerce. These plague epidemics plague consequently spread throughout the spread with sea commerce and diffused to area.26 different cities via seaports. Mass This outbreak of the plague was also movements of populations into new areas the first recorded incidence of biological may have also triggered the spread of the warfare. The Tatars, descendants of plague in a pandemic. Volcano eruptions in Genghis Khan, controlled the area of north Asia in 536 may have killed off crops that Crimea. In order to gain control of the ports forced nomadic tribes to relocate in the of Crimea, they allied with the Venetian search of new food.24 Warfare could have traders and attacked the rival Genoese, who also contributed to the massive spread of the were forced to retreat behind the walls of the disease. In the sixth century, Muslim city of Caffa. Gabriel De Mussis left behind conquerors spread out from the Arabian a vivid description of the events of the siege: Peninsula, potentially taking the deadly plague along with them. In addition, fleas, Infinite numbers of Tartars the main carriers of plague, could easily and Saracens suddenly fell accompany humans on their travels, which dead of an inexplicable disease… The dying Tartars, stunned and stupefied by the 21 "Three Major Plague Pandemics." Centers immensity of the disaster for Disease Control and Prevention. Centers brought about by the disease, for Disease Control and Prevention, 14 Sept. and realizing that they had no 2015. Web. 22 July 2016.
6 hope of escape, lost interest in the siege. But they ordered corpses to be placed in catapults and lobbed into the city in the hope that the intolerable stench would kill everyone inside…27 Soon all the air was infected and the water poisoned, corrupt and putrefied and such a great odor increased…28 Cadavers that were flung over the walls of Caffa were most likely still infested with fleas that carried the disease. The infection could have also spread by rats migrating into and out of the city. Survivors of the attack fled back to the Mediterranean and brought along infected rats with them. The Bubonic Plague then appeared in Figure 1: Chronology of the initial spread of bubonic plague in the mid-14th century 31 Constantinople and ports of Egypt, followed by Sicily and Greece. Further shipping from Those that lived in areas around seaports the Genoa spread the disease to Marseilles, 29 quickly realized the danger of the plague France and then Mallorca. The plague and attempted to install the practice of reached the Mesopotamian area via caravans quarantine. Facilities were established that traveled south, carrying silk and spices outside of the city for visitors to spend forty (Fig 1). Emperor John VI wrote a history of days being quarantined before they were the Byzantine Empire’s experience with the allowed into the city. However, this did not plague, stating “the Black Death attacked prevent rats and fleas from escaping into the almost all the sea coasts of the world… and city and infecting the population. all the islands, … and spread throughout 30 Between the years 1348 and 1350, it almost the entire world.” is estimated that the Black Death killed 25 million people, about one third of the world population.32 It is also estimated that about 70 percent of those that contracted the illness, died. Since the majority of the world was in chaos, insufficient labor caused crops to go unattended and harvests to rot.
Widespread famine led to malnutrition, 27 Mark Wheelis, “Biological warfare at the which allowed people to become susceptible 1346 siege of Caffa,” Center for Disease Control and Prevention. Web. Sept 2002, Aug 2016, 31 Mark Wheelis, “Figure 1,” Center for http://wwwnc.cdc.gov/eid/article/8/9/01- Disease Control and Prevention. Web. Sept 0536_article. 2002, Aug 2016, 28 Bollet, 20. http://wwwnc.cdc.gov/eid/article/8/9/01- 29 Hays, 42. 0536-f1 30 Bollet, 21. 32 Bollet, 22.
7 to other diseases including smallpox and leaves infected fleas looking for an typhus.33 alternative host. This makes fleas more Severe epidemics of plague likely to infect humans. In fact, during the continued all over the world way after the medieval times, records often noted the main outbreak in the mid-fourteenth century. finding of large numbers of dead rats prior 1.5 million people were recorded to have to the outbreak of plague epidemics.37 died as a result of a plague outbreak in However, if the rat population is permanent Lombardy, Italy between 1630 and 1631. kept low, risk of a large rodent outbreak is 30,000 people died in 1709 in a plague low, making human infection less likely. outbreak in Prussia. Between 1720 and Because cases of bubonic plague continue to 1722, 50 percent of the population died in be reported in various parts of the world, it Marseilles and Toulon, France. A protective can be inferred that the disease can exist in measure taken by Austria in the early animals and then later be reintroduced to eighteenth century highly contributed to the different populations of humans, usually by slowing of the rate of infection. A barrier commercial trade.38 was erected and primarily ran through Hungary. It was manned by 100,000 men Malaria and Yellow Fever and contained both quarantine and Malaria is thought to have spread checkpoint stations. The wall, referred to as from the rain forest of tropical Africa to the the “Sanitary Cordon” highly limited human Nile Valley and then to the northern trade and traffic, which prevented the spread 34 Mediterranean. Fossils of mosquitos up to of infection. 30 million years old were discovered to During the 1890s, the plague contain the malaria vector.39 Malaria can be epidemic hit mainland China and Hong broken down into “mal aria” meaning bad Kong. The initial spread of the plague was air in French. It was introduced into the attributed to maritime trade and appeared in 35 western hemisphere at the end of the major port cities around the world. The fifteenth century. It is evident that the initial recent outbreak caused two physicians, Dr. spread of the disease was coastal and spread Yersin and Dr. Kitasato to identify the from ports by Anopheles mosquitoes. In disease-producing agents. The bacillus, tropical areas, malaria persisted while in Yersinia pestis, was responsible for the colder climates, malaria had to be plague. Both of these physicians noted that reintroduced every summer.40 The fact that flies infected with Y. pestis were dying in people lived around marshes, breeding large numbers. Shortly after, tropical rat grounds for infected mosquitos, constantly fleas, as well as marmots, rabbits and their contracting fevers, led Romans to enact the fleas were shown to be carriers of the first drainage programs.41 plague.36 It is worth noting that rat-catching campaigns have proven effective in the past, 37 Ibid. however, only temporarily. Eliminating rats 38 Ibid. indeed decreases the pool of infection but it 39 Paul Henri Lambert, “History of Malaria,” Nobel Prize. Web. 9 Dec 2003, Aug 2016. 33 Ibid. https://www.nobelprize.org/educational/med 34 Bollet, 23. icine/malaria/readmore/history.html 35 Ibid. 40 Bollet, 36 36 Ibid. 41 Lambert.
8 Detailed records from soldiers Consequently, yellow fever spread to St. fighting in the Civil War point to extensive Kitts, Guadeloupe, and Cuba.45 incidences of malaria. Of the 1.2 million In August 1793, a yellow fever recorded cases, 8 thousand lost their lives.42 epidemic hit Philadelphia, the capital of the The accounts noted that once a soldier was United States. The yellow fever most likely infected, he became susceptible to reached the city on a ship that carried people recurrences. Modern studies show that the fleeing from the revolution in the French vivax and ovale forms of parasite can persist Caribbean colony of Haiti. It is estimated in the liver and re-emerge at various that as many as 5 thousand people died out intervals to attack red blood cells.43 of a population of 51,000. At least 20,000 Malaria is prevalent in wet weather fled the city, making the mortality rate due to the ideal conditions for mosquito among the remaining people especially breeding. Global warming may be an high.46 The western reliance on trade with underlying factor in the persistence of the the tropics left the new country highly vectors through the cold seasons. Other than susceptible to pathogens of tropical diseases, transmission by mosquitoes, malaria can be especially yellow fever. diffused by blood transfusions. What that Yellow fever is characterized by means is that if a blood donor had an yellow eyes and skin (which gives it its incidence of malaria many years ago, the name), purple blotches under the skin, black parasite may still exist in a dormant state in stools, vomit, and high fever. The Aedes sufficient quantities to trigger an outbreak in mosquitoes were determined to carry the the recipient. Similarly, a contaminated disease from the original host, the monkey, needle can pass on the infection. A mother to people and then from people to people.47 can also transmit the disease to her fetus.44 New Orleans had the most frequent Malaria remains the most common parasitic and harsh outbreaks of the yellow fever disease, affecting humans today. epidemic in America. It was affected by The first outbreak of yellow fever twelve crippling epidemics between 1825 occurred in 1647 in the West Indies. and 1860. In 1841, yellow fever was Because incidences of yellow fever have not responsible for over 30 percent of the deaths been recorded prior to the importation of and about 25 percent in 1849. Undoubtedly, slaves, it is presumed that the disease the location of the city made it a perfect originated in Africa and was carried onto location for infection – low terrain, swampy slave ships by Aedes mosquito larvae. An ground, fetid air, and unsanitary mess. estimated one half of the white population of Furthermore, the social structure of New Barbados died in the yellow fever epidemic. Orleans made it especially vulnerable. As slaves replaced English immigrants from Many immigrants from Europe who had no agricultural jobs, they took to engage in previous exposure to yellow fever came to business ventures and exploration. New Orleans, which increased their risk of contracting it. New Orleans also relied on trade with the Caribbean and South America where yellow fever was endemic.48 This
42 http://ocw.jhsph.edu/courses/malariology/P 45 Ibid, 47 DFs/lecture1.pdf 46 Hays, 185 43 Bollet, 37 47 Ibid. 44 Ibid, 41 48 Hays, 262
9 heavy reliance on trade made the method of arrived in Mexico City in 1520. Smallpox quarantine impossible to maintain. rapidly spread throughout the native population. Smallpox is a great example of Smallpox how epidemics can be easily introduced into Japan experienced a deadly smallpox virgin soils by a single carrier. In Peru, epidemic in 735-737 C.E. 49 The disease Francisco Pizarro ordered his men to spread began in the seaport region of Dazaifu, smallpox to native Incas by infected Japan. Records say that the disease may blankets with the lesions of the sick and then have been transported from Dazaifu to the gifting them to the people. This same main island of Honshu on the boat of an biological warfare strategy was also used in emissary who was looking to repair relations the French and Indian war in 1763, when the with Korean states.50 The disease was British purposely tried to spread smallpox among the Native Americans with characterized by red swellings on the skin, 52 unusually high fever, extreme thirst, and blankets. diarrhea. The smallpox epidemic was so In the eighteenth century, smallpox deadly that it is estimated that about half of came to be understood as a specific disease Japan’s population died from the disease. and methods of inoculation and vaccination Because Japan is an island, it was protected became standard practices to prevent from constant spurs of disease outbreak. smallpox. Inoculation was widely practiced This allowed a generation or a few from 1714-1790 and involved the generations to separate one epidemic from introduction of the disease into a healthy the next. Because of this gap, each time a person’s body. It was performed differently smallpox epidemic reached the island, the in various cultures. For instance, in China, population did not have any immunity or dried scabs of infected persons were blown previous exposure to the disease. The into the nasal passages of healthy persons. In population was especially vulnerable to the some areas of Africa, fluids from infected onset of this outbreak because there was a persons were introduced to scratches or major spurt in the population growth in rural incisions in the healthy. The method of areas and the years preceding the epidemic inoculation actually proved to be significant were characterized by immense harvest in providing immunity against smallpox. In other cases, however, the healthy patients failure, meaning the disease attacked a large, 53 severely malnourished population.51 fell deathly ill from the procedure. In Smallpox became endemic in the 1778, Edward Jenner invented the smallpox Arabian Peninsula by the 6th century and vaccine after carefully studying the persisted in the Middle East for the next relationship between cowpox and smallpox. thousand years, being reintroduced to the He realized that people that were introduced to cowpox developed immunity to smallpox. rest of the world with the travel of crusaders. 54 Smallpox first made its way to the New However, the immunity was not lifelong. World when African slaves were introduced Currently, in 1960, the UN is acquiring data from all over the world regarding outbreaks to work the sugarcane plantations in 55 Hispaniola in 1517. It was then introduced of smallpox. Hopefully, the identification to Mexico when competitors of Cortez
52 Bollet, 78 49 Hays, 31 53 Hays, 155 50 Hays, 31 54 Bollet, 85-86 51 Hays, 32 55 Ibid.
10 of outbreaks would allow vaccinations to be cholera accompanied rapid urbanization. delivered to all of those susceptible, and Conditions in quickly growing cities were smallpox could be eradicated in the world anything but sanitary – lack of proper by 2017. disposal systems, human feces dropping directly into street drains, polluted rivers and Cholera dirty water supplies. The outbreaks of A series of cholera pandemics swept cholera occurred during the time of the through the world in the nineteenth century. Enlightenment, which greatly influenced the The spread of cholera was undoubtedly ideology of the great sanitarians of the time expedited by the spread of Western colonial who believed that the environment was powers and by the increase in world responsible for disease. They argued that 56 civilization created the power to solve traffic. Cholera itself results from fecal 59 contamination of rivers that are then used as fundamental public health issues. a source of water for drinking or bathing. The bacteria Vibrio cholerae, the Contaminated urban water supplies have causative agent of cholera, can be killed by caused major epidemics in major cities the acidity of gastric juices, however, when 57 consumed in large quantities, it thrives and throughout the world. Infected food 60 supplies, perhaps those that were treated becomes deadly. Temperatures below 50 with contaminated water, are also degrees Fahrenheit have the tendency to kill responsible for the spread of the disease. As the bacteria meaning that in temperate areas demonstrated by Figure 2, cholera made its the disease can persist in the summer and die way around Asia, the Arab states, and parts off in the winter, giving the population an of Africa through the movement of British opportunity to prevent future introduction of military and naval personnel. the disease. Vaccines against cholera have not been effective and fail to provide the person with protective immunity.61
Influenza Influenza is a viral disease that is contagious via the respiratory system and is transmitted by humans. Its symptoms resemble the common cold but tend to be more severe. Ordinary influenza can result in high fevers, sweating, muscle pain, sneezing, dry cough, and prostration.62 The influenza pandemic of 1781 did not Figure 2: First cholera pandemic, 1817- necessarily have a high mortality rate but it 1824 58 had a high morbidity rate – about three The spread of cholera to Europe and the Americas occurred shortly afterwards. It 59 J. N. Hays, The Burdens of Disease, was no coincidence that the high rates of Epidemics and Human Response in Western History (New Brunswick: Rutgers University Press, 2003), 143 56 Hays, 194 60 Bollet, 92. 57 Bollet, 93 61 Ibid. 58 Hays, 194 62 Bollet, 104.
11 fourths of the entire population of Europe strict fines were imposed on those that fell ill from the disease.63 Although the first sneezed or coughed without covering their sweep of influenza was not deadly, those mouth.69 that were already suffering respiratory Rapid intercontinental spread of trouble and those that were weak, especially influenza was unquestionably accelerated by children and the elderly, fell fatally ill. the ongoing World War. Armies were Pneumonia, which often set in after brought together in close quarters, influenza, was also fatal. European increasing the incidence of contagion. Other experience with the disease confirmed that large masses of people were transported to the disease did not travel by environmental various areas to participate in war efforts factors, such as air currents, but rather either as soldiers or workers. The demand through human contact because of west-to- for materials for the war significantly east winds.64 In addition, the influenza virus increased trade between countries and can infect domestic animals such as pigs, continents as well. Steamships and railroads horses, and chickens that can be infective in reduced the amount of time it took to travel humans.65 The most prominent type of across countries and continents, facilitating influenza is type A, which passes rapidly the spread of the disease. The amount of from one person to the next. In addition to medical personnel available was also being extremely contagious, the influenza significantly decreased because their virus is also rapidly mutating meaning that attention was deferred to wounded soldiers. immunity is never ensured.66 Governments had to deal with constant The most widespread pandemic collapses of public health services and event in human history occurred between shortage of public health infrastructures.70 1918 and 1919. Over 50 million people died It is no question that the influenza from influenza and many more people were pandemic was significantly more deadly infected.67 The disease originated in pigs than any previous incidence of influenza. and quickly spread to humans. J.S. Koen, a But what caused such a lethal pandemic? veterinarian, reported the outbreak of Mutations in the virus were identified as the influenza. He noted, “… an outbreak in the cause of lack of immunity against the family would be followed immediately by disease. However, recently, in 1957, a strain an outbreak among the hogs, and vice versa, of the influenza virus was used to produce a as to present a most striking coincidence, if vaccine. The strain that was isolated was not suggesting a closer relation between the significantly different than the previous two conditions.”68 Panic broke out in cities, strain so old vaccines were not effective. which closely resembled the mass hysteria Since it is not possible to predict the that ensued during the bubonic plague. mutation in the new virus, an outbreak of the Theaters, movies, dance halls, schools and new influenza virus needs to surface in order churches were closed. People in the United to collect the antigenic characteristics and States were required to wear facemasks and create a new vaccine. The release of the 1957 vaccine occurred too late and only 7 million people were vaccinated in the United 63 Hays, Epidemics and Pandemics, 171 States. 70,000 people in the United States 64 Ibid, 172 65 Bollet,104. 66 Hays, Burdens, 270 67 Hays, Epidemics and Pandemics, 385. 69 Ibid. 68 Bollet, 106. 70 Hays, Epidemics, 388-391
12 died from that episode.71 The evasive nature accessible. They can be located in nature, of viruses and consequently the lag in produced in a lab, and are long lasting. vaccine availability remains one the largest Anthrax spores can also be released quietly biological problems today. and without a trace. The spores are microscopic and can be easily concealed in powders, sprays, food and water. The Contemporary Conditions potential use of anthrax as a bioweapon is a serious threat to all nations.76 (After 1960, Anthrax anthrax has been used many times in acts of Anthrax is a very serious infectious bioterrorism.) disease that results after an infection by gram-positive, rod-shaped bacteria Bacillus anthracis. It is rare but highly infectious, Tuberculosis especially for those that come into contact Tuberculosis is one of the most with infected animals or feces.72 Human serious human diseases. Tuberculosis results infection can occur via inhalation, through from an infection of the lungs by a the skin, or through the gastrointestinal microorganism called Mycobacterium system.73 Typically, anthrax is contracted tuberculosis. A tuberculosis infection is when spores are released in the air. The usually associated with a specific infection spores are then carried all the way into the in the lungs called pulmonary tuberculosis but it can infect other parts of the body as alveolar spaces of the lung and transported 77 into the lymph nodes in the middle of the well such as lymph glands. The disease has chest where they mature and produce toxic seen a large decline between 1900 and 1950 bacteria. The toxins can then cause due to a variety of preventative measures hemorrhage, edema, tissue necrosis and such as sanatoriums and the BCG vaccine. death.74 The wide use of antibiotics also began to be In 1948, the United States built a test effective in putting an end to tuberculosis chamber in Fort Detrick, Maryland, to study outbreaks. In 1960, tuberculosis was the spread of anthrax spores as well as other virtually forgotten in the Western world; diseases and determine their threat as a however, it remained the number one killer bioweapon. Anthrax was determined to be in other, underdeveloped parts of the world. the deadliest.75 The tests proved that it was For instance, tuberculosis was the primary cause of death in China in the first half of too feasible to cover a large area of the 78 country with biological weapons. In a the twentieth century. Many nations do not separate potency test using 2,000 monkeys, have the proper infrastructure, high it was determined that it would take about standards of living, or access to 3,000 spores to kill 50 percent of them. vaccinations. Furthermore, people with Anthrax spores can be easily used as tuberculosis in developing areas often failed a bioweapon because the spores are easily to seek medical help and were often difficult
71 Bollet, 113 72 CDC, “Anthrax,” CDC. Web. 1 Sept 76 CDC, “Anthrax, The Threat,” CDC. Web. 2015, Aug 2016. 1 Aug 2014, Aug 2016. https://www.cdc.gov/anthrax/ http://www.cdc.gov/anthrax/bioterrorism/thr 73 Bollet, 206. eat.html 74 Ibid. 77 Hays, Epidemics, 469 75 Bollet, 212. 78 Ibid.
13 to identify because the symptoms often UNICEF extended its territory into that of mimicked other diseases. the WHO, the assistance that UNICEF provided in terms of transportation, syringes, and vaccines actually Yaws complimented the advisory role of the Yaws is a chronic skin, bone, and WHO.81 The problem with WHO and cartilage infection. It is caused by the UNICEF supported TB programs is that they bacterium Treponema pertenue, a require specialized staff to diagnose the subspecies of a bacterium that causes disease, provide treatment, and administer venereal syphilis. However, yaws is a non- the vaccine. Many developing countries venereal infection and is not transmitted were not and are not able to support the sexually. It is transmitted through direct growing initiatives because they lack the skin contact with an infected person and infrastructure and the staff is not well contagion can be expedited in areas of trained.82 overcrowding and poor sanitation. The In the 1950s, the WHO and the British disease is also mainly prevalent in warm, Medical Research Council conducted a study in humid, and tropical areas of Africa, Asia, 79 Bangalore, India, which revealed that cases of and Latin America. TB could be easily identified if patients that Symptoms of the disease include an were exhibiting symptoms were closely initial development of a papule and if left examined. All that was required was a low-tech untreated, will cause skin lesions and bone method of sputum microscopy. Studies by the pain. Late yaws is characterized by damage WHO in 1956 showed that those that were ill to the skin, bones, joints, and facial with TB could just have easily been treated at 80 disfiguration. There is currently no vaccine home as in hospitals. This new method of to prevent yaws and the only principle for treatment could potentially change the prevention is to avoid transmission. tuberculosis treatment guidelines proposed by the WHO in our committee.83 Past International and UN 1952 Yaws Campaign Action In 1952, WHO and UNICEF led a 1950 Tuberculosis Immunization worldwide campaign to control the spread of World War II had left the population and eventually eradicate yaws. Control of Europe weak and vulnerable. Incidences programs were established in 46 countries of tuberculosis reached epic magnitudes, and actually influenced the development of which influenced the creation of a mass primary health facilities in the affected disease campaign. In 1947, the Scandinavian Red Cross partnered with the United Nations International Children’s 81 UNICEF, “The 1950s: Era of the Mass Emergency Fund (UNICEF) to create a Disease Campaign,” UNICEF. Web. 2016, campaign with the goal of immunizing Aug 2016. uninfected children in Europe. Although http://www.unicef.org/sowc96/1950s.htm 82 UNICEF, “Tuberculosis, Complacency 79 WHO, “Yaws: A forgotten disease,” Kills,” Bugs, Drugs, and Smoke. Web. 2016, WHO. Web. 2016, Aug 2016. Aug 2016. http://www.who.int/neglected_diseases/dise http://www.who.int/about/bugs_drugs_smok ases/yaws/en/ e_chapter_6_tuberculosis.pdf 80 Ibid. 83 Ibid.
14 areas.84 The World Health Assembly private and public monetary contributions to resolution WHA2.36 supported the control the malaria campaign effort. 87 of endemic yaws and introduced penicillin Proponents of the program argued in mass campaigns into countries such as that eradication and prevention were much Bosnia, Haiti, Indonesia, the Philippines, more financially feasible than the control of and Thailand, which were highly malaria. They also wanted to effectively use successful.85 In 1960, the WHO proposed a DDT to wipe out malaria before DDT strategy to integrate yaws surveillance and resistant mosquitoes emerged. Critics of the control into primary health care, but this program argued that it was not possible to approach was not successful.86 Consider eradicate malaria everywhere because poor why this approach did not work. What can communities lacked public health systems, be a better approach to incorporating communication systems, and access to surveillance into a community? resources. This was especially true for the environments of tropical Africa. As the 1955 Malaria Eradication campaign moved forward, overconfidence in Following the great success of using the belief that eradication was feasible dichloro-diphenyl-trichloroethane (DDT) to meant that fundamental issues were fight malaria, WHO enacted the Global overlooked. Resistant mosquitoes emerged Malaria Eradication Program (GMEP) in in 1960 and “problem areas” where malaria kept returning even after repeated 1955. DDT was first used in the US Army 88 during World War II and was very effective insecticide treatments. What can we learn in killing adult mosquitoes. Although DDT from the GMEP? stopped the spread of malaria, the application required a great deal of support, 1958 Smallpox Eradication transport, and distribution which was The eradication of smallpox was expensive and required infrastructure. continuously discussed at the World Health Eradication of malaria seemed feasible and Assembly (WHA) in 1950, 1953, 1954, and the GMEP was approved by the 8th WHA in 1955. Still, after much study and debate, the Mexico in 1955. WHO was responsible for Eighth WHA decided that the endeavor providing technical advice for would be unrealistic and the resolution implementation of the resolution and the WHA8.38 was adopted that simply stated ability to coordinate resources. The that various public health sectors should resolution also established a Malaria campaign against smallpox. However, at the Eradication Special Account to channel Eleventh WHA, Professor Zhdanov argued that eradication was feasible, extremely vital
for endemic and non-endemic countries, and 84 Kingsley Asiedu, “Yaws eradication: past national programs had demonstrated their efforts and future perspectives,” WHO. Web. commitment to the cause. At the Twelfth July 2008, Aug 2016. http://www.who.int/bulletin/volumes/86/7/0 8-055608/en/ 87 José A. Nájera, “Some Lessons for the 85 Kingsley Asiedu, “Eradication of Yaws: Future from the Global Malaria Eradication Historical Efforts and Achieving WHO's Programme (1955–1969),” NCBI. Web. Jan 2020 Target,” NCBI. Web. 2014, Aug 2016. 2011, Aug 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/P http://www.ncbi.nlm.nih.gov/pmc/articles/P MC4177727/ MC3026700/ 86 Asiedu, Yaws 88 Ibid.
15 WHA, resolution WHA12.54 was adopted 4. How will the development of that stated that “the eradication of smallpox vaccines and antibiotics keep pace from an endemic area can be accomplished with the constantly mutating by successfully vaccinating or revaccinating pathogens? What will be the cost? 80% of the population within a period of How will different nations be able to four to five years.”89 The resolution afford these costs? Which nations acknowledged, “although great progress has will have access? been made in the eradication of the 5. What steps will the WHO take to disease… smallpox still remains in other regulate the security of isolated, areas, especially in South-East Asia and dangerous pathogens in laboratories? Africa, from which the disease can be What preventative measures will be exported to countries already free of it.”90 in place to prevent the accidental release of pathogens from research laboratories? Questions a Resolution Must 6. How will nations adjust to the rapid modernization of technology and Answer increasing potential of spread of disease? Delegates should note that one resolution 7. How will the WHO increase does not necessarily needs to address all of awareness? What role will these questions but different resolutions can international actors and local focus on specific areas of questions governments play in increasing presented below. Use these questions as a knowledge of diseases and guideline when developing your papers. preventative measures? 8. What steps will local governments 1. What are the factors that contribute take to regulate the quality of food in to the spread of disease? Are they the area? What regulations will be social, environmental, political, imposed to prevent malnutrition and economic? What are the prominent contamination of foods? What factors that affect your specific regulations will be imposed by the nation? WHO? 2. How should at-risk cities and areas 9. How will the resolution establish be identified? Do any of these at-risk appropriate infrastructure for vaccine areas have common features or are distribution, research and they at-risk for a common type of development, education, surveillance pathogen? and other preventative measures to 3. How should the topic of biological take effect? warfare be addressed? 10. What steps will the resolution take to ensure clean drinking water in all nations? 89F. Fenner, “Smallpox and Its Eradication: 11. What is the role of the WHO in Development of the Global Smallpox prevention of disease? In what ways Eradication Programme, 1958-1966,” will the resolution promote Biotech. Web. 1988. Aug 2016. international cooperation? http://biotech.law.lsu.edu/blaw/bt/smallpox/ who/red-book/9241561106_chp9.pdf 90 Ibid.
16 Bloc Positions Americas. PAHO engages in cooperation with member countries in order to battle Europe and North America infectious diseases and provide methods of The bloc of Europe and North prevention. PAHO also serves as a Regional America make up developed countries and Office of the WHO and promotes health in include their own groups of agencies the Americas.92 designed to monitor and prevent disease A big issue that concerns this bloc is outbreaks. For instance, the United States the abundance of rodents that live in close has the Communicable Disease Center proximity to the population. Wild and (CDC) and the National Institute of Health domestic rodents play a huge role in the (NIH) that supports efforts for disease transmission of infectious diseases such as eradication and research. Furthermore, the plague, South American hemorrhagic various private research institutions in this fevers, and Venezuelan encephalitis.93 bloc allowed for the development of Countries in this bloc will undoubtedly be vaccines and vaccine trials in order prevent seeking a resolution that favors the control the advent of diseases. Vaccines are one of of rodents as well as insect repellents in the greatest achievements of biomedical tropical areas. These countries also science and the developed countries of sympathize with financial limitations and Europe and North America typically contain will encourage a resolution that can be the type of infrastructure necessary for the feasibly applied to all areas of the world. implementation of vaccination programs.91 Typically, due to the advanced nature of this bloc, preventative measures such as Asia and the Pacific surveillance, vaccine availability, clean In the bloc of Asia and the Pacific, water, and pesticides are highly available. China is a critical player in providing public Previously, this bloc has been willing health advances in terms of environmental to offer aid and resources to developing sanitation, vaccination, improving rural countries in order to prevent disease health, and disease prevention through outbreaks. Countries in this bloc will seek campaigns such as clean water initiatives resolutions that favor world eradication in and vector control. There was also a huge terms of implementing maximum effort to increase “health literacy” in rural surveillance, education, and spread of Asian populations starting in 1950. Other pesticides. disease control programs were in effect such as the outlawing of prostitution, the Central and South America 92 The Pan American Health PAHO, “About the Pan American Health Organization (PAHO) is responsible for Organization (PAHO),” PAHO. Web. Aug 2016. overseeing the health of the countries of the http://www.paho.org/hq/index.php?option=c om_content&view=article&id=91&Itemid= 91 National Immunization Program, 220&lang=en “Achievements in Public Health, 1900-1999 93R. B. Mackenzie, “Public Health Impact of Vaccines Universally Importance of Rodents in South America,” Recommended for Children -- United States, NCBI. Web. 1972. Aug 2016. 1990-1998,” CDC. Web. 1999. Aug 2016. https://www.cdc.gov/mmwr/preview/mmwr http://www.ncbi.nlm.nih.gov/pmc/articles/P html/00056803.htm MC2480904/
17 campaign to exterminate sparrows, rats, medical staff and poor implementation of flies, and mosquitos, and training of preventative measures. For instance, the midwives to prevent infections occurring in Global Malaria Eradication Program in its newborns.94 initial stages was deemed impossible to The WHO relies on China to stream continue due to the reoccurrence of the the efforts towards increasing preventative disease since insecticides were often times measures in Asia since the majority of used incorrectly and at improper intervals. epidemic outbreaks stem from Russia and Furthermore, the tropical environment and Asia. Countries in this bloc will look poor sanitation in most countries in this bloc favorably upon resolutions that favor health means that diseases, such as malaria, have a education, research and development, and much higher chance of reoccurring, despite vector control, as well as other methods that the use of insecticides. Special attention they are already implementing. Other, less should be given to the African bloc since it developed countries in Asia will look poses the greatest challenge to programs favorably upon offers of assistance and aid. with global eradication as the ultimate goal.
Africa Conclusions Africa is the most vulnerable bloc to communicable diseases, therefore Rapid development and prevention of diseases is extremely industrialization brought this world new important. Tropical Africa especially earned technologies and means of transportation. a reputation of being a breeding ground for With increasing trade and movement, comes various infectious diseases. Health the easy spread of disease. The 1960s was a Infrastructure lags behind in development as critical decade in determining the well as sewage, housing, and water supplies approaches to disease eradication and in crowded cities. Medical staff is usually prevention, especially during the time of not properly trained and greatly lacking in such advanced growth. The resolutions numbers. Unfortunately, the African public proposed in committee should reflect your health system has not received enough country’s position and should offer a attention or analysis. 95 For this reason, this solution on how to prevent communicable bloc would greatly benefit from a resolution diseases in a profound way, innovative way. that emphasizes an increase in surveillance After all, the control of communicable and survey of the public health status in diseases remains the top priority for the previously unreported areas of Africa. World Health Organization today. Various global disease eradication Understanding historical achievements and programs have failed due to unreliable mistakes in combatting these public health issues is the key to preventing diseases in the future. 94 David Hipgrave, “Communicable Disease Control in China: From Mao to Now,” NCBI. Web. 2011. Aug 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/P MC3484775/ 95 Mario Joaquim Azavedo, Disease in African History: An Introductory Survey and Case Studies (Durham, N.C: Duke University Press, 1978), 15, 46
18 Topic B: Response to the Polio been recorded.99 Those cases were all instances of infantile paralysis, which left Epidemic thousands of young children crippled for life. However, in the 1930s, 1940s, and Introduction 1950s, incidences of polio progressively spread out over other age groups.100 The rate of polio infection indeed allowed it to The World Health Organization is reach the level of an epidemic, however, the designed to track the outbreaks of evolving resulting mass hysteria elevated the infectious diseases and to initiate the kind of significance of the outbreak.101 The response needed to protect populations from responses to the polio epidemic were the consequences of epidemics, regardless of controversial – some focused on therapy that their origin.96 In the late 19th century, would ease the symptoms of polio while increasing trade and travel with Eastern others tried to reverse the paralysis. 102 In countries let to outbreaks of cholera and 1955, the polio vaccine began to make its other infectious diseases in Europe. With way around the world. tens and thousands of people dying from Although the application of the polio epidemics in Europe, the first International vaccine was undoubtedly a huge success, Sanitary Conference convened in Paris in many questions rose about the roles of 1851 as the first attempt to establish an biomedical science in modern society. 103 international organization with the aim of For instance, throughout the final course of disease prevention and control.97 vaccine testing, humans must have been Throughout the world, organizations with chosen for trials. How were they chosen, the goal of promoting a healthy population and why? How were the results of the were established: the Pan American Health testing determined to be conclusive? Organization (PAHO) in 1902, L’Office Furthermore, had a cure been developed, International d’Hygiene Publique in 1907, how would access to the medication be and the International Sanitary Convention in established? What is the role of the World 1926. Finally, in 1948, the First World Health Organization in answering the Health Assembly, comprised of six regional preceding questions? These issues should organizations, met in Geneva to establish the be kept in mind as you read the rest of the priorities of the organization. information presented in this background Communicable diseases, such as malaria, guide. tuberculosis, yaws, endemic syphilis, polio, The outbreak of polio is truly an leprosy, and trachoma were among the top important topic for this committee. It will diseases targeted in a series of wide-ranging 98 disease control efforts. th Prior to the early 20 century, only 99 Bollet, Alfred J. Plagues & Poxes: The isolated cases of Poliomyelitis (Polio) have Impact of Human History on Epidemic Disease. New York: Demos, 2004. Print. 100 Hays, J. N. "Poliomyelitis in the United 96 "Communicable Diseases and Crises." States." Epidemics and Pandemics: Their WHO. WHO, n.d. Web. 14 July 2016. Impacts on Human History. Santa Barbara, 97 McCarthy, Michael. "A Brief History of CA: ABC-CLIO, 2005. 411-20. Print. the World Health Organization." The Lancet 101 Ibid. 360 (2002): 1111. Print. 102 Ibid. 98 Ibid. 103 Ibid.
19 allow the course of the discussion to cover a the decision about who is responsible to vast amount of key areas in terms of initiate action in the midst of an epidemic. responses to epidemics. With polio being Keep in mind that the first topic such a debilitating disease, recovery requires (communicable diseases) is centered on the effective planning in the establishment of prevention of human epidemics in the first rehabilitation programs and vaccine place while the second topic (Polio) is distribution agendas. Although the polio centered on the responses to an epidemic. epidemic in the mid 20th century occurred Splitting up these two aspects of primarily in the United States and Europe, communicable diseases will allow you to outbreaks of polio continue to occur all delve deeper into the specifics of polio, around the world. Currently, two countries, potential responses, and detailed plans of Afghanistan and Pakistan, still remain polio- action. endemic, compared to 125 countries affected in 1988. While this is a considerable Historical Background reduction, all countries are at risk of contracting polio as long as a single child Origin of Polio remains infected in the world.104 Polio, (poliomyelitis), has been Furthermore, the primary knowledge of around since antiquity. An Egyptian wall- polio in the Western worlds of Europe and plaque from the period 1580-1350 BC North America comes from the available depicts a young man with a withered leg, scholarly data that has been published, leaning on a staff. The term poliomyelitis indicating that a better method for derives from two Greek words, polios, surveillance and data collection is required meaning grey, and myelos, or matter, and refers to the grey matter of the spinal cord. in underdeveloped countries to accurately 106 rate the influence of the epidemic.105 The disease has had many names, In our historical committee, you have including infantile paralysis, Heine-Medin the opportunity to rewrite history. Success disease, myelitis of the anterior horns, and in total eradication of polio is the ultimate paralysis of the morning. goal of the WHO. In this committee, you The first attempt at a clinical have the chance to develop a thorough description appeared in the second edition of solution to adequately respond to polio in Michael Underwood's Diseases of Children order to provide rehabilitation therapies, (1789), which attributed polio to "teething spread immunization infrastructures, and and foul bowels." The first reported ensure that polio is merely history in 2017. outbreak was of four cases in Worksop, The topic will open up a serious England, in 1835, and the afore-mentioned discussion about ethics when it comes to Jacob von Heine wrote the first systematic safety checks regarding vaccination investigation of poliomyelitis in Germany in development and testing, the 1840. implementation of therapeutic facilities, and A puzzling aspect of polio was its transformation at the end of the 19th and beginning of the 20th century from a 104 "Poliomyelitis." World Health comparatively rare endemic disease into an Organization. WHO, n.d. Web. 15 July 2016. 106 World Health Organization. “Polio 105 Hays, J. N. Epidemics and Pandemics: Laboratory Manuel.” 4th. Edt. 2004 Their Impacts on Human History. Santa http://whqlibdoc.who.int/hq/2004/WHO_IV Barbara, CA: ABC-CLIO, 2005. Print. B_04.10.pdf 10/10/16
20 epidemic disease in the world's most A United States Army virus advanced societies, particularly in commission operating in North Africa Scandinavia and the United States.107 during World War II was mystified by the Epidemics in Stockholm in 1887, in number of young servicemen contracting Vermont in 1894, and in Sweden again in polio in an area thought to be free of it. 1905 and 1911 prefigured the great New Subsequent investigations revealed that York epidemic of 1916, in which 27,000 there was polio, but it was never recognized people, mainly but by no means exclusively in the acute phase.109 In countries where children, were disabled and 6,000 died. polio was endemic, they reasoned, there Public health authorities responded by were not more cases because most people placarding houses where it had struck and acquired immunity in infancy by having a by tearing children suspected of having mild form of the disease. In countries where polio from their mothers' arms to remove developments in hygiene and sanitation had them to hospitals. reduced the occurrence of contagious In 1905, Dr. Ivar Wickman of diseases, by contrast, people no longer Stockholm recognized the contagious nature acquired immunity naturally in infancy and of polio and the importance of abortive became vulnerable to the virus when it nonparalytic cases in spreading the circulated: hence the periodic epidemics. In disease.108 In Vienna in 1908, Dr. Karl other words, epidemic polio was a Landsteiner and Dr. Erwin Popper byproduct of the measures taken to control discovered that the infectious agent was a other infectious diseases. virus; but this filterable virus was so small The majority of people that are that it could not be seen until the electron infected with poliomyelitis develop viral microscope was invented in the 1930s. In replication in their alimentary tract that does the United States, Dr. Simon Flexner not cause symptoms while about 24% of succeeded in transferring poliovirus from others develop fevers, headaches, and monkey to monkey artificially, but failed to soreness. In less than one percent of distinguish between experimental infections, the virus enters the nervous poliomyelitis in the monkey and the natural system and demolishes motor neurons, spread of the disease in man. As a result of causing severe debilitation. 110 his influence, the discovery that polio was initially an intestinal infection, the virus Historical Treatments circulating by the oral-fecal route, was In the early 20th century—in the delayed in America. It was thought that the absence of proven treatments—a number of virus was airborne, and in the 1930s, time odd and potentially dangerous polio and money were wasted in developing treatments were suggested. In John Haven ineffective nasal sprays. Emerson's A Monograph on the Epidemic of Poliomyelitis (Infantile Paralysis) in New
107 PHI's About Polio: History of Acute Polio. Accessed October 10, 2016. http://www.post- polio.org/edu/aboutpol/hist.html. 109 Ibid 108 PHI's About Polio: History of Acute 110 WHO, “Poliomyelitis,” WHO. Web. 26 Polio. Accessed October 10, 2016. Nov 2015, Nov 2016. http://www.post- http://www.who.int/biologicals/areas/vaccin polio.org/edu/aboutpol/hist.html. es/poliomyelitis/en/
21 York City in 1916, one suggested remedy to stimulate patient’s muscles and did not reads111: prove to be an effective treatment. “Give oxygen through the In 1948, Vitamin C became another lower extremities, by positive popular treatment for poliomyelitis. It was electricity. Frequent baths treated like an antibiotic and was using almond meal, or administered every two to four hours in oxidising the water. doses ranging from one thousand to two Applications of poultices of thousand milligrams. Some children under Roman chamomile, slippery the age of four even received injections of elm, arnica, mustard, vitamin C directly into their muscles.114 Dr. cantharis, amygdalae dulcis Klenner, the main proponent of the Vitamin oil, and of special merit, C treatment, made serious claims about the spikenard oil and effectiveness of the vitamin against polio, Xanthoxolinum. Internally which contradicted experts’ claims that it use caffeine, Fl. Kola, dry was not effective. Indeed, Dr. Albert B muriate of quinine, elixir of Sabin, an established physician specializing cinchone, radium water, in polio, revealed in a 1939 paper, that when chloride of gold, liquor calcis rhesus monkeys were treated with vitamin and wine of pepsin” C, paralysis caused by polio was not Following the 1916 epidemics and prevented or cured.115 having experienced little success in treating Conventional treatments to polio patients, researchers set out to find poliomyelitis required patients to remain new and better treatments for the disease. In immobilized. While some were given splints 1926, the department of physical therapy and metal braces to maintain support, others located in the Reconstruction Hospital of were required to sleep on boards. Sister New York began a clinical trial aimed at Elizabeth Kenny, earning the title sister for treating polio with electrical therapy.112 being a chief nurse in World War I, created Physicians believed that the stimulation of the Kenny Regimen.116 In treating polio motor neurons by electric shock would cases in rural Australia between 1928 and strengthen the production of necessary 1940, Kenny had developed a form of biological molecules to result in the restoration of neural control of the muscles.113 However, electrotherapy failed http://aim.bmj.com/content/11/2/66.abstract #cited-by 114 Robert Landwehr, “Origin of Vitamin C 111 Emerson H (1977). A monograph on the Treatment for Polio,” AscorbateWeb. Web. epidemic of poliomyelitis (infantile 22 Mar 2003, Nov 2016. paralysis). New York: Arno Press. 112 JAMA, “Electrodiagnosis and http://www.cosmicpenguin.com/codex/4- Electrotherapy in Paralysis Following Origin_Of_Vitamin_C_Treatment_For_Poli Poliomyelitis,” Jamanetwork. Web. 13 Mar o-Klenner.html 1926, Nov 2016. 115 Ibid. http://jamanetwork.com/journals/jama/articl 116 Miki Fairley. "Sister Kenny: Confronting e-abstract/240029 the Conventional in Polio Treatment." O&P. 113 AIM, “A Brief Review of the History of Nov 2008, Nov 2016. Electrotherapy and its Union With http://www.oandp.com/articles/2008- Acupuncture,” AIM. Web. 1993, Nov 2016. 11_09.asp
22 physical therapy that—instead of metal respirator assumed an immobilizing afflicted limbs—aimed to almost animate personality relieve pain and spasms in polio patients and became a symbol of through the use of hot, moist packs to protection and security… We relieve muscle spasm and early activity and were incomplete embryos in exercise to maximize the strength of a metal womb.”119 unaffected muscle fibers and promote the neuroplastic recruitment of remaining nerve In 1939, the National Foundation for cells that had not been killed by the virus. Infantile Paralysis (NFIP), or the March of Sister Kenny later settled in Minnesota Dimes, distributed the iron lung in massive where she established the Sister Kenny quantities, contributing to the increasing Rehabilitation Institute, beginning a survival rate of polio patients.120 In addition, worldwide crusade to advocate her system the NFIP, headed by Basil O’Connor, of treatment. Slowly, Kenny's ideas won created a system of local chapters that was acceptance, and by the mid-20th century had able to fundraise and provide aid to those become the hallmark for the treatment of suffering from polio.121 paralytic polio. In combination with antispasmodic medications to reduce Contemporary Conditions muscular contractions, Kenny's therapy is still used in the treatment of paralytic poliomyelitis.117 Polio, first, became a reason for Polio patients also used the tank respirator, major concern in 1894 when over 100 cases or more commonly known as the Iron Lung, were reported in the US in Vermont. Years after its invention in 1927. Philip Drinker passed, and the number of poliomyelitis and Louis Agassiz Shaw created the cases continued to grow. With the fear of electrically powered machine with the polio sweeping across the globe, researchers function of sustaining a person’s respiration set off to the task of developing a vaccine to for up to two weeks. This machine was able treat the disease. Out of this effort, a few to circulate air in and out of the lungs, attempts to create a viable vaccine occurred. keeping patients who were unable to breathe Some of these efforts even went into testing, on their own alive.118 In 1954, Larry while the others had no effect on the disease. Alexander, a polio patient, remarked: Of the ones being tested, one of the vaccines “There was a tremendous was delivered to over a thousand children; in psychological element at turn, the vaccine proved unviable, and even work in all of us in our caused a few deaths. With the risk of killing relationship to the lung. The more children, researchers then turned to testing the other vaccine attempts on particular patients at mental hospitals. These 117 Cartwright, R.L. "Sister Kenny Institute." Sister Kennedy Institute. Accessed October 12, 2016. 119 Ibid. http://www.mnopedia.org/thing/sister- 120 Ibid. kenny-institute. 121 March of Dimes, “A history of the 118 Smithsonian, “The Iron Lung and Other March of Dimes,” March of Dimes, Web. Equipment,” Smithsonian. Web. Nov 2016. Nov 2016. http://amhistory.si.edu/polio/howpolio/ironl http://www.marchofdimes.org/mission/a- ung.htm history-of-the-march-of-dimes.aspx
23 tested vaccines were not successful in to polio. 125 There was around 60 to 70% treating and immunizing against polio.122 success rate in preventing polio. In 1947, Dr. Jonas Salk began his However, all of a sudden, the testing research on the poliomyelitis, in an effort to of the vaccine led to 200 more cases of polio develop a potential vaccine. The disease had and even a few deaths. In light of this news, been progressively growing at the time with the testing of Salk’s vaccine was no clear indication of how it was spreading immediately stopped, and an investigation of so quickly.123 By 1952, Salk had developed the recent events was ordered. Fear had a polio vaccine in the form of an injection; gripped the nation; many began to believe he injected a benign strain of polio into a that there would be no way to combat the human, so that the body would produce the spreading disease. Examiners, from the needed antibodies itself to combat the virus. investigation, found that the vaccines He tested its effectiveness on subjects who responsible for the new polio cases and the had already had the virus, and then on deaths were created in the same faulty subjects, including him, who had never batch.126 At once, people nationwide caught the disease. Dr. Salk received regained hope to finally get rid of polio. To positive results, and published his findings. prevent any more faulty batches, drug Upon announcing his results, the US saw companies were held to higher benchmarks, him as a hero.124 and testing and production of the vaccine The US government took note of this resumed. Finally, in 1955, the US new vaccine, and authorized its testing Government licensed the nationwide throughout the country. In 1954, Thomas distribution of this polio vaccine. As every Francis Jr. at the University of Michigan year passed, the number of polio cases took charge of the clinical trials of Salk’s dropped by half as a result of the vaccine. vaccine. Francis Jr. conducted this testing on The effect the vaccine had on the number of a much higher level than had ever been affected patients was so remarkable that by done; the severity of the disease placed 1959, nearly 100 countries around the world much pressure on testing the vaccine, which began distributing Salk’s vaccine.127 accounts for the huge interest and Not convinced the vaccine Salk participation in its trials. Around 2 million produced was effective enough, Albert children in the US received a dosage as a Sabin took to developing his own form of part of the clinical trial. Gathering the results vaccine using a strain of polio closer to the of the trials, Francis Jr. found that Salk’s one spreading nationwide. He managed to poliomyelitis vaccine was a success; Salk develop a live oral polio vaccine, which was had developed a safe and efficient treatment ready to be tested by 1957.128 Though the vaccine improved the relative ease with which subjects could be treated, there was not a huge deal of support for this new
122 Beaubien, Jason. "Wiping Out Polio: How The U.S. Snuffed Out A Killer."NPR. 125 “Polio." Diseases and the Vaccines That NPR, 5 Oct. 2012. Web. 07 Aug. 2016. Prevent Them. Centers for Disease Control 123 “Salk Produces Polio Vaccine.” PBS. and Prevention, Feb. 2013. Web. Aug. 2016. PBS, 1998. Web. 04 Aug. 2016. 126 “Salk Produces Polio Vaccine.” PBS. 124 "Salk Announces Polio Vaccine." PBS, 1998. Web. 04 Aug. 2016. History.com. A&E Television Networks, 127 Ibid. 2010. Web. 05 Aug. 2016. 128 Ibid.
24 vaccine, forcing him to test in other places and could lead to muscle paralysis.134 US such as Soviet Union and other countries in President Franklin D. Roosevelt was a in Eastern Europe.129 victim of polio, which left him paralyzed; in Yet, as people got a hold of the polio an effort to bring more attention to this vaccine, many were exposed to the simian virus, he founded the National Foundation virus 40 (SV 40). SV40 had contaminated for Infantile Paralysis as well as was one of the vaccines, and ended up infecting the frontrunners in pushing for funding more millions of patients. This virus was present research on the poliovirus.135 in the tissue cultures that were used to make Paralysis was very much-dreaded the polio vaccines. The SV 40 thing among many in the US. Americans contamination of polio vaccines had been nationwide saw paralysis as crippling and detected in 1960.130 feared this loss of independence. Yet, as The fight for many polio victims did polio spread and paralyzed many patients, not end after surviving the infection. Years people were forced to become more after recovering, many are affected by post- accepting and more aware of these effects of polio syndrome or PPS. Though not deadly, polio. As a result, many rehabilitation PPS can cause weakening throughout the hospitals were opened to the paralyzed body among other issues. Post-polio victims of polio. In the past, rehabilitation syndrome is a result of polio affecting motor focused mainly on soldiers who were at war. neurons in the central nervous system, Polio opened the eyes of many and led to a which causes the fatigue and pain many greater awareness to better rehabilitation experience. 131 Those more severely affected programs.136 by polio initially tended to face the harsher Within these rehabilitation hospitals, conditions of post-polio syndrome. 132 efforts were taken to help those paralyzed, However, much was not known regarding especially from polio, recover as much as this ailment until after the 1960s.133 possible. Doctors would assist patients with When the poliovirus attacks, it regular exercise to work the paralyzed affects the motor neurons within the brain, muscles. Some hospitals even used electrical currents on these muscles to reawaken them.137 In addition, patients were helped 129 Ibid. 130 Butel, J. S. "Simian Virus 40, Poliovirus Vaccines, and Human Cancer: Research Progress versus Media and Public 134 Tiffreau, V., et al. "Post-polio Syndrome Interests." Bulletin of the World Health and Rehabilitation." Annals of Physical and Organization 78.2 (2000): 195-98. World Rehabilitation Medicine 53.1 (2010): 42-50. Health Organization. Web. 05 Aug. 2016. Web. 05 Aug. 2016. 131 "Post-polio Syndrome." Centers for 135 “Salk Produces Polio Vaccine.” PBS. Disease Control and Prevention. Centers for PBS, 1998. Web. 04 Aug. 2016. Disease Control and Prevention, 02 Aug. 136 Wilson, Daniel J. "Braces, Wheelchairs, 2016. Web. 07 Aug. 2016. and Iron Lungs: The Paralyzed Body and the 132 "Polio." March of Dimes. March of Machinery of Rehabilitation in the Polio Dimes, 2007. Web. 05 Aug. 2016. Epidemics."Journal of Medical Humanities 133 "Post-Polio Syndrome Fact Sheet." Post- J Med Humanit 26.2-3 (2005): 173-90. Web. Polio Syndrome Fact Sheet. National Aug. 2016. Institute of Neurological Disorders and 137 "Polio - Rehabilitation." WHO. WHO, Stroke, 23 Feb. 2015. Web. 05 Aug. 2016. n.d. Web. Aug. 2016.
25 getting used to wheelchairs, crutches, and Past UN and International iron lungs.138 As the patients affected by polio Action slowly recovered, they came to understand that those disabled are much more capable As seen in the case of the poliovirus than was once thought. Originally, people outbreak in the US, the number of affected saw the paralyzed or disabled as polio victims gradually began to decrease untouchables and incapable of doing after the distribution of Salk’s poliovirus anything. Opinions quickly changed as polio vaccine. A few mass immunization camps left many disabled. To help themselves were set up around the US to control the receive a greater appreciation nationwide, outbreak in the most efficient way the affected polio victims came together and 142 139 possible . Albert Sabin’s oral polio vaccine formed the Disability Rights Movement. was found to be the more favored vaccine Their goal was to push legislation to help since it was cheaper and relatively simpler those disabled overcome the barriers to utilize.143 instituted culturally. By the 1970s, the However, major UN resolutions movement started to gain ground with 140 concerning poliomyelitis have not been legislators. passed. Here is where we can learn from It was not uncommon to find polio future efforts! In 1988, the World Health and PPS victims overcome with depression Organization passed the Global Polio or other mental health issues. Those who Eradication Initiative.144 With both the oral were affected by polio were generally were and inactivated polio vaccines healing those treated as untouchables. This, in turn, caused affected and preventing others from being many victims of polio to feel isolated and 141 affected, WHO found the poliovirus to be sometimes even depressed. manageable enough to completely eradicate in the coming decades. Mass immunization was a key factor in facilitating the process.
142 "The U.S. Government and Global Polio Efforts." Global Health Policy. The Henry J. Kaiser Family Foundation, 10 June 2016. Web. 05 Aug. 2016. 143 Sutter, R. W., and C. Maher. "Mass 138 Wilson, Daniel J. "Braces, Wheelchairs, Vaccination Campaigns for Polio and Iron Lungs: The Paralyzed Body and the Eradication: An Essential Strategy for Machinery of Rehabilitation in the Polio Success." Current Topics in Microbiology Epidemics."Journal of Medical Humanities and Immunology Mass Vaccination: Global J Med Humanit 26.2-3 (2005): 173-90. Web. Aspects — Progress and Obstacles 304 Aug. 2016. (2006): 195-220. PubMed. Web. 04 Aug. 139 "NMAH | Polio: Scientific and Medical 2016. Legacy." NMAH | Polio: Scientific and 144 Armstrong, Gregory L., MD. "For the Medical Legacy. Smithsonian, n.d. Web. Record: A History of Polio Eradication Aug. 2016. Efforts." Chapter 3 Infectious Diseases 140 Ibid. Related to Travel. Centers for Disease 141 "Polio and Post Polio Syndrome." NHS. Control and Prevention, 9 June 2015. Web. NHS, 26 Aug. 2015. Web. Aug. 2016. 04 Aug. 2016.
26 In addition, advocates from nations around containment efforts.146 There is a the world came together and pushed their fundamental role for environmental fellow citizens to get immunized in order to surveillance in routine monitoring as an stop the poliovirus; the support the program early warning system in polio-free countries. received from many health and political The Europe should emphasize the utilization leaders worldwide was necessary for it to of environmental monitoring in sewage as become as successful as it is now.145 well as maintain high polio immunity levels Yet, the initiative did and still is in order to prevent re-establishment of facing a few issues. In a few countries, such circulation of wild poliovirus. Given the as Nigeria, political leaders refused to stand proximity of the European countries, the for the eradication, which led to a decline in circulation of wild poliovirus in one country vaccinations in the respective nations. Not is a threat to all others. Vaccination only does this highlight the effectiveness of coverage is necessary to be prevalent and the vaccines, but also stresses the complete in Europe. More than 60,000,000 importance of having leaders with much had been vaccinated in the U.S.S.R. alone influence advocating for the cause. To without reported ill effects.147 Joint efforts ensure complete eradication of polio, of European countries are conductive in basically everyone worldwide needs to be polio fight. As five northern European vaccinated; however, there are a few groups nations have international agreements for of people who do not believe in vaccines joint action in the war on polio, these because of religious beliefs, and end up countries should poor their efforts and share allowing the poliovirus to continue to respirators, doctors, nurses, physiotherapists spread. 12 Understanding the aftermath of the and other assistants.148 initiative will allow you to come up with better solutions to the eradication initiative North America in committee. North America has been devoting its efforts in developing effective vaccination against polio. The Unite States domestically Bloc Positions has been undergoing a massive promotion of Europe vaccination. For instance, Sabin, MD, European countries are at high or developer of the oral polio vaccine intermediate risk of poliovirus transmission. participation such as the Pan American The time from collection of a stool sample Health Organization (PAHO) and Rotary to analysis for poliovirus in polio eradication International, coalition against polio is under programmes has often been weeks, not days, development. Advances in science often causing delays in response, more widespread meet temporary setbacks, and it is hardly transmission, and greater and more costly 146 Heymann, D., and Q. Ahmed. "The Polio Eradication End Game: What It Means for Europe." Eurosurveillance 19, no. 7 (2014): 145 Lahariya, Chandrakant. "Global 20702. doi:10.2807/1560- Eradication of Polio: The Case for “finishing 7917.es2014.19.7.20702. the Job”." Bulletin of the World Health 147 "Oral Polio Vaccine." Jama 173, no. 17 Organization 85.6 (2007): 421-500. Bulletin (1960): 1929. of the World Health Organization. World doi:10.1001/jama.1960.03020350047012. Health Organization. Web. 05 Aug. 2016. 148 Ibid.
27 surprising that the Salk polio vaccine ran including measles and polio. With the help into trouble. On April twelfth, at Ann Arbor, of Revolving Fund, LAC will be able to Michigan, 500 scientists and 100 reporters eradicate polio and measles. Guaranteeing assembled for the unveiling of Dr. Thomas the supply of vaccines for the countries of Francis’ report on the vaccine’s nationwide LAC has required very strong and field trials of 1954.149 The vaccine was committed relationships between private described as safe and effective. Not only vaccine manufacturers, PAHO, and there should be effective promotion of safe participating member countries. utilization of polio vaccination, but also more government funding is required for Asia and the Pacific North America to lead research projects to Reaching people in a place like East combat commutable diseases. Asia and the Pacific, which is home to many mountains, thousands of islands and a huge Latin America and the Caribbean variety of languages is not an easy task. The Latin America and the Unrelated polio outbreaks were recently Caribbean countries will try to work closely seen in Laos and Myanmar, where hard to with the Pan American Health Organization reach communities were affected by through the Revolving Fund that offers a ‘vaccine-derived poliovirus’. This virus is a sustainable supply of safe and effective rare but well-documented weakened strain vaccine. The Pan American Health of poliovirus used in the oral polio vaccine, Organization (PAHO) is the Regional Office which is sometimes found when vaccination of the Americas for the World Health levels are low. If people in Asia and the Organization (WHO). As such, it bears the Pacific are fully immunized, the yare mandate to provide technical cooperation to protected against all forms of the virus. But member countries for improving health in areas where there is low immunization conditions, including the universal provision coverage and where people do not have of immunization services.150 The activities access to safe water and sanitation systems, of the PAHO Revolving Fund, coupled with there is a risk of fecal-oral transmission of the provision of high-quality technical this weakened virus to unimmunized assistance, were crucial to the successful people.151 Hence, the governments of Asian control, elimination, or eradication of most countries should share a common objective. of the region’s great childhood killers, They should work with the foreign partners to ensure the availability of vaccine supplies and inform communities in some of the most 149 Hampton, Lee. "Albert Sabin and the remote areas on the need for children to be Coalition to Eliminate Polio From the fully vaccinated. The only way to ensure the Americas." American Journal of Public Health 99, no. 1 (2009): 34-44. doi:10.2105/ajph.2007.117952. 151 Eltayeb, By Simon Nazer Abu Obeida, 150 Andrus, Jon, and Ciro De Quaddros. By Xiaojun Wang, and By UNICEF "New Vaccines for Developing Countries: EAPRO. "The Big Switch: Eradicating Polio Will It Be Feast or Famine?" American - UNICEF East Asia & Pacific." UNICEF Journal of Law and Medicine 35 (2009). East Asia Pacific The Big Switch http://eds.b.ebscohost.com/ehost/pdfviewer/ Eradicating Polio Comments. 2016. pdfviewer?sid=f6855bb6-2c43-4b10-a669- Accessed October 12, 2016. a3c9257e0a16@sessionmgr101&vid=1&hid https://blogs.unicef.org/east-asia-pacific/the- =127. big-switch-eradicating-polio/.
28 crippling poliovirus is eradicated is by government-run child immunization ensuring immunization coverage levels services, track children’s immunization remains high. history and encourage vaccination of children missing scheduled vaccinations, Africa and mobilize local opinion leaders. More The polio-eradication initiative has activities are needed to promote vaccination led to the largest influx of public health awareness and safety, household hygiene, sanitation, home diarrheal-disease control, resources into Africa since the smallpox- 153 eradication campaign, comprising both and breastfeeding. human resources and infrastructure investment. The threat of a global influenza pandemic highlights the value of well Questions a Resolution Must coordinated, functional disease surveillance Answer systems for Africa to build up. Leaders in
Africa need to design, develop and implement efficient, flexible and In addition to answering the comprehensive systems that integrate staff, questions posed in the introduction, the resources, and information systems to following questions should be considered conduct infectious disease surveillance and when writing the resolution: response. The objective for Africa is to prepare for effective and timely public 1. How will public health sectors be able to health responses that demonstrate the ability overcome regional concerns over vaccine of health systems to provide reliable and safety? timely information for action. Surveillance Parents seem increasingly concerned plays a critical role to record public health about the safety of the vaccinations responses and early detection of human recommended for their children due to some disease. The surveillance system can be serious side effects. While it is perfectly organized into different levels---peripheral, reasonable for parents to be concerned about intermediate and central levels.152 the vaccines given to their children, vaccination plays an irreplaceable role for NGOs commutable disease control. Concerns about The vaccination should spur the vaccine safety are more common among formation of a coalition of governments, parents of under-immunized children, but international organizations, and nonprofits. many parents of fully immunized children The NGO sector should try to improve have also expressed concerns. Vaccine- access and reduce family and community hesitant parents tend to believe they can resistance to vaccination. It should help train control their child’s susceptibility to disease, thousands of mobilizers from high-risk have doubts about the reliability of vaccine communities to visit households, promote 153 Successful Polio Eradication in Uttar 152 "Planning an Integrated Disease Pradesh, India: The Pivotal Contribution of Surveillance and Response System: A the Social Mobilization Network, Matrix of Skills and Activities." BMC NGO/UNICEF Collaboration. 2013. Medicine. Accessed October 12, 2016. Accessed October 12, 2016. http://bmcmedicine.biomedcentral.com/artic http://www.ghspjournal.org/content/1/1/68.s les/10.1186/1741-7015-5-24. hort.
29 information, prefer negative outcomes due 4. How important is the impact of to inaction versus negative outcomes due to infrastructure on growth in developing action, or rely on herd immunity to protect countries? their child. Other characteristics include Understanding the impact of parents with alternative medical beliefs, infrastructure on growth is essential to have those with direct experience with adverse a balanced quantitative view on the events to vaccines, college graduates, relevance of infrastructure for growth. That females, and whites. infrastructure matters to growth is now relatively well recognized and widely 2. How would the Revolving Fund make the understood among practitioners and policy health products prices affordable for makers. There is a plethora of anecdotal and national immunization programs in Latin more technical evidence that better quantity America and the Caribbean? and quality of infrastructure can directly To establish innovative financial raise the productivity of human and physical mechanisms for procuring products at capital and hence growth. However, how affordable prices is no easy task. If LAC much, specifically, and which infrastructure depends on the Revolving Fund for health matters when to output levels and their improvements, countries have to make growth in developing and transition tangible arrangements for proper programs economies is not as clearly settled. to take place. Internally, the financial mechanisms have to be well developed. 5. Why are infectious diseases are still a problem? 3. How much should the developing In the 1970s many experts thought countries fund disease fight compared with that the fight against infectious diseases was the developed countries? over. In fact, in 1970, the Surgeon-General The developing countries need to of the United States of America indicated invest to tackle commutable diseases like that it was "time to close the book on Polio. Forecasting a total of $34 billion infectious diseases, declare the war against needed to fight NTDs for the next 16 years, pestilence won, and shift national resources the WHO said governments whose people to such chronic problems as cancer and heart are blinded, disfigured and killed by such disease". diseases should recognize the great potential Indeed, complacency about the threat human and economic return on tackling of communicable diseases in the 1970s led them. While increased investments by to less priority for communicable disease national governments can alleviate human surveillance systems. Partly as a result, these misery, distribute economic gains more systems were not maintained in large parts evenly and free masses of people long of the developing world, and this retarded trapped in poverty, endemic countries recognition of the magnitude of problems should play their part. Some endemic posed by new and re-emerging countries are fast developing, and as they communicable diseases, and therefore move up the ladder they also have more effective action to control them. means to pay for tackling diseases. Overall, eradication of polio is achievable with In addition, consider the questions that were continued effort and investment. posed in the introduction: 6. How were people chosen for clinical trials, and why?
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7. How were the results of the testing determined to be conclusive?
8. Had a cure been developed, how would access to the medication be established?
9. What is the role of the World Health Organization in answering the preceding questions?
10. In addition, what steps should the World Health Organization take to encourage the eradication of the poliomyelitis virus?
Conclusion
The topic of polio is an essential one for this committee, especially since it will allow for a fruitful discussion about various aspects of the response efforts. With polio being such a debilitating disease, the road to recovery requires effective planning in the establishment of rehabilitation programs, vaccine distribution agendas, and surveillance methods. Presently, two countries, Afghanistan and Pakistan, still remain polio-endemic. As long as a single child remains infected in the world, all countries are at risk of contracting polio. The ultimate goal of WHO is total eradication of polio. In this historical committee, delegates have the opportunity to rewrite history, determine the optimal course of action, and learn from past decisions.
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