RI General Secretary John Hewko’s Address to

the World Vaccine Congress – 12 April 2012

Washington, DC

It is my honor and privilege to be here at the World

Vaccine Congress and to proudly represent the 1.2

million men and women of Rotary

And on behalf of the 34,000 Rotary clubs worldwide,

let me also express my sincerest gratitude to every

person in this room. Because if it weren’t for you —

the professionals who fund and conduct vaccine

research — who develop, produce, and distribute

these lifesaving agents — we at Rotary could not do

what we do.

And what do we do?

As you saw in the video: We eradicate polio.

We do other things too, of course. Rotary clubs

support literacy and education. We promote

maternal and child health. We improve access to

clean water and sanitation.

But Rotary’s highest priority is the eradication of

polio.

This crippling childhood disease has been Rotary’s

sworn enemy for more than three decades, and you

provide us and our partners with the weapons — the

vaccines — that have carried us to the threshold of

victory. Thanks to vaccines, humanity was able to

conquer smallpox. And now we are poised to make

history a second time by eradicating polio.

But before I talk in more detail about how close we

truly are to a polio-free world, I want to share a little

story about the polio vaccine. Call it a pop-culture

tidbit that perhaps illustrates just how much a part of

our lives vaccines have become — in ways that we

don’t always expect.

A few weeks ago, I came across a news story about

a gentleman named Robert Sherman, who had just

passed away at the age of 86.

His obituary indicated that he was an award-winning

composer who did a great deal of work for Disney

Studios. One of his assignments was to write the

songs for the 1964 musical, Mary Poppins, a very

popular movie that I certainly remember, and I

imagine many of you do too.

One day, Mr. Sherman found himself struggling with

the lyrics for one of the film’s most important songs.

He needed a catchy phrase around which to build

the song — to anchor it. Something memorable. But

try as he might, nothing seemed to work.

Then his 8-year-old son came home from school.

The father asked the age-old question: “So how was

school?”

“Great, we got the polio vaccine today,” came the

response.

Mr. Sherman assumed it was delivered by injection.

“Did it hurt?”

“Nah,” the boy said. “They just stuck the medicine on

a lump of sugar.”

A light bulb popped above the father’s head, and an

instant classic was born.

“A Spoon Full of Sugar Helps the Medicine Go

Down.”

Yes, the same vaccine that has saved millions of

children from a lifetime of disability also inspired one

of the most memorable songs in Hollywood history,

a song that helped Mr. Sherman win an Academy

Award for Best Original Score that year.

I would say that’s a great example of creative, off-

label use.

Now let me shift gears and take a look at how

Rotary and our partners in the Global Polio

Eradication Initiative have put the oral polio vaccine

to its intended use.

And to great effect, I must say.

Rotary officially took on polio eradication as our

number one priority when we started our PolioPlus

Program in 1985. We were the first NGO to address

the problem.

In 1988, Rotary was joined by the World Health

Organization, UNICEF, and the US Centers for

Disease Control and Prevention to launch the Global

Polio Eradication Initiative. And more recently, the

Bill & Melinda Gates Foundation has joined the

cause.

Rotary’s chief responsibilities are fundraising,

advocacy, and mobilizing volunteers — and we do a

very good job at all three.

In fact, to date Rotarians have contributed more than

$1.2 billion to the polio eradication effort.

Many consider the polio eradication initiative to be

the most ambitious and successful public-private

partnership ever forged. And I want to get back to

the private sector part of the equation in a few

minutes, because it’s very important and it speaks

directly to many of us here today — as private sector

professionals.

But first, let’s look at what this partnership has

accomplished so far.

Since the initiative began its work to immunize the

world’s children against polio, the incidence of polio

has dropped by more than 99 percent — from

350,000 cases a year to fewer than 700 for all of

2011. This year, we’ve had 36 cases worldwide as

of April 1, well below the case-count at the same

point in 2011.

Think about these numbers.

We have reached more than two-and-a-half

BILLION children with the oral polio vaccine. Polio

eradication activities have reached more families

than any other public health initiative in history –

introducing millions of parents to the basic concepts

of preventive health care.

In doing so, we have prevented more than 5

MILLION cases of childhood paralysis and hundreds

of thousands of pediatric deaths.

Already this year, we have celebrated the long-

anticipated milestone of seeing India removed from

the list of polio-endemic countries, leaving only

Afghanistan, Nigeria, and Pakistan as nations where

the wild poliovirus has never been stopped.

And because this is such an important milestone,

let’s look a little more closely at India, a country of

more than a billion people and a host of challenges

— among them poverty, pollution, and poor

sanitation — challenges that until recently made

India an epicenter of polio.

When the eradication initiative began, India was

experiencing about 75,000 new polio cases a year.

And if you have spent any time at all in India, you

have seen the ravages of polio for yourself —

children and adults permanently disabled, unable to

walk — the so-called crawlers of the streets — and

most of them with little hope of receiving any

meaningful treatment or rehabilitation.

However, defeating polio in India didn’t “just happen.”

Instead, India’s progress demonstrates — perfectly

— how determination, persistence, and planning will

ultimately win the day.

Year after year, thousands of health workers and

volunteers — many of them Rotarians — have

methodically carried out massive immunization

rounds — called National Immunization Days — in

an effort to reach every Indian child under age five

with the oral polio vaccine.

This means going door-to-door — from the remotest

villages to the teeming urban slums — to make sure

no child is missed.

Public awareness rallies drive home the importance

of vaccinations.

Parental misgivings and cultural misconceptions are

identified and addressed.

Detailed records are kept. Home addresses are

logged.

Even the children themselves become living medical

records — their pinky fingers dyed purple to show

they have received the vaccine.

Over and over again these immunization rounds

take place — vaccinating more than 170 million

children each time. Then come the mop-up rounds,

targeting communities where children may have

been missed or where risk is particularly high.

And sure enough, over time, India’s polio infection

rate began to drop. By 2009, new cases totaled just

over 700. In 2010, only 42 cases were reported. In

2011, there was only one case — a young girl in

West Bengal — recorded on January 13 of that year.

And that was it.

On January 13, 2012, India celebrated a full year

without one new case of polio. India’s removal from

the endemic list was announced in February during

a Polio Summit in New Delhi — a meeting convened

jointly by Rotary and the Indian Health Ministry.

Ladies and gentlemen, if polio can be beaten in

India, it can be beaten anywhere.

Of course, the vaccine industry has been vital to our

progress.

In India, for example, it was very likely that the

introduction of the new bivalent vaccine — which

targets poliovirus types 1 and 3 — contributed

substantially to the steep case-count reductions we

saw in 2010 and 2011.

The swift production and deployment of the bivalent

vaccine resulted from an extraordinary collaboration

between WHO, UNICEF, government regulatory

agencies and — of course — the vaccine companies.

Throughout the history of the polio eradication

initiative, the vaccine industry has been amazing in

its ability to continually and quickly reconfigure the

polio vaccines to make sure we have the right

weapons at the right time to use against this

tenacious disease.

Polio vaccine producers have been incredibly

generous in negotiating prices to help make

vaccines affordable to developing countries, even

donating vaccine supplies for use in emergency

responses to sudden outbreaks.

When such emergencies occur, we know we can

rely on our pharmaceutical industry allies to deploy

the right vaccine in the quantities needed to respond

swiftly and effectively.

Trivalent. Monovalent. Bivalent. Each type of oral

polio vaccine has proven indispensable to our effort.

And as we approach the end game with polio, it is

almost certain that injectable, inactivated polio

vaccine — IPV — will be introduced into the mix to

help in the final stages of eradication and our

transition into the post-eradication era.

Yes, I said post-eradication era, but let us not get

ahead of ourselves. There is still much to do — and

serious challenges to overcome — before we reach

that point.

The Global Polio Eradication Initiative retains an

Independent Monitoring Board that issues quarterly

reports that take a very critical look at our strategies

and practices.

These reports provide a valuable reality check that

keeps us from becoming too giddy over our

successes – even India’s milestone, as wonderful

and important as that is.

While acknowledging India’s success, the board in

its most recent report said we simply have to do a

better job on-the-ground – at the local level – to

reach every child with the vaccine in the remaining

polio-affected countries.

This means giving the vaccinators the resources and

tools they need to get the job done — better training,

fair compensation, creative incentives, adequate

support, continuous motivation.

We have to make sure that the changes and

improvements we make at the organizational level

are put into practice at the community level, where it

counts.

The Independent Monitoring Board reminds us that

beyond the three endemic countries, so-called “re-

established polio” has become persistent in Angola,

Chad, and the Democratic Republic of Congo.

And 20 additional countries have had smaller polio

outbreaks since the start of 2010. Again, these are

countries where the poliovirus had once been

stopped.

This is alarming, to be sure. And it demonstrates

why it is so critically important to stop the

transmission of the poliovirus in the three endemic

countries, which are the reservoir that enables the

disease to re-establish itself elsewhere.

For example, in 2011, polio cases in non-endemic

countries totaled 310, almost as many as the 340

cases in the endemic countries.

To me, one of the most surprising outbreaks last

year occurred in China, which had been polio-free

for more than a decade. The 21 cases there were

genetically linked to the same strain of the type 1

poliovirus circulating in neighboring Pakistan – once

again, proof that we must stop polio in the endemic

counties at all costs.

And speaking of costs.

As you would expect, funding remains the single

biggest challenge to the Global Polio Eradication

Initiative.

To date, the world has spent more than $8 billion on

polio eradication. Yet, the initiative right now faces a

funding gap of more than $1 billion in order to carry

out immunization activities through 2012-2013.

Believe me — we are working hard to close that gap.

In January of this year, we at Rotary announced that

our membership had succeeded in raising more than

$200 million in new money for polio eradication. And

when you think about the state of the global

economy during the past few years, it makes what

our members did even more impressive.

This fundraising effort was in response to a $355

million Challenge Grant from the Bill & Melinda

Gates Foundation, which has added another $50

million to the total to recognize Rotary’s commitment.

To date, Rotary and the Gates Foundation each has

contributed more than $1 billion to polio eradication.

In addition to raising funds for polio eradication,

Rotary advocates as a global organization to

encourage the world’s governments to commit public

resources to a cause that benefits all families, no

matter where they live. Because Rotary is present in

more than 200 countries and regions, this has

proven to be a very effective tactic.

As I mentioned earlier, you can see how important

the private sector is to polio eradication.

Without the leadership, participation, support, and

cooperation of the private sector — vaccine

manufacturers, foundations, the professional and

community leaders in Rotary clubs — polio

eradication would still be a pipe-dream, not a global

health initiative that is 99 percent of the way to

achieving its goal.

In fact, for the purposes of polio eradication, we

could reverse the order, and call it a PRIVATE-public

partnership, because the private sector was there

first, leading the way.

It was the private sector — Rotary — that proved to

the World Health Assembly that polio eradication

was even feasible.

In 1979, the same year that smallpox was declared

eradicated, Rotary committed $750,000 through its

own grant program to buy polio vaccine to immunize

6.3 million children in the Philippines, which at the

time had the highest polio rate in the West Pacific.

By 1982, the incidence of polio in the Philippines

had dropped by 68 percent. Using the Philippine

experience as a model, Rotary launched successful

polio immunization projects in several other Asian,

African, and South American countries over the next

few years.

Rotary’s early successes in these countries

demonstrated that millions of children could be

systematically immunized against polio.

Rotary then mobilized its worldwide membership to

raise an initial war chest of $247 million to vaccinate

all of the world’s children, easily doubling its original

goal of $120 million. And as I said earlier, we

established our PolioPlus Program in 1985.

With such solid groundwork in place, in 1988 the

World Health Assembly adopted the historic

resolution that formally targeted polio for eradication,

thus creating the Global Polio Eradication Initiative,

the wonderful partnership we’ve been talking about.

And I must add that a key vaccine researcher was

with us from the beginning. Dr. Albert Sabin was a

staunch ally of Rotary and spoke at two Rotary

International conventions, in 1980 and 1985, to

encourage Rotary to embrace polio eradication as

our global cause.

Dr. Sabin was a visionary. He could see the history-

making potential of his oral polio vaccine, delivered

to the world’s children through the resources of

Rotary, an organization of everyday business and

professional people committed to the goal of a polio-

free world.

Yes, it has become increasingly clear to me that

private sector leadership is one of the key

components to any valid solution to community

problems the world over — and polio historically has

been a major one.

The continuing support of the world’s governments

is by all means crucial to our success – of course it

is — but governments alone cannot eradicate polio.

But by working together, as a team — leveraging the

strengths of both the public and private sectors —

WE CAN eradicate polio. And we will.

So what will be our legacy when polio is finally gone

for good?

For one thing, the world’s $8 billion investment will

be protected. In fact, eradication will result in net

benefits estimated at $40 billion to $50 billion over

the next two decades.

Most of the benefits will accrue in developing

countries, as per capita production goes up and

health care costs drop after the burden of polio is

lifted.

Another tangible benefit is the solid public health

infrastructure that polio eradication will leave in

place — systems that can be used for the delivery of

other vital health services.

For example, active disease-surveillance networks

have been established in all of these countries,

assets that can be readily repurposed to address

other diseases, such as measles, malaria, and HIV.

Once achieved, polio eradication will set the stage –

and provide the inspiration — for the next great

global health initiative.

But the most important legacy, of course, will be our

collective gift to children everywhere: a polio-free

world.

This realization hit me hard — and in a very

emotional way — last November in Mumbai, where

my wife and I had our first opportunity to vaccinate

children as part of a Subnational Immunization Day.

The first child I immunized that day was a little girl. I

can honestly say that the feeling of joy and pride that

I felt as I placed the vaccine drops into her mouth

will live with me forever.

Two small drops and a lifetime of misery is

prevented.

There are few certainties in life, but at least her

parents can be certain — as I am certain — that

polio will not rob that child of her future.

What more can I say?

It was a truly humbling experience, and I thank you

for enabling me — and the thousands of my fellow

Rotarians who have devoted countless hours to

immunize the world’s children — to have such a

profound and powerful impact on another human’s

life.

And I also invite YOU to become personally involved

in our cause.

Use your voices. After you leave the World Vaccine

Congress and return to your homes and to your jobs,

tell your families and colleagues how the polio

vaccines that you develop — that you manufacture,

distribute, and regulate — are helping us to make

history.

Together, we WILL End.Polio.Now.

Thank you.