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American Journal of Public Health, Vol. 87, Issue 6 922-925, Copyright © 1997 by American Public Health Association

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Ethical dilemmas in current planning for polio eradication.

C E Taylor, F Cutts and M E Taylor

Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205, USA.

Intensification of polio eradication efforts worldwide raises concerns about costs and benefits for poor countries. A major argument for global funding is the high benefit-cost ratio of eradication; however, financial benefits are greatest for rich countries. By contrast, the greatest costs are borne by poor countries; the Pan American Health Organization has estimated that host countries bore 80% of costs for polio eradication in the Americas. The 1988 World Health Assembly resolution setting up the Polio Eradication Initiative carried the proviso that programs should strengthen health infrastructures. Drastic cuts in donor funding for health make this commitment even more important. Two international evaluations have reported both positive and negative effects of polio and Expanded Programme on Immunization programs on the functioning and sustainability of primary health care. Negative effects were greatest in poor countries with many other diseases of public health importance. If poor countries are expected to divert funds from their own urgent priorities, donors should make solid commitments to long-term support for sustainable health development.


Related articles in AJPH:

Comment: ethical dilemmas in worldwide polio eradication programs.
R W Sutter and S L Cochi
AJPH 1997 87: 913-916. [PDF]  

Ethical dilemmas in polio eradication.
J W Lee, B Melgaard, H F Hull, D Barakamfitiye, and J M Okwo-Bele
AJPH 1998 88: 130-132. [PDF]  

Ethical dilemmas in polio eradication. Hyder responds.
A A Hyder
AJPH 1998 88: 131-132. [PDF]  



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B. Loevinsohn, B. Aylward, R. Steinglass, E. Ogden, T. Goodman, and B. Melgaard
Impact of Targeted Programs on Health Systems: A Case Study of the Polio Eradication Initiative
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F T Cutts and R Steinglass
Should measles be eradicated?
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