How a muddy yard in Makati changed the world

“Great things always have a small beginning.” These were the words of M.A.T. Caparas, the first Filipino president of Rotary International, and the “great thing” he referred to was the ambition to eradicate polio. Caparas is a living witness to the “small beginning” that laid the groundwork for the Global Polio Eradication Initiative, which, spanning every hemisphere, has reduced polio cases by 99.9 percent since it was founded in 1988.

In 1979, in a muddy yard in Makati, leaders of Rotary sat down with Filipino officials and signed an agreement to immunize over five million children in the Philippines against polio over five years.

At the time, those leaders did not know that they were launching the precursor to the largest global public health initiative ever attempted. But they did know that it was possible to overcome a vaccine-preventable disease, as they had seen the eradication of smallpox earlier that year. They also found a willing partner in Unicef when they planned to carry out their first large-scale immunization program. And the Philippines was an ideal test, as it had the highest incidence of polio in the Western Pacific at that time.

This year, we mark 40 years of Rotary’s fight against polio, and the progress has been remarkable. The Philippines was the staging ground for a decades-long effort, driven forward by millions of brave health workers and dedicated volunteers. Its success gave Rotary the confidence that polio eradication could be pursued on a grand scale, and it was one milestone in the arduous path toward convincing the world that global eradication was possible. The effort would not only have to win over heads of state, but populations of every culture, from the boat-dwelling fishing communities in Cambodia and Vietnam, to nomads in Pakistan, Afghanistan and Somalia, construction workers in Delhi, and even those who resisted the vaccine in wealthy countries.

Since 1988, when Rotary formally partnered with Unicef, the World Health Organization, the US Centers for Disease Control and, more recently, the Bill & Melinda Gates Foundation, more than 2.5 billion children have received the polio vaccine. More than 18 million people, mainly in the developing world, are alive or walking because they were immunized against polio.

The Americas were declared polio-free in 1994. The Philippines was declared polio-free in 2000, along with the Western Pacific region. Europe and Southeast Asia followed in 2002 and 2014.

Today, we see new wild polio cases in just two countries: Pakistan and Afghanistan. But outbreaks of circulating vaccine-derived poliovirus continue in underimmunized populations. We’re responding to such an outbreak in the Philippines right now. Although the vaccine is safe and effective, we need a high level of population immunity through immunization to achieve what doctors call “herd immunity”—to ensure that the poliovirus won’t spread.

One child suffering from polio is one too many, and we must finish what we started, as polio can easily make a lethal return to the places where it hasn’t been seen for years. There is a simple solution for this: maintaining high immunization rates to keep the population protected.

It’s not just the end of polio that’s at stake, although that in itself would be a momentous achievement for humanity. It’s our ability to ward off other vaccine-preventable diseases, and a test of our resolve. The dengue outbreak in this country is unfortunately a result of too many people refusing a safe and effective vaccine. Our health, and our children’s health, is imperiled as long as we fail to overcome these refusals.

Should we need any reminder of the reasons to be grateful for polio eradication, and to support its progress, we should think back to the “small beginning” in a yard in Makati 40 years ago.

It is said that, at this site, Jim Bomar, then Rotary president, noticed a group of small boys playing football in the mud. Their knees were covered with strips of tire rubber. Every one of the boys had been paralyzed by polio. While giving them their first drops of vaccine, Bomar felt a tug at his trouser leg. He looked down and saw at his feet one of the paralyzed boys, who said, grinning, “Thank you, thank you, thank you.” Then he pointed to a baby girl who had just received her first dose of polio vaccine, who would now be protected from the paralysis that had afflicted him. Beaming with pride, he said: “My sister!”

Rafael M. Garcia III is a Rotary International director.