The New Yorker magazine recently published a piece, titled “The political fight against polio”. This article, reviewing current challenges in polio eradication in Nigeria and conflict ridden areas in general, argues that the polio prevention “plot [got] messy” and has become at least as much of a political, as an epidemiological issue because of its geography. But has polio ever been anything but political? And has it always been a fight?
Polio is a relatively new disease. It started to appear in epidemic waves in the late 19th and early 20th century, and by the 1950s it became a global issue. By then, the epidemic waves became more and more severe and vaccine development saw funding and international cooperation as never before. The stakes were high: this disease spared no-one, it affected rich and poor all the same. Most importantly, polio was (and is) primarily a childhood disease, hence its older name, infant paralysis – a name that is still the official term used in a number of languages. It’s a disease that can cause permanent paralysis, most often in the limbs and occasionally in the respiratory muscles.
Polio’s threat of debilitating future generations was most acutely felt in post-war societies, especially those that suffered a significant blow to their population in World War II. In countries scrambling out of destruction, bracing themselves for a new, albeit Cold War, polio decidedly became political as well as a fight. It is this, post-war setting that ultimately set the tone for the last 60 years of polio. The prevention of contagious diseases became proxy-wars in the Cold War, as in the case of malaria, as Marcos Cueto’s and Randall Packard’s work show. Polio treatment also became a “fight”, whether, as David Serlin points out, encapsulating ideas of heroic masculinity in the West, or as a struggle with the state and its ideologies in the East.
Political agendas have also been ever-present in preventing and treating the disease. These politics are, on the one hand, part of broader perceptions of disease and vaccination, and on the other, are particular to polio. Susan Sontag’s and Emily Martin’s work on AIDS show how contagious diseases are inseparably intertwined with politics. This is, of course, nothing new, Foucault would tell us, pointing to the plague. Even on the level of international disease control, the politics have long played the leading role, as João Rangel de Almeida demonstrates in his research on 19th century efforts.
A relatively new method of prophylaxis, vaccination, also adds another layer to the political: vaccines themselves can be potentially harmful, causing disease instead of curbing it. Polio was a particularly powerful example to prove this point: in 1955, a faulty batch of Salk vaccine, produced by Cutter laboratories caused a wave of polio in vaccinated children. But such a dramatic example is not even needed to ignite fears of vaccines. While many living in the Global North dismiss resistance to polio vaccination in the South as “superstition” or something “backward thousands in the United States and Europe are resisting vaccination in general, mostly due a single, scientifically discredited article on the relationship between MMR vaccines and autism.
Perhaps one of the most interesting aspect of the political in the case of polio is its perception as being non-political. In some ways similarly to the smallpox eradication campaign, as Erez Manela’s research shows, conflicting sides made an effort to cooperate in global campaigns of disease prevention. While this seemingly apolitical enterprise was, of course, heavily laden with Cold War politics, it brought together scientists, diplomats and public health officials from both sides in meaningful ways. The intense decade of polio research shows us a different face of the Cold war, and, not in the least, the effort did curb the disease on a global scale. As importantly, in the course of polio vaccine development, key players emerged as guarantors of the “apolitical”: the WHO became a major mediator between East and West when it came to the evaluation of the Sabin vaccine based on Soviet results. With this, the agency was making a strong statement against something the Soviets knew all too well: they were the first to demonstrate the importance of politics in the international organization, when they left it on political grounds shortly after it came to life.
The global “fight” against polio therefore has been represented, and, genuinely perceived by many as being apolitical. That this view is not universally shared, though, should not come as a surprise. While many of the issues that contribute to the challenges of today’s eradication efforts are complex with backgrounds of a wide variety, the history of the disease tells us that fears of polio vaccination and reservations about the international agencies behind it are hardly new. But then, this same history also shows that solutions to polio prevention have cropped up in unexpected spaces, and the last 60 years have resulted in a tangible result: that for millions, polio has become a distant memory.