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- [00:04]
A
From Rotary magazine. This is the Rotary voices podcast. I'm JP Swensen. In 2026, many Western governments have pulled back funding and reduced their commitments to the United Nations. In its latest Global Humanitarian response plan for 2026, the UN is asking for only half of what it requested last year, even though humanitarian needs around the world are higher than ever. And later this month, the United States will officially withdraw from the World Health Organization. Rotary and the United nations have a long shared history. Since its founding in 1945, while the UN has always been a forum for sovereign states, civic organizations like Rotary have greatly expanded their role. Today, they represent a powerful third force in global affairs. For example, in 1988, alongside UNICEF and others rose Rotary and the WHO became founding partners of the Global Polio Eradication Initiative, or gpei. As a result of this collaboration, global polio cases have fallen by 99.9%. The global campaign to Eradicate Polio now stands as one of the largest, most successful public health efforts ever. More than 20 million cases of paralysis have been avoided. The GPEI consists of Rotary, the WHO, UNICEF, the US Centers for Disease Control, the Gates foundation and Gavi, the Vaccine Alliance. Recently, leadership from the WHO and UNICEF visited the Rotary International headquarters. Chicago journalist Jerome McDonnell sat down with them to check in on the current state of the polio eradication program.
- [01:46]
B
With me is Dr. Jamal Ahmed. He is Director of Polio eradication with with the World Health Organization. He serves as the Strategy committee chair for the Global Polio Eradication Initiative. He's from Kenya. Nice to meet you. And with us from UNICEF is Stephen Lawai. He's director of the polio eradication program with UNICEF. Steven's originally from Belgium and previously served as UNICEF's head in Somalia and Madagascar and deputy head in Congo and Cote d'. Ivoire. Great to meet you, Steven. And with us from Rotary is Valerie Wafer. She is former Rotary International Director and she is now with Rotary's International Polio Plus Committee. She lives in Toronto. Great to meet you, Valerie.
- [02:33]
C
Nice to be here.
- [02:34]
D
Thank you.
- [02:34]
B
I wanted to get to know you all a little better and what brought you to this work. How did you all gravitate to polio eradication? And Jamal, you want to start us out?
- [02:44]
D
Thank you so much. First of all, it's wonderful to be here. I was a district medical officer of health in Kenya in a very rural district where one of my tasks used to be to implement the surveillance activities campaigns as Rotarians were fundraising globally and ensuring that children across the globe are vaccinated. I Was effectively the tool on the ground that was helping to deliver over that, through many years of work, slowly I've shifted from. From working in my home country to global health and working in various countries on polio and polio related activities.
- [03:22]
B
Stephen, how did you come to polio eradication? It sounds like you've been around the block with emergency work in unicef.
- [03:28]
E
Yeah, no, I started with emergency work, my career, and then, and I was for a short period about the year I worked in polio in Somalia in the beginning of the 2000s. So that's nearly 25 years ago now. And that was really setting up this campaign in the middle of a country that was dominated at that moment by warlords and we had to negotiate, et cetera, et cetera. And that was my first interaction with the polio world, how to do that in very difficult circumstances. And then I moved away from this polio world back into my humanitarian world where I traveled around this globe to set up responses to humanitarian situations in very difficult, high risk areas. A little time in Gaza, for example, a long time ago, but also been in Cote d', Ivoire, the Democratic Republic of Congo, Somalia, back Madagascar. Well, Madagascar was less of a threat area. But anyway, there were countries where you had to set up things in very complex situations. Then I got back into the polio work as director of polio education at unicef. And it helps because in a way or another, the countries where we have these emergencies and conflicts going on, also the conflict where the virus found gaps in the health systems, where the virus found a way to propagate.
- [04:53]
B
Again, really interesting, Stephen and Valerie, you're kind of new to the Polio Plus Committee, but we're director of Rotary. It sounds like you're learning stuff all the time.
- [05:01]
C
I am learning constantly. I'm probably also a typical Rotarian who comes from a country. And I was born in 1965, so I'm sharing my age here. Where the endemic was over in Canada, people were being immunized. And it wasn't until I joined Rotary that I realized that polio was still around. Hearing from some of the members of my Rotary club about the summers. They couldn't go swimming in the swimming pool, they couldn't go to public places, go to summer camps. And so really the learning experience for me was pretty quick in Rotary. And then I had the opportunity to go to India for a national immunization day. And it was actually the year that the last case in India had occurred. And so just having that personal experience, being on that dusty street corner with all the noises going on as you hear in India just brings back so much memories of if India can eradicate this disease, anyone can do it. And the hope that that spread through Rotarians who had been fighting this fight for now over 40 years is a big boost. And so I'm so thrilled to have been in Geneva last month with our partners unicef, who to learn about the whole process of what they actually do on the ground and social mobilization and procurement and outbreak restrict response. It's just incredible. I just feel like I have a new story to tell. And the accountability of the money that we raise in Rotary is in such great hands. It's making such a difference and we will get there. And I'm just so thankful to have these new friends in Steven and Dr. Jamal because we're in this together. We have a shared goal and that goal is going to be realized.
- [06:38]
B
I've seen it described that we're 99.9% of the way there to polio eradication. And it's just that last 1/10 of 1% that is bopping around a little bit here. Can you explain where we are exactly at Dr. Jamal?
- [06:53]
D
Absolutely. And if you step back and imagine when, as you rightly said in Manila those years back when Rotary kick started this whole process, polio was endemic everywhere else, from almost all of South America, Brazil, the whole of Africa. I don't think there was a single African country that was not endemic. Many European countries, by the way, many Asian countries, including India and Indonesia and Bangladesh. So that effort with the virus now cornered in just two countries, the wild virus just highlights the road covered and the distance covered. So the main challenging zones are actually in areas along the common border between Afghanistan and Pakistan. And they have peculiarities, insecurities, inaccessibility, socioeconomic challenges. And overcoming that means ending wild polio for good. And just to highlight, when we talk about wild polio, we talk about three types, type 1, 2 and 3. Two of them we are done global, including in Afghanistan and Pakistan with wild polio. And the third one is what we are fighting now to finish wild polio one. And if we do that, then it brings up the next stage of the eradication, which is to end what we call variant polio viruses that come from the tools we use to fight the disease. And that will give a big wind in our sales and hopefully push us to the end. So when we say 99.9%, I will actually even think it's 99.99%. Going back to that first day in Manila.
- [08:27]
C
I like that I think we should start using that percentage.
- [08:31]
B
That is a great framework to think about it. What Stephen was saying earlier about instability, that is exactly what is going on along the border of Pakistan and Afghanistan. That is where it still gets to. And one of the great benefits of a vaccine campaign is it builds up a healthcare arm. If you didn't have one before, you've got to have one go in. And so we've essentially got to have some kind of healthcare presence in that community now.
- [08:59]
D
Absolutely, absolutely. And one thing this program has been very good at for many years is never to take, you know, an obstacle and say, oh, we can't do something about it. So in all of these areas, we just have to innovate. And by innovation, it doesn't mean just technical know how, it just means thinking through how do we access those children in those villages that are inaccessible to us momentarily and figure out how to reach that. And UNICEF has been a fantastic partner in many ways when it comes to engaging with communities, working through community influencers and, you know, religious leaders, and helping us cover that last mile into those pockets that are extremely difficult to reach. You know, Afghanistan and Pakistan have been the epicenter for so things in the last two decades. So there's a reason why it's Afghanistan and Pakistan for many reasons beyond just the public health.
- [09:50]
B
There's six partners in the Global Polio Eradication Initiative, and UNICEF is one. Can you explain a little more about UNICEF's role and what it brings to the table?
- [10:01]
E
Yeah, well, Jamal already said it. We do two things, and it's very simple. There's the first one. When you're eradicating a disease that's vaccine preventable, you need a vaccine. And once you have the vaccine, the children, their parents have to accept the vaccine. So you have to convince them in a way or not, or they have to know about it. And those are the two things we do. First of all, we buy all the vaccines for the Global Polio Eradication Initiative and bring them to the countries and to the children and to the vaccinators. And then that's a major, major job because we're not talking about one vaccine. We're talking at this moment about three vaccines that we procure. And these vaccines have to be bought about six months to a year in advance because they're a production process. So we have to do a lot of planning, but also see that they reach areas that are quite difficult, where you sometimes don't have health systems working, and where we have to see that there is a cold chain, which means these vaccines have to stay on a certain temperature till the end. We have to see that whole cold chain is not interrupted. That means from the factory up to the vaccination point, you have to keep that vaccine on the same temperature in the plane, in the boat, when it arrives in the capital, when it goes to the provincial capital, and then goes to an area in a health center, or sometimes not a health center on the back of a donkey or a vaccine carrier that has somebody has to carry for 10 miles, that temperature has to be maintained. So there's a whole organization behind that. In places where there sometimes there are no health centers, you have to work with big cool boxes and bring them from sometimes 100 kilometers further to that vaccination point. So it's an enormous work and enormous planning. And then the second thing we do is we have to convince people that these vaccines work, that they don't have to be afraid and go against all kind of conspiracy theories. Luckily, there is trust in these vaccines, because we have been doing this for the last 30, 40 years. People are used to polio vaccine and they know that there is no negative effect. But nevertheless, people have to be aware that the campaign is going on, and that's not automatic in the middle of southern Afghanistan. So we have to talk to these communities. We use all means, can be social medias, for example, but can also be TV and radio that we use. But also people that go into the streets and shout through the streets that a campaign is coming and they have to get out of their houses or let their doors open for a vaccinator. But then we also have to go go into a personal conversation to talk to the mothers when we are vaccinated, what we're doing exactly, but also when the next round is and how long their children will be protected, et cetera, et cetera. And if there is a mother or father that refuses, trying to convince this mother and his father, and then if they're not convinced next time, come back and try to convince them again. And with doing that, we actually convince 98% in most of the cases to get vaccinated. But that needs trust. So you also have to select the right people to talk to the communities who are part of those communities. It's an immense job taking into account all the different places and cultures where we're working.
- [13:32]
B
That's really interesting. The whole initiative, the Global Polio Eradication Initiative, though it's a unique public private partnership. And explain how the private funders come in. And the Gates Foundation's obviously One of them. And certainly Rotary, it all meshes together at once.
- [13:48]
C
Well, you're absolutely right about how it meshes together, because as Dr. Jamal and Stephen has explained their role from their organizations, you can see how intricate it is and how we can't be responsible for everything as one organization. Right. And we can't do it ourselves. And that's why our partnership is so important. We, as Rotarians certainly are committed to fundraising. We have made a $1 billion investment in this over the years, and it is an investment. It's not something we can walk away from because the consequences of walking away from it or not fulfilling our promise is just too hard to imagine. We just can't do that. So we are committed to raising $50 million a year. And I'm so proud of the Rotarians around the world and all the innovative ways that we look at fundraising, because that money is important for that match from the Gates Foundation. And so, of course, the Gates foundation matches us 2 to 1. We hear a lot about, you know, the fatigue. We've been at this for a long time, and Rotarians have been part of this for over 40 years. So we hear about, you know, what's next for Rotary, but nothing is next until we finish the job that we have in front of us, which now I'm going to say is 99.99%. Thank you, Dr. Jamal. I think that we have been doing a really great job. Last year alone in the Rotary world, we saw more clubs giving to polio. We saw more gifts, major gifts to polio. Our Rotarians are realizing that we need this final push to get the job done, and they're stepping up to do it. One of the mechanisms that many districts around the world right now are using is the Polio Plus Society. So if you pledge an amount every single year at a recurring donation, you can belong to this Polio Plus Society. And I have to say, Rotarians love their pins. And they love to be part of something, you know, innovative and know that they're making a difference. So we have to continuously be innovative to get where we are in the areas that we still have cases. We do not have a lot of Rotary clubs. Rotarians are the best advocates in the world for this. We have 1.2 million Rotarians around the world, and each one of us have connections that we may or may not even realize today. Connections with local national government officials, people who can make a difference, who can then use their voices. I happen to sit on the Canadian Advocacy Task Force, and we meet with our government on A bipartisan basis, even when we're not asking for money. Although I'm really proud of Canada and our commitment to always support polio and the gpei. But we have these advocacy groups around the world and they are truly making a difference so that this does remain on everybody's agenda. And I know that times are really tough now on a lot of budget agendas for our governments around the world. But that just means that we have to work a little harder and we have to have these conversations more and more. We have to tell our personal stories. Both of you have been in the field and you've seen and have so many stories in Rotary. We know that that personal storytelling, this Rotary Voices podcast, is so important because what happens is our audience is listening and they're gonna be inspired to tell their own personal stories. And until this disease is eradicated, we need to continue this work. So it's definitely a partnership. We can't do our individual pieces as one. We need to work together.
- [17:06]
B
I wanna talk about some of the funding challenges because governments around the world have cut back on their public health budgets. And it's hitting everybody in the partnership. Almost everybody is seeing cutbacks, some of them pretty stiff. How do we juggle things around with these cutbacks? How threatening is this to the whole initiative of polio eradication?
- [17:29]
D
There are so many committed countries and many member states of the United nations who are really, really maintaining their support in not just polio eradication, but also gender global health initiatives. One thing that is clear is it's 2025, and an infection anywhere, an outbreak is something that's a threat to everybody. There's nobody who is sitting in an island somewhere with no connection to the rest of the world. So the funding cuts that we are seeing is a threat to the global health security in many ways. When I look at it from that perspective for polio, thank God we have a strong partnership that's pulling together and making sure that we are still on track to deliver our key objectives and our goals. But for polio and even for other activities, it just basically means the risk of failure is a resurgence in cases, a resurgence in children getting paralyzed, a resurgence in measles, a resurgence in every other childhood disease that we thought disappeared. And there's no way you will contain that in Pakistan and Afghanistan. It's going to spread out back to other countries. That is something that we absolutely don't want. And I think there are many countries who are putting together to ensure that we remain on track for as much as we can.
- [18:50]
B
Leadership Matters though, doesn't it? I know that Nelson Mandela in Africa stood up and said we were going to eradicate polio in Africa.
- [18:58]
D
Leadership definitely matters. Nelson Mandela was a hero. I remember in many ways they kicked polio out of Africa effort that was linked also to major sports events that pushed that all eradication effort. But also we have to remember the resources that was raised by this public private partnership by Rotarians up and down the world who contributed their dollars and cents and made that whole effort possible. So leadership matters. But also that strong bond that this partnership has been having for many years is also as critical.
- [19:32]
B
And I know that in a lot of communities there is skepticism about vaccines. And Steven, you've been dealing with this at unicef. Are there new wrinkles in that battle to overcome skepticism? Vaccines?
- [19:48]
E
Yeah, they are, because we are in a connected world. So if there's someone posting something on the Internet in Wisconsin, it might be picked up in Guinea Conakry and create a whole mayhem there. So we have to be aware what is going on globally and particularly in social media. And we're monitoring that on a daily basis. Oh, actually every minute we monitor in it and seeing if some of these rumors are getting out of control. We have about thousands and thousands of volunteers who are working now with us across the world who are countering these messages as well and helping us tell what polio eradication really is about. But it's not only social media. It's sometimes very personal interaction that is necessary in the middle of nowhere where people don't have access to the Internet and where you have to sit down on the carpet, have a couple of glasses, glasses of green tea and be very patient and explain to a mother who is worried about her kids why again, they have to get this vaccine and why they don't get other public health interventions to them. And that takes time, that takes effort, that takes energy. These community health workers are doing every day. And that is the key to polio eradication is this motivation, this commitment of everybody who works towards this, from the director at WHO to this community health worker at the bottom who's going to bring the vaccine but also convince the mother to make it happen. It's a work of hundreds and thousands of people every day to make that happen.
- [21:34]
C
And each one equally as important as the other. Especially, you know, Steven, when you talk about the healthcare worker going door to door and not always in safe conditions. And you know, we really need to recognize the women who put their lives on the line quite often to save lives.
- [21:52]
E
And without the women, we can't do it. You see the difference between eastern Afghanistan and southern Afghanistan. In eastern Afghanistan the workforce is made of 50% women and we got an exception for them to work there. In southern Afghanistan, it's like 4%. And the difference in quality of vaccination is enormous. And where can the virus still survive? Where very few women are working because we don't have access to the families and we don't have the same conversation going on. It's really the success factor.
- [22:26]
C
I was really fascinated with the discussion today at our meeting about grandmothers, trusted matriarchs of the family and. Yeah, absolutely, yeah.
- [22:34]
E
Then these areas where we can't work, but frontline workers that are female, we're using our own grandmothers to also help us convince families because they're trusted.
- [22:47]
D
And just to add community health workers also help report cases in the event that you have something in a very insecure area. They figured out how to communicate and we are then able to collect samples.
- [23:01]
E
And also beyond polio, I think that's.
- [23:04]
B
Probably an underestimated feature of the polio eradication effort is it had an add on effect with so many other situations from infectious disease to just probably general healthcare extensions. It has just built up healthcare networks.
- [23:21]
D
Absolutely. The beauty of this thing is it's using a single virus and a single disease and pushing the whole system forward.
- [23:30]
B
We've touched on a few of the obstacles that are out there for eradicating polio. But are there some really promising developments out there that people should know about? Are there promising stories, something good that's happening out there?
- [23:44]
E
Oh, there's a lot of good happening. But first of all, since about a year we haven't seen any cases anymore in southeastern Africa and there were hundreds of cases before. And then countries like Madagascar, Mozambique, Tanzania, the Democratic Republic of Congo, that was the centerpiece of a big, big outbreak. There's nearly no cases anymore detected. So we are clearing large parts of the world and even bringing it a bit closer. We have the least percentage of refusals ever in Pakistan last year, ever. And we rolled out a new vaccine in a period of two, three years. A billion doses were administered in a very short period of time of that vaccine that could protect quite a lot of children against type 2 variant.
- [24:33]
D
Absolutely. And just to add also Stephen talked about these outbreaks. We had one in southeast Africa. We had a wild polio virus that was exported historically. Such an outbreak will be multi country outbreaks. We were able to contain it with effectively a few progresses, stop that potential spread and close that outbreak. That's a big deal. The other one is also through the investment in surveillance through the polio program. We've been expanding the lab network in many countries. They now have capacities for sequencing, capacities for early detection. By the way, some of these capacities were used in the initial response to Covid in Pakistan, for example. Those initial detections was done by the polio lab because the tools that you use for what one pathogen, one virus, can be adapted to another one if you just have the right primers and the right reagents. So the technical know how that has been fantastic. We've been working also through the who, also with rolling out new techniques in detection called direct detection, where you take samples and you quickly detect.
- [25:43]
B
Stephen, I understand there's something called infodemics that you've been working on at unicef. Explain what's going on and what this is.
- [25:51]
E
So it's a bit a watch about what is going on with vaccines on social media. So we follow all social media everywhere in the world, chat boxes, Facebook X and other social media platforms to in a way see what information are people spreading about vaccines. The majority of the information that people are spreading is really very positive, but there's also some very negative information and false information about vaccines. We don't not only track everything about polio, but vaccines in general because it gives us an indication of the willingness for mothers to get their children vaccinated. And we see that sometimes rumors picked up in one part of the world come out of another part of the world and start creating havoc. So we know who these people are, where this comes from. But then we have also in each country thousands of volunteers who are working to help us. And actually quite a number of them are in the different countries from Rotary help us then counter this information that is spreading, but also going into a dialogue with people who spreading this information because everybody can have his opinions, but it's a question of talking to each other, stopping this kind of infodemics as we call it, across the world.
- [27:14]
B
So you've got influencers out there on TikTok, is that what you're saying?
- [27:18]
E
Everywhere? Not only on TikTok, they're on Facebook. I'm a bit an older generation, but yeah, on all the platforms that are out there we have people, young people, older people, Rotarians, some of them are teenagers that help us with it.
- [27:35]
B
Now I understand there's a new action plan with the WHO on polio. Can you explain what's going on with the action plan?
- [27:42]
D
The action plan is a GPI action plan. It's A collective action plan for the whole global polio eradication initiative. With everything that's going on now in the world, with all the headwinds when it comes to funding and resource mobilization, and also understanding the current programmatic challenges that we talked about, for example in Afghanistan and Pakistan, but also other parts of the world, we took a step back and decided, okay, let's review the whole program and think through what it will take to put us back on the road to zero, both in Afghanistan and Pakistan and globally. And that action plan is. This is effectively a distillation of that work into one document. We've completed that now. The Poly Oversight Board of the GPI has endorsed it. And our work now is to really get back and implement that. The essence of it is, number one, to realign the whole program and make sure that we are able to function within the resource constrained environment. And we foresee that environment may continue for, for a few more years. The second component of that is to really hone in on some of those sub national areas, not in the country level, but below the country at those provinces and regions and districts where we've seen some persistent transmission for a while. Identify each of those areas, the specific problems and try to tackle those problems as quickly as we can and redirect some of our resources through special initiatives. So hopefully through that action plan we get more streamlined over the next few years and we are able to push ahead and deliver that zero polio that you all want.
- [29:26]
B
And Valerie, is there anything you want Rotarians listening to know about how they can help get to that place?
- [29:32]
C
Well, just continue to tell your story, continue to advocate, to continue to support. There's a huge sense of pride that we're all going to have to know that we were part of this journey and that we made a difference. And I think that they need to take that ownership, they need to realize they are making history and that this is something that hopefully my grandchildren and their grandchildren all say. What is polio? Not the reason we say it today, because I know it happens today as well, but because it is no longer with us. And I think that once that happens, along with our partners, we're going to have a huge sense of pride. And that second disease in the world that has been eradicated and we were part of, of that.
- [30:13]
B
Well, go get them. Valerie Wafer is a rotary International's polio plus committee member and also with us has been UNICEF's Stephen Lawere. He's the director of the Polio eradication program with UNICEF. And Dr. Jamal Ahmed is Director of Polio Eradication with the World Health Organization. Go get him.
- [30:35]
A
This episode of the Rotary Voices Podcast was Produced by Dan JP Swenson and edited by Wen Huang. Jerome McDonnell was our host. Production by Joe Desaux. If you enjoyed the show, please rate us five stars on Apple Podcasts and Spotify and share it with your friends. The Rotary Voices Podcast is produced by Rotary Magazine, the official monthly publication of Rotary International. Thanks for listening.
- [31:04]
E
SA.