Eradicating polio: Mission possible for Alan Janssen
Alan Janssen’s personal and professional mission to eradicate polio is a lot like the popular Eagles song, Hotel California: “You can check out any time you like, but you can never leave.”
Janssen worked at the Centers for Disease Control and Prevention for 25 years—the last eight in global health, which included polio eradication. He traveled to Asian and African countries including India, Nigeria, Kenya and Liberia, where he and his team members worked with community leaders to educate the public about the need to vaccinate against poliovirus.
He joined ORAU as group manager for health communication in 2017, but didn’t leave his polio work behind. Janssen is still involved as a volunteer for the Emory-Clifton Road Rotary Club a club that joins CDC staff and Emory faculty together to work on domestic and global projects. “We’re close to eradicating polio, but when you get close to eradication the work becomes far more difficult,” Janssen said. “We were closer a couple of years ago than we are today, but then we ran into some problems in the northeastern area of Nigeria and select areas of Afghanistan and Pakistan.”
Often long-standing beliefs held by people living in remote parts of the world have become major challenges to eradication that are difficult but not impossible to overcome, he said.
Janssen relates the story of overcoming resentment against the polio vaccine in Nigeria a few years ago. Janssen was part of a UNICEF team that met with the Sultan Muhammadu Sa'ad Abubakar III of Sokoto, the supreme leader of the Moslem faith in Nigeria. The Sultan became an important advocate for polio eradication and communicated the importance of polio eradication down to the Emirs and ultimately local clerics throughout the country. Through mosque talks and other community-based communications initiatives, the polio teams gained access to the polio outbreak areas and were able to vaccinate children across Sokoto and other areas of Nigeria, but this effort would not have been possible without support from the Sultan.
Communications tactics like mosque talks are important because one’s religious leader is a person of trust, Janssen said.
“Certain sects of the Muslim faith believed that polio is a disease that was the will of Allah and had adopted a 'fatalistic viewpoint' toward the disease. Most of these people had limited education and often never traveled outside their home areas. They often look to religious leaders for guidance. Today, small numbers of polio cases continue to be detected in Afghanistan and Pakistan, while the outbreak in Nigeria appears to have been contained according to the Global Polio Eradication Initiative, a partnership including the World Health Organization, Rotary International, the United Nations Children’s Fund (UNICEF), the Bill and Melinda Gates Foundation, and the CDC.
Because polio reaches all children, even in difficult, hard-to-reach areas, polio eradication initiatives often lead other health programs. One of the other advances that the polio program has brought is disease surveillance programs that find and report disease in places where they never existed before,” he said.
A national health surveillance program was launched in India that got its start from polio eradication efforts. On the other hand, better disease surveillance is needed in places like the Democratic Republic of Congo, where Ebola outbreaks have occurred with some frequency—usually detected long after the start of the disease. Quick detection and rapid response to an outbreak are key factors that lessen the impact of the disease.
“There are places where there is no ongoing healthcare and there is no way of knowing if you have a disease outbreak. Often you have the disease circulating, but just don’t know everywhere that outbreaks are happening.”
The same is true for remote areas of the world where polio exists. Still, there is almost always a means to reach people. In Kabul, the capital of Pakistan, health workers did live radio broadcasts. In Somalia, they used Voice of America transmissions to tell people where they could get vaccinated when they traveled from the bush to larger cities.
“A lot of the communication strategies we use around the world are similar to what we would use here to reach people,” Janssen said, including working with religious leaders and hairdressers, or using mass media like radio. “It’s the same kinds of things we would do anywhere, just different players are involved.”
While he isn’t traveling the globe now, Janssen is involved in efforts to eradicate polio through Rotary. Janssen was one of the emcees for a Rotary Club-sponsored polio symposium in Atlanta on the past, present and future of the disease held in September 2018. As a visual reminder of the disease and the impact eradication has had on medicine, an iron lung was featured. While no longer commonplace, this negative-pressure machine kept a person diagnosed with polio alive, allowing them to breathe. At last report there were three people in the United States that still depend on the iron lung to survive the horrors of this disease.
“The symposium brought in a number of people involved in polio eradication and was a clear demonstration of how far we’ve come,” he said. “And we’ll get there.”
For information about ORAU’s health communication, preparedness and response needs, contact Marcus Weseman, M.P.A., vice president and senior associate director, Health Communication programs, at 865.576.3420 or firstname.lastname@example.org.