Polio cases on the rise in Muslim countries

WASHINGTON — A decade ago, polio had been virtually eradicated in most developing nations, including in Muslim countries. In 2001, it reached an all-time low, with only 483 cases reported worldwide. But the polio saga does not yet have a happy ending.

In the past two years, the virus has begun to spread again. So far this year, 1,004 new cases have been reported globally, said David Heymann, representative of the World Health Organization for polio eradication.

One troubling aspect of the resurgence is its concentration in the Muslim world and the poor response by wealthy Islamic governments. Of the $4 billion spent to eradicate polio since 1988, only $3.5 million — less than 1 percent — has come from members of the Organization of the Islamic Conference (OIC), even though 96 percent of all recent cases have occurred in Muslim countries, Heymann said.

The inadequate support has many causes, according to officials from international aid groups. One involves cultural and religious misperceptions that sabotage medical treatment in poor regions. Another is the failure of some wealthy governments to shoulder responsibilities or show solidarity with less-fortunate neighbors.

In 2003, rumors that polio vaccines were harmful began circulating in the Muslim state of Kano in Nigeria, and were echoed by politicians and health officials. One rumor had it that the vaccine caused sterility in girls and had been developed by Western powers to diminish the Muslim population.

According to Heymann, 1 billion children have received doses of the vaccine with no such side effects.

Another swirl of gossip in Nigeria propagated fears that inoculation against polio would spread HIV/AIDS among children. Although the governor of Kano knew better, he was reluctant to defy popular opinion, one U.N. official said.

All vaccination drives in Kano were suspended and polio began spreading from the region. Nigeria registered 355 new cases in 2003, while the disease moved into neighboring Niger, then headed east to Chad and Sudan and also appeared in Saudi Arabia, Yemen and Indonesia. By 2004 it had reached 18 countries, almost all members of the OIC.

The OIC issued three resolutions and organized the intervention of Muslim clerics. In 2004, fatwas, or religious edicts, supporting the vaccines were issued by Egypt's grand mufti, the country's senior spiritual leader, and the grand imam of the Al Azhar mosque in Cairo, as well as by local imams. But officials at the United Nations and other aid groups said the effort had little effect and came too late to stop the spread of Nigeria's polio strain.

Two cases were reported last year in Saudi Arabia, where millions of Muslim pilgrims gather annually in the ritual pilgrimage known as hajj, and 400 cases have been documented this year in neighboring Yemen, which had reported no cases since 2000.

Polio has now re-established itself as an endemic disease that can be transmitted and exported in a number of countries, Heymann said. Yet despite the surge in oil prices, wealthy Islamic countries such as Saudi Arabia, Kuwait, Qatar and the United Arab Emirates have been essentially turning their backs on the problem.

The $4 billion spent on polio eradication since 1988 has come mainly from industrialized countries, including the United States, Britain, Norway, Sweden and Japan, and such groups as the Rotary Foundation and the U.N. Foundation.

The United Arab Emirates contributed $500,000 in 2004 and Qatar gave $330,000 this year. King Fahd, the late Saudi monarch, donated $500,000 last February. Kuwait contributed nothing. Heymann said he and others lobbied OIC officials and Saudi diplomats unsuccessfully for larger donations.