There are a lot of rumors coming out of Ukraine right now about a new form of swine flu, a brand new illness, or some kind of virulent pneumonia. I suspect it’s no more than swine flu with complications, but it’s causing some major panic in Kiev.

Britain’s Daily Express newspaper has the terrified tabloid version. They report that “A cocktail of three flu viruses are reported to have mutated into a single pneumonic plague, which it is believed may be far more dangerous than swine flu. The death toll has reached 189 and more than 1 million people have been infected.” The New York Times has a slightly more nuanced report. They identify the mystery illness as swine flu and quote a WHO official who says that “Early findings are that serious cases mounted because the sick avoided hospitalization until their illness was dangerously advanced, stockpiles of Tamiflu were locked in centralized locations and the supply of ventilators fell short.”

I suspect that the WHO and the New York Times have it right. There are a lot of barriers to access to health care in Ukraine, under-the-table payments being one of the biggest. I can well imagine people refusing to go to a doctor until their lungs were past saving. Avian Flu diary agrees, attributing the unusual severity to viral hemorrhagic pneumonia as a complication of swine flu. They also have an enlightening comment at the bottom of their post from a commenter in Ukraine watching the situation unfold.

Secrecy is not helping the government of Ukraine here. In a nation with a history of cover-ups – Chernobyl being the most famous – the population is quick to panic when they sense that they’re not getting the real story. Getting the real story out as fast as possible and backing it up with access to medical care – is the only way to stop the panic.

The World Health Organization has released a new report on childhood immunization. It holds a surprising amount of good news. We’ve got more vaccines, and more effective vaccines, than ever before. The number of child deaths is falling globally. However, despite the good news, 20% of children – mainly in Africa and Asia - are still not getting the full set of vaccines.

So what do we do about it? The WHO estimates that it will cost an additional $76 billion through 2015 to protect 90% of children, and get to herd immunity, in 117 low- and middle- income UN member states. This would mean vaccinating them for 14 illnesses - diphtheria, pertussis, tetanus, measles, polio, tuberculosis, hepatitis B, Hib, rubella, meningococcal disease, pneumococcal disease, rotavirus, Japanese encephalitis (where needed), and yellow fever. This would save the lives of 2 million children a year.

The question, I guess, at this point comes down to whether the world community willing to spend $6300 per child’s life?

If you’re wondering how it can cost so much to deliver vaccines, it’s because we need more than just the vaccines themselves to immunize a child. You need a health system capable of tracking children so they know to vaccinate them, a health worker to do the vaccination, and a logistics system capable of keeping the vaccines cold until they’re delivered. The 20% of kids left insufficiently vaccinated are the ones who are hard to reach; it’s going to take a major investment in health systems to get to them.

I was pleased to see Alanna Shaikh comment on the Kingdom of Saudi Arabia’s generous gift, and critical commitment to help us move closer to global polio eradication. Ms. Shaikh noted in her commentary, there are Muslim populations which have been reluctant to take advantage of the polio vaccine, due to false rumors that it may lead to infertility or the spread of HIV. It is these misconceptions which make the efforts of Saudi Arabia to dispel myths and require vaccination for every Haj Pilgrim momentous.

To be clear, while no vaccine is infallible, the benefits of the polio vaccine far outweigh its risks. In the last ten years, more than 10 billion doses of the vaccine have been given and have protected against a life of misery. Of these ten billion people who are now protected from the wild polio virus, 383 of them contracted vaccine-derived polio. That amounts to a risk of less than one in 10 million. With this ratio in mind, I believe that it would be difficult to for anyone to suggest that to make the vaccine mandatory for Haj Pilgrims is to put them at additional risk.

In the 1980s, polio paralyzed at least 1,000 children EVERY DAY all over the world. Due to polio vaccine efforts during the last ten years, the wild polio virus has taken a greatly reduced toll. In 2008, there were only 1,300 cases for the entire year, worldwide. Today, after international efforts to immunize every child everywhere, five million people are walking who would otherwise be paralyzed and the world is almost polio-free. Polio remains endemic in four countries—Nigeria, India, Pakistan, and Afghanistan. We are hopeful that this directive from Saudi Arabia, will be one of the final, crucial steps toward eliminating polio globally.

Dan Carucci is the VP of Global Health at the UN Foundation

At the Clinton Global Initiative, The United Nations Foundation (which supports this blog) and the Kingdom of Saudi Arabia announced a $30 million program to eradicate polio.

As it stands, polio is close to being wiped off the map. There were only some 1650 cases reported in 2008. About 90% of those cases originated from countries where polio remains endemic: India, Nigeria, Pakistan and Afghanistan. The money will largely directed to polio eradication campaigns in those four countries.

Interestingly, as part of the commitment to eradicate polio, Saudi Arabia announced that it is requiring every pilgrim entering Mecca will to receive the polio vaccine.  From the release.

In addition to the financial commitment, Saudi Arabia, the Keeper of the Two Holy Mosques, is also requiring every pilgrim entering the Kingdom for the Hajj, the annual pilgrimage to Mecca, to receive a polio vaccination. By raising awareness about the importance of polio immunizations among Muslim pilgrims, the Kingdom is helping to dispel misconceptions about the safety of vaccines and is underscoring that polio immunizations are not only appropriate, but essential.

Learn more about the Global Polio Eradication Initiative.