Remembering Ciro de Quadros and the Eradication of Polio in Latin America

Ciro de Quadros, who passed away at his home in Washington, D.C. on May 28, 2014, was a present-day hero, who ought to be much better known. In brief, de Quadros, a Brazilian epidemiologist, single-handedly initiated and then led efforts in the 1980s to eradicate polio from the Latin America continent.

The incidence of polio in Latin America had already been significantly diminished by the early 1960s via the introduction of Sabin’s vaccine. However, de Quadros insisted that epidemics would remain possible on the continent until mass immunization of the population might be achieved. He was particularly concerned with reaching unimmunized children who lived in the remotest areas. So, starting in 1985, in his role as an executive of the Pan American Health Organization (PAHO; a subsidiary of the United Nation’s WHO), de Quadros sent teams of health workers to 15 countries; some of which contained the most isolated and war-torn regions of Latin America.

El Salvador and Guatemala were particularly unstable at the time. So, in order to administer vaccinations in those nations, de Quadros first negotiated 24-hour cease-fire agreements between rebel and government forces. These so called “tranquility days” enabled health care workers to enter combat zones and carry out immunizations in relative safety.

In Peru, de Quadros was unable to secure cooperation from the Shining Path guerillas that operated there. So, he had his teams work around the areas controlled by the guerillas, and come back to those areas when the battle lines shifted elsewhere.

In 1994, the success of de Quadros’ immunization program led the PAHO to declare that polio had been officially eradicated from Latin American. The last reported case of polio on the continent occurred in 1991, in Pichanaki, Peru.

Interestingly, de Quadros had to fight an uphill battle to obtain support for his immunization efforts; even with the WHO, which preferred to use its limited resources to sustain primary health care. But, de Quadros forcefully maintained that vaccination is the starting point for effective primary health care, especially for children. And, while he was mainly concerned with polio, his vaccination teams also were prepared to immunize against measles, diphtheria, pertussis, tetanus, and tuberculosis.

Earlier in his career, in the 1970s, de Quadros was recruited by Donald A. Hendreson, then director of the WHO’s global smallpox eradication program, to help organize smallpox eradication in Ethiopia. In a phone interview with a NY Times reporter after de Quadros’ passing, Henderson recalled de Quadros’s steadfastness during Ethiopia’s civil war, when a half-dozen of his teams were kidnapped by rebels and one of his United Nations helicopters was commandeered along with its pilot. De Quedros helped negotiate the release of the health teams and the pilot, all of whom returned to their vaccination duties. Henderson noted that the helicopter pilot, who had vaccine aboard when he was hijacked, actually vaccinated the rebels who held him captive.

On May 2, 2014, less than one month before his death, de Quadros was honored by the PAHO/WHO as a Public Health Hero of the Americas. The award was presented to de Quadros by PAHO/WHO director Carissa F. Etienne, during an international vaccine symposium celebrating the 20th anniversary of the Sabin Vaccine Institute, where De Quadros was serving as Executive Vice President and Director of Vaccine Advocacy and Education. Etienne stated, “We at PAHO believe that no single person has done more to extend the benefits of immunization to people throughout the Americas.”

Dr. Carissa F. Etienne, Dr. Donald A. Henderson, Dr. Ciro de Quadros, Dr. Anthony Fauci, and Dr. Jon K. Andrus
Dr. Carissa F. Etienne, Dr. Donald A. Henderson, Dr. Ciro de Quadros, Dr. Anthony Fauci, and Dr. Jon K. Andrus

Etienne went on to say, “His (de Quadros’) leadership and vision were essential to our region’s becoming the first in the world to eradicate polio, a success story that inspired the global polio eradication campaign.” Also, de Quadros is regarded as a leader in the development of the surveillance and containment strategies that facilitated the eradication of smallpox worldwide, and he also directed measles eradication efforts in the Americas.

 

 

 

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