Immunization: A call for action against disease>

Day for remembering
and looking forward

Medal creates permanent memorial
to polio triumph

Memories of life with poliomyelitis and the story of a world forever changed by the announcement of a vaccine for the disease were shared April 12 when the University celebrated the historic 50th anniversary of the famous polio vaccine trials and conferred, for the first time, a new medal that signifies U-M's ongoing commitment to public health worldwide.

At the very hour of the 1955 announcement of the vaccine's efficacy by Thomas Francis, Jr., former chair of epidemiology, the community gathered in Rackham Auditorium to remember the fateful day that changed the face of global public health.

"I cannot tell you what an honor and thrill it is for me to be standing at the very spot where Dr. Francis and his protégé, Dr. Jonas Salk, announced their triumph," President Mary Sue Coleman said before bestowing the first Thomas Francis, Jr. Medal in Global Public Health.

"He was an international leader well before the triumph over polio, but the field trials and the dramatic announcement here in Rackham Auditorium sealed his place in history," Coleman said of Francis, who conducted the now-famous double-blind polio trials on some 1.8 million children nationwide.

Coleman hailed the accomplishments of Dr. William Foege, recipient of the first medal, who pioneered a successful strategy to eradicate smallpox in the 1970s and spent his career working to combat disease and increase awareness of global health issues. He served as chief of the U.S. Centers for Disease Control (CDC) Smallpox Eradication Program and was appointed director of the CDC in 1977. He is the former director of the Carter Center and now is senior advisor to the Bill and Melinda Gates Foundation.

"Since helping lead the global victory over smallpox, Dr. Foege has taken a leadership role in some of the most important public health issues of the last 30 years, including child survival and development, the global tobacco plague, preventive medicine, and injury control," Coleman said. "He has given less fortunate children a better life, helped to eradicate smallpox, and worked to eliminate Guinea worm."

In accepting the medal, Foege said not only did the polio vaccine nearly wipe out the disease; it also led to a major shift in philosophy about managing public health.

"We often dwell on the science that day, and we describe it as a breakthrough—and it was—but it led in turn to a social breakthrough," Foege said.

President Mary Sue Coleman presents Dr. William Foege with the first Thomas Francis, Jr. Medal in Global Public Health April 12 in Rackham Auditorium. (Photo by Martin Vloet, U-M Photo Services)

At the time of the announcement, government was not involved in public health, Foege said. Once Francis declared the Salk vaccine effective, public demand for it was great, but there were no regulations or assured resources to guide its production and distribution. After considerable public pressure following the polio trials, then-president Dwight D. Eisenhower reversed his previous position that government had no business in the health arena, Foege said.

"Because the public became involved, vaccines went that week from the protection of individuals to a social good," Foege said.

This led to what Foege called an interruption of measles transmission, an expansion of the geographic scope of public health efforts, and the socialization of immunizations. He said the shift in philosophy paved the way 10 years later in 1965 for development of a vaccine to eradicate smallpox worldwide—an effort led by the United States.

Dr. Howard Markel, the George E. Wantz Professor of the History of Medicine, professor of pediatrics and communicable diseases, and director of the Center for the History of Medicine, said it was fitting for the University to celebrate Francis' role in the eradication of polio, since the history books—like the media in 1955—focused more on Salk's discovery of the vaccine.

"Perhaps the greatest benefit of reflecting on the past is the opportunity to adjust one's understanding of the events and human interactions," Markel said. "History would be well served by not only commemorating Jonas Salk's monumental achievement but by restoring Tommy Francis' contributions back into view."

Markel described Francis' work as the "critical, unglamorous task" of coordinating some 150,000 volunteers at 15,000 schools, with the cooperation of 44 of 48 state departments of health, and then tabulating all of the data without the benefit of a computer.

Others at the 50th anniversary celebration also credited the many polio pioneers, children who received the vaccine or a placebo during the trials.

"The world is healthier today because of you," School of Public Health Dean Noreen Clark said.

"Many of you here today weren't even born in 1955, so you may not really appreciate the fear that gripped the nation," Clark said, recalling her own childhood of closed swimming areas and adults talking about polio in hushed voices when she entered a room.

"This is a day of celebration that begins with a flood of memories for each of us who has a reason to remember," Board of Regents Chair Rebecca McGowan said during welcome remarks.

McGowan told about her husband's uncle and her own uncle who both suffered from polio. The latter contracted the disease after his first year at Harvard and was paralyzed from the neck down. McGowan recalls being enthralled by the iron lung and with watching her uncle's nurse lower him into a "swimming pool filled with hardware and warm salt water" from the ocean.

"I don't remember being frightened myself by this life-altering scourge of my youth," she said. When it came time for her to take the vaccine, McGowan recalls thinking, "Was this really necessary?"

Polio survivor Sunny Roller, an educator and researcher at the University, told the audience that while the disease is gone from this country and efforts are underway to eradicate it in other parts of the world, the effects linger for some of the 20 million survivors worldwide. Roller, who contracted the disease at age 4, is one of half-million survivors to experience recurring symptoms in what has been diagnosed as Post-Poliomyelitis Syndrome.

"Now we are having to fight the disease again," Roller said. "As we celebrate annihilation of the disease, much has to be done. Polio survivors still have needs."

With polio still infecting people in more than a dozen countries of North Africa, the Middle East and southern Asia, experts used the anniversary celebration as a time to call attention to it and other diseases still affecting the world.

"Let's also remember the vital health concerns facing us today, and commit ourselves to resolve them," Clark said. "One message to take away from here: we cannot take our health or the public health system that protects it for granted."