There was an increase in the number of polio cases reported worldwide in 2008. Although the United States sees only about 10 cases per year, usually caused by the Oral Polio Vaccine  the disease is still endemic in some parts of the world. Providing vaccinations and the personnel to administer them requires a significant amount of money. The recent rise in the number of cases per year is an indication that there is not a lot of time to control the disease before it spreads to countries where it has been curtailed or eradicated.

Since the polio vaccine was first used in the 1960s, the disease was effectively eliminated in the United States and many parts of the industrialized world. In 1988 the World Health Organization and partners began an effort to wipe out the crippling disease once and for all. Since that time around $6 billion has been spent to immunize in the four countries where polio is still endemic: Nigeria, Afghanistan, India, and Pakistan. Recent donations by the Gates Foundation and the governments of Germany and U.K. will add $535 million to the amount already spent. Rotary International has pledged that its members will raise $100 million over the next three years to add to the funds. Rotary has long contributed funds and deployed volunteers to help with the inoculation efforts.

Even with the new funds WHO needs an additional $340 million to continue the campaign through 2010, and estimates another $2 billion would be needed until 2013, at which time the hopes are that polio will have been wiped out. “We urge other countries to join us in closing the funding gap,” says Heidemarie Wieczorek-Zeul, German Minister for Economic Cooperation and Development.

If the optimistic goal of elimination of polio by 2013 was met it would be the second deadly disease wiped out in the last century. Smallpox was officially wiped from the planet in 1980. In recent years the polio program has faced monetary difficulties with government donations falling off. The new commitments by non-governmental entities offers a much needed cash injection to finish the job. “The huge costs of the program mean that the faster we move, the easier it will be”, according to Bill Gates “but I’m optimistic that we will be successful.”

Because of a shortage in donor organs, many Americans with chronic kidney disease wait years for a transplant, and some die before ever making it to the first stage of the process. To add insult to injury, a recent study found strong evidence that women over 45 have a significantly less chance of being placed on a kidney transplant list than their male counterparts, even though women who receive a transplant have an equal or slightly better chance of survival. “This is different from most factors that create access to transplant disparities, such as obesity and race,” said lead researcher Dr. Dorry Segev. “Those disparities continue even once you’ve been listed—for example, blacks are less likely to get listed and, once they’re listed, are also less likely to receive a transplant.”

In order to determine access to transplantation , either through deceased donor or live-donor transplant, and survival benefits from transplantation, researchers at Johns Hopkins Medical Institutions in Baltimore examined data from the United States Renal Data System on 563,197 patients who developed end-stage kidney disease from 2000 to 2005. They found that women 45 and younger were as likely as men the same age to be placed on a transplant waiting list, but by the time women were 46 to 55, they were 3 percent less likely to be listed. The disparity grew even greater with each decade. At ages 56 to 65, women were 15 percent less likely to be placed on the list; 29 percent less likely at 66 to 75; and 59 percent less likely by the time they were 75 or older. The chance of a woman getting listed was even worse if she had additional diseases such as diabetes or heart disease. “This study suggests that there is no disparity in ATT for women in general but rather a marked disparity in ATT for older women and women with co-morbidities,” the authors concluded.

Dr. Segev said he believes the gender gap is because older women are perceived to be frailer than they really are, which subconsciously factors into the listing process. Two main steps determine who is placed on the United Network for Organ Sharing kidney transplant list: referral by a nephrologist and how the patient decides to act on that referral. “It appears as though either the nephrologist believes women have a worse chance of survival or some women don’t think they will have a good outcome,” Segev said. “Once they are listed, however, women and men have an equal chance of getting a kidney, regardless of age.”

Dr. Segev contends that this “perceived frailty” has no basis in fact, since for every age group analyzed in the study, the survival outcome for women after transplantation was equal to or slightly higher than men. “Knowing that the gender disparity is limited to older women indicates that efforts should be made to identify specific differences between older men and older women rather than general differences between all men and women in an effort to minimize the gender disparity in access to transplantation,” Dr. Segev said in a news release.