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Can Polio Be Eradicated? A Skeptic Now Thinks So

Two weeks ago, at the end of an interview about whether polio really can be eradicated, Bill Gates muttered aloud to an aide escorting the interviewer: “I’ve got to get my D. A. Henderson response down better.”

By that he meant that as long as he was committing his fortune and prestige to the battle against polio — as he did that day in an announcement at the former Manhattan home of Franklin D. Roosevelt — he would need a stronger riposte to journalists quoting Dr. Henderson’s powerful arguments that the virus is just too elusive to subdue.

In a world of quotable medical experts, why does it matter what one particular expert thinks? Because, for better or worse, the mantle has been wrapped around the venerable 82-year-old Donald A. Henderson that he is “The Man Who Wiped Out Smallpox.”

(In truth, the smallpox fight — the only successful one so far against a human illness — had many generals. One is Dr. William H. Foege, 74, a former director of the Centers for Disease Control who is now a senior adviser to the Bill and Melinda Gates Foundation and who fervently believes that polio can be eradicated. But over the years, Dr. Henderson has patiently explained his doubts, in persuasive detail, to many medical journalists calling him with questions about any disease eradication effort.)

What neither Mr. Gates nor the reporter interviewing him knew was that Dr. Henderson had changed his mind two days before.

“I see as much greatly augmented the probability that we can stop wild polio virus,” he said Wednesday in a follow-up interview — the opposite conclusion to the one he had given to the same reporter on Jan. 26, five days before the Gates interview.

“I apologize,” he added. “It’s not my wont to turn on a dime like this. I don’t think I’ve done anything like this before.”

What changed his mind, he said, was a conversation with Dr. Ciro de Quadros on Jan. 29.

Dr. de Quadros, a former director of the Pan American Health Organization, has his own mantle: “The Man Who Found the Last Case of Smallpox in Ethiopia and Chased Polio and Measles Out of the Western Hemisphere.”

While nothing has changed about the virus or the vaccine, several things Dr. de Quadros told him were persuasive, he said.

“I was unaware of how committed Gates is,” he said. “He’s saying polio is his No. 1 priority.”

Also, he said, he was impressed with the new nine-member monitoring board being set up to advise the World Health Organization. Polio has been driven down by 99 percent since 1985, but the last decade has been frustrating, with repeated outbreaks in countries where the virus had been eliminated.

“There’s been too little dissent in the last 10 years,” he said of the approach used by the W. H. O. and its partners, much of which depended on endless new rounds of fund-raising. “Now the thinking and the muscle have changed,” he said.

Also, Gates Foundation money will allow more experimentation with the oral vaccine used in poor countries. In theory, he said, the live virus in it can be weakened enough to prevent the one-in-two-million chance that it will mutate into a form that can paralyze, a problem known as vaccine-derived polio. (While one in two million sounds infinitesimal, it is not when 134 million children are vaccinated in one day, as happened in India in 1998.)

And it may be possible to make a vaccine that needs no refrigeration. Vaccine going bad in the tropical sun is a major problem for rural vaccination teams.

Also, he added, Dr. de Quadros himself taking a role will change the field.

“I watched him perform in Ethiopia,” said Dr. Henderson, who recruited Dr. de Quadros into the smallpox campaign. “The obstacles were unbelievable — the emperor assassinated, two revolutionary groups fighting, nine of his own teams kidnapped, even a helicopter captured and held for ransom. He kept the teams in the field — and that helicopter pilot went out and vaccinated all the rebels.”

Asked about Dr. Henderson’s change of mind, Mr. Gates said on Monday, “He’s right, and I’m looking forward to sitting down with him in the next month and getting his advice on this thing.”

A version of this article appears in print on  , Section D, Page 4 of the New York edition with the headline: Can Polio Be Eradicated? A Skeptic Now Thinks So. Order Reprints | Today’s Paper | Subscribe

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