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October 28, 1914
New York, New York
|Died||June 23, 1995 (aged 80)|
La Jolla, California,
|Residence||New York, New York|
La Jolla, California
virology and epidemiology
|Institutions||University of Pittsburgh|
University of Michigan
|Alma mater||City College of New York|
New York University
University of Michigan
|Doctoral advisor||Thomas Francis, Jr.|
|Known for||First polio vaccine|
|Notable awards||Lasker Award (1956)|
|Spouse||Donna Lindsay (m. 1939–68)|
Françoise Gilot (m. 1970–95)
October 28, 1914
New York, New York
|Died||June 23, 1995 (aged 80)|
La Jolla, California,
|Residence||New York, New York|
La Jolla, California
virology and epidemiology
|Institutions||University of Pittsburgh|
University of Michigan
|Alma mater||City College of New York|
New York University
University of Michigan
|Doctoral advisor||Thomas Francis, Jr.|
|Known for||First polio vaccine|
|Notable awards||Lasker Award (1956)|
|Spouse||Donna Lindsay (m. 1939–68)|
Françoise Gilot (m. 1970–95)
Jonas Edward Salk (//; October 28, 1914 – June 23, 1995) was an American medical researcher and virologist. He discovered and developed the first successful inactivated polio vaccine. He was born in New York City to Jewish parents. Although they had little formal education, his parents were determined to see their children succeed. While attending New York University School of Medicine, Salk stood out from his peers, not just because of his academic prowess, but because he went into medical research instead of becoming a practicing physician.
Until 1957, when the Salk vaccine was introduced, polio was considered the most frightening public health problem of the post-war United States. Annual epidemics were increasingly devastating. The 1952 epidemic was the worst outbreak in the nation's history. Of nearly 58,000 cases reported that year, 3,145 people died and 21,269 were left with mild to disabling paralysis, with most of its victims being children. The "public reaction was to a plague," said historian Bill O'Neal. "Citizens of urban areas were to be terrified every summer when this frightful visitor returned." According to a 2009 PBS documentary, "Apart from the atomic bomb, America's greatest fear was polio." As a result, scientists were in a frantic race to find a way to prevent or cure the disease. U.S. president Franklin D. Roosevelt was the world's most recognized victim of the disease and founded the organization, the March of Dimes Foundation, that would fund the development of a vaccine.
In 1947, Salk accepted an appointment to the University of Pittsburgh School of Medicine. In 1948, he undertook a project funded by the National Foundation for Infantile Paralysis to determine the number of different types of polio virus. Salk saw an opportunity to extend this project towards developing a vaccine against polio, and, together with the skilled research team he assembled, devoted himself to this work for the next seven years. The field trial set up to test the Salk vaccine was, according to O'Neill, "the most elaborate program of its kind in history, involving 20,000 physicians and public health officers, 64,000 school personnel, and 220,000 volunteers." Over 1,800,000 school children took part in the trial. When news of the vaccine's success was made public on April 12, 1955, Salk was hailed as a "miracle worker," and the day "almost became a national holiday." His sole focus had been to develop a safe and effective vaccine as rapidly as possible, with no interest in personal profit. When he was asked in a televised interview who owned the patent to the vaccine, Salk replied: "There is no patent. Could you patent the sun?"
In 1960, he founded the Salk Institute for Biological Studies in La Jolla, California, which is today a center for medical and scientific research. He continued to conduct research and publish books, including Man Unfolding (1972), The Survival of the Wisest (1973), World Population and Human Values: A New Reality (1981), and Anatomy of Reality: Merging of Intuition and Reason (1983). Salk's last years were spent searching for a vaccine against HIV. His personal papers are stored at the University of California, San Diego Library.
Jonas Salk was born in New York City on October 28, 1914. His parents, Daniel and Dora (Press) Salk, were from Jewish immigrant families, and had not received extensive formal education. According to historian David Oshinsky, Salk grew up in the "Jewish immigrant culture" of New York. He had two younger brothers, Herman and Lee, a child psychologist. The family moved from East Harlem to the Bronx, with some time spent in Queens.
When he was 13, Salk entered Townsend Harris High School, a public school for intellectually gifted students. Named after the founder of City College of New York (CCNY), it was, said Oshinsky, "a launching pad for the talented sons of immigrant parents who lacked the money—and pedigree—to attend a top private school." In high school "he was known as a perfectionist . . . who read everything he could lay his hands on," according to one of his fellow students. Students had to cram a four-year curriculum into just three years. As a result, most dropped out or flunked out, despite the school's motto "study, study, study." Of the students who graduated, however, most would have the grades to enroll in CCNY, noted for being a highly competitive college.:96
Salk enrolled in City College of New York from which he earned a Bachelor of Science degree in 1934. Oshinsky writes that "for working-class immigrant families, City College represented the apex of public higher education. Getting in was tough, but tuition was free. Competition was intense, but the rules were fairly applied. No one got an advantage based on an accident of birth."
At his mother's urging, he put aside aspirations of becoming a lawyer, and instead concentrated on classes necessary for admission to medical school. However, according to Oshinsky, the facilities at City College were "barely second rate." There were no research laboratories. The library was inadequate. The faculty contained few noted scholars. "What made the place special," he writes, "was the student body that had fought so hard to get there ... driven by their parents... From these ranks, of the 1930s and 1940s, emerged a wealth of intellectual talent, including more Nobel Prize winners—eight—and PhD recipients than any other public college except the University of California at Berkeley." Salk entered City College at the age of 15, a "common age for a freshman who had skipped multiple grades along the way.":98
As a child, Salk did not show any interest in medicine or science in general. He said in an interview with the Academy of Achievement "As a child I was not interested in science. I was merely interested in things human, the human side of nature, if you like, and I continue to be interested in that."
According to Oshinsky, NYU based its modest reputation on famous alumni, such as Walter Reed, who helped conquer yellow fever. Tuition was "comparatively low, better still, it did not discriminate against Jews, . . . while most of the surrounding medical schools—Cornell, Columbia, University of Pennsylvania, and Yale—had rigid quotas in place." Yale, for example, accepted 76 applicants, in 1935, out of a pool of 501. Although 200 of the applicants were Jewish, only five got in.:98
During Salk's years at the New York University School of Medicine, he stood out from his peers, according to Bookchin, "not just because of his continued academic prowess—he was Alpha Omega Alpha, the Phi Beta Kappa Society of medical education—but because he had decided he did not want to practice medicine." Instead, he became absorbed in research, even taking a year off to study biochemistry. He later focused more of his studies on bacteriology which had replaced medicine as his primary interest. He said his desire was to help humankind in general rather than single patients. And as Oshinsky writes, "it was the laboratory work, in particular, that gave new direction to his life."
According to Salk: "My intention was to go to medical school, and then become a medical scientist. I did not intend to practice medicine, although in medical school, and in my internship, I did all the things that were necessary to qualify me in that regard. I had opportunities along the way to drop the idea of medicine and go into science. At one point at the end of my first year of medical school, I received an opportunity to spend a year in research and teaching in biochemistry, which I did. And at the end of that year, I was told that I could, if I wished, switch and get a Ph.D. in biochemistry but my preference was to stay with medicine. And, I believe that this is all linked to my original ambition, or desire, which was to be of some help to humankind, so to speak, in a larger sense than just on a one-to-one basis."
In 1941, during his postgraduate work in virology, Salk chose a two-month elective to work in the laboratory of Dr. Thomas Francis at the University of Michigan. Francis had recently joined the faculty of the medical school after working for the Rockefeller Foundation, where he had discovered the Type B influenza virus. According to Bookchin, "the two-month stint in Francis's lab was Salk's first introduction to the world of virology—and he was hooked.":25 From that time originates the first controversy (the second one relates in revealing SV40 in the rhesus monkey kidney cells used for multiplying poliomyelitis virus for vaccines in 1960) in Salk's career: Francis and other researchers, one of whom was Salk, deliberately infected patients at several Michigan mental hospitals with the influenza virus by spraying the virus into their nasal cavities.
After graduating from medical school, Salk began his residency at New York's Mount Sinai Hospital, where he again worked in Francis's laboratory. Few hospitals in Manhattan had the status of Mount Sinai, particularly among the city's Jews. Oshinsky interviewed a friend of Salk's, who said, "to intern there was like playing ball for the New York Yankees ... only the top men from the nation's medical schools dared apply. Out of 250 who sought the opportunity, only a dozen were chosen."
According to Oshinsky, "Salk quickly made his mark." Although focused mainly on research, "he showed tremendous skills as a clinician and a surgeon." But it was "his leadership as president of the house staff of interns and residents at Mount Sinai that best defined him to his peers." The key issue for many of them in 1939, for example, was not the fate of the hospital, but rather the future of Europe after Nazi Germany's invasion of Poland. In one instance, "several interns responded by wearing badges to signify support for the Allies", but the hospital's director told them to remove them lest they upset some of the patients.
The interns then took the matter to Salk, where he said that "everyone should wear the badge as an act of solidarity." One intern recalled, "Jonas was a very staunch guy. He never took a backward step on that issue or any other issue of principle between us and the hospital." The hospital administrators backed off and there was no further interference from the director.
At the end of his residency, Salk began applying for permanent research positions, but he discovered that many of the jobs he desired were closed to him due to Jewish quotas, which, according to Bookchin, "prevailed in so much of the medical research establishment." Nor could he apply at Mount Sinai, as its policy prevented it from hiring its own interns. As a last resort, he contacted Dr. Francis for help, but Francis had left New York University a year earlier after accepting an offer to direct the University of Michigan's School of Public Health.
However, "Francis did not let him down," writes Bookchin. "He secured extra grant money and offered Salk a job" working on an army-commissioned project in Michigan to develop an influenza vaccine. He and Francis eventually perfected a vaccine that was soon widely used at army bases, where "Salk had been responsible for discovering and isolating one of the flu strains that was included in the final vaccine.":26
By 1947, Salk decided to find an institution where he could direct his own laboratory. After three institutions turned him down, he received from William McEllroy, the dean of the University of Pittsburgh School of Medicine, an offer which included a promise that he would run his own lab. He accepted, and in the fall of that year, left Michigan and relocated to Pennsylvania. But the promise was not quite what he expected. After Salk arrived at Pittsburgh, "he discovered that he had been relegated to cramped, unequipped quarters in the basement of the old Municipal Hospital", writes Bookchin. As time went on, however, Salk began securing grants from the Mellon family and was able to build a working virology laboratory, where he continued his research on flu vaccines.
Salk's work on influenza viruses has been associated with ethical controversy. The Associated Press reported that Salk authored a research paper describing a federally funded study that began in 1942. Salk injected patients in a state insane asylum in Ypsilanti, Michigan, with an experimental influenza vaccine, then exposed them to influenza virus months later to check the vaccine's efficacy. It is questionable at best whether any of these patients could have understood what was being done to them, or why.
He was later approached by the director of research at the National Foundation for Infantile Paralysis and asked whether he would like to participate on the foundation's polio project which had earlier been established by President Franklin D. Roosevelt, at the time thought to be a victim of polio himself. Salk quickly accepted the offer, saying he "would be happy to work on this important project."
In 1956, Wisdom magazine ran a cover story about Salk, summarizing some of the reasoning behind his desire to do research:
There are two types of medical specialists. There are those who fight disease day and night, who assist mankind in times of despair and agony and who preside over the awesome events of life and death. Others work in the quiet detachment of the laboratory; their names are often unknown to the general public, but their research may have momentous consequences.
Polio was a medical oddity that baffled researchers for years. It was first recorded in 1835 and grew steadily more prevalent. It took a long time to learn that the virus was transmitted by fecal matter and secretions of the nose and throat. It entered the victim orally, established itself in the intestines, and then traveled to the brain or spinal cord.
At the start of the 20th century, during the 1914 and 1919 polio epidemics in the U.S., physicians and nurses made house-to-house searches to identify all infected persons. Children suspected of being infected were taken to hospitals and a child's family was quarantined until that child was no longer potentially infectious, even if it meant the family could not go to their child's funeral if the child died in the hospital.
There are many famous polio victims, most of whom were able to overcome their disabilities, while others were less fortunate: Itzhak Perlman, one of the world's finest violinists, was permanently disabled at age four, and still plays sitting down; actor Donald Sutherland; writer Arthur C. Clarke; writer Robert Anton Wilson; actress Mia Farrow; singer-musician Neil Young; Olympic dressage rider Lis Hartel; actor Alan Alda; musician David Sanborn; singer Dinah Shore; singer Joni Mitchell; former Supreme Court Justice William O. Douglas; director Francis Ford Coppola; nuclear physicist J. Robert Oppenheimer; actor Lionel Barrymore; and Congressman James H. Scheuer.
According to American historian William O'Neill, "Paralytic poliomyelitis (its formal name) was, if not the most serious, easily the most frightening public health problem of the postwar era." He noted that the epidemics kept getting worse and its victims were usually children. By 1952, it was killing more of them than was any other communicable disease. In the twenty states that reported the disease back in 1916, there were 27,363 cases. New York alone had 9,023 cases, of which 2,448 (28%) resulted in death, and a larger number in paralysis.:136 However, polio did not gain national attention until 1921, when Franklin D. Roosevelt, former vice presidential candidate and soon to be governor of New York, came down with a paralytic illness, diagnosed at the time as polio. At the age of 39, Roosevelt was left with severe paralysis and spent most of his presidency in a wheelchair.
Subsequently, as more states began recording instances of the disease, the numbers of victims grew larger. Nearly 58,000 cases of polio were reported in 1952, with 3,145 people dying and 21,269 left with mild to disabling paralysis. In some parts of the country, concern assumed almost the dimensions of panic. According to Olson, "parents kept children home from school, avoided parks and swimming pools, and played only in small groups with the closest of friends."
Cases usually increased during the summer when children were home from school. "The public reaction was to a plague," noted O'Neill. "Citizens of urban areas were to be terrified every summer when this frightful visitor returned." As a result, Olson points out, "scientists were in a frantic race to find a cure." The famous U.S. artist Andrew Wyeth painted his neighbor, Christina Olson, who was crippled with polio. The painting is considered his most famous work.
Salk became ambitious for his own lab and was finally granted one at the University of Pittsburgh. However, he was disappointed. The lab they had given him was much smaller than he had hoped and the university forced him to conform to many rules which stunted his research as a beginning virologist.
In 1948, Harry Weaver, the director of research at the National Foundation for Infantile Paralysis (NFIP), which later became known as the March of Dimes, contacted Salk. He asked Salk to join the fight against polio and research/confirm how many polio types there were. At the time, scientists had discovered three; they wanted to know if there were any more types. Although this type of polio research would be repetitious, boring, and time-consuming, the National Foundation agreed to pay for additional space, equipment and researchers. Once the research was finished, Salk would be able to keep the facilities and continue his previous work.
Because Salk desperately needed space, he joined the fight. For the first year, he gathered supplies and researchers. Dr. Julius Youngner, Byron Bennett, Dr. L. James Lewis and secretary Lorraine Friedman joined Salk's team as well. Youngner remembers this period:
Jonas was swimming against the current. He was a young whippersnapper who came out of nowhere, and suddenly is taking on this responsibility, and not only that, but getting the support of Basil O’Connor, because Jonas convinced Basil O’Connor that we were going to do it.
Oshinsky writes that as "headlines screamed, 'Polio Scourge,' 'Polio Panic,' and 'Polio's Deadly Path,'" parents "faced a dilemma" and a feeling of personal helplessness in the midst of an "apparently runaway epidemic." Their "postwar culture was being turned upside down" as polio became the "crack in the fantasy" of a suburban home "bursting with children." Parents began to see that there would be an alternative, however: "Since worry did no good and quarantine seemed fruitless, parents might best protect their children by helping others to discover a vaccine against polio, and, perhaps, even a cure." The public soon realized that this kind of research demanded "big money" and an "army of devoted volunteers,":85–87 but Salk was determined to make it over this barrier.
The fight against polio did not really get under way until 1938 when the National Foundation for Infantile Paralysis was born, headed by Basil O'Connor, the former law partner of President Roosevelt, the US's most famous polio victim. That same year, the first March of Dimes fundraising program was set up, with radio networks offering free 30-second slots for promotion. Listeners were asked to send in a dime and the White House received 2,680,000 letters within days.
As the fear of polio increased each year, funds to combat it increased from $1.8 million to $67 million by 1955. Research continued during those years, but, writes O'Neill, "everything scientists believed about polio at first was wrong, leading them down many blind alleys . . . furthermore, most researchers were experimenting with highly dangerous live vaccines. In one test, six children were killed and three left crippled."
"This was the situation when young Jonas Salk, a medical doctor in charge of a virology laboratory at the University of Pittsburgh, decided to use the safer killed virus," writes O'Neill. Despite a general lack of enthusiasm for this approach, O'Connor backed Salk handsomely. After successful tests on laboratory animals, it next had to be tested on human beings. On July 2, 1952, assisted by the staff at the D.T. Watson Home for Crippled Children, Jonas Salk injected 43 children with his killed virus vaccine. A few weeks after the Watson tests, Salk injected children at the Polk State School for the retarded and feeble-minded. In November 1953, at a conference in New York's Waldorf-Astoria Hotel, he said, "I will be personally responsible for the vaccine." He announced that his wife and three sons had been among the first volunteers to be inoculated with his vaccine.
It was critical that Salk develop the trust of the US public for his experiments and the mass tests that would become necessary. An associate of his noted, "That boy really suffers when he sees a paralytic case. You look at him and you see him thinking, 'My God, this can be prevented'." An article in Wisdom notes that at one point, "he even thought of giving up virus research":
But as he was sitting in a park and watching children play, he realized how important his work was. He saw that there were thousands of children and adults who would never walk again and whose bodies would be paralyzed. He realized his awesome responsibility, and so he continued his task with renewed vigor.
As a result of Salk's preliminary results in 1954, "when polio was destroying more American children than any other communicable disease, his vaccine was ready for field testing."
The field trial set up to test the vaccine developed by Salk and his research team was, according to O'Neill, "the most elaborate program of its kind in history, involving 20,000 physicians and public health officers, 64,000 school personnel, and 220,000 volunteers," with over 1,800,000 school children participating in the trial. A 1954 Gallup poll showed that more Americans knew about the polio field trials than could give the full name of the US President.
According to medical author Paul Offit, "more Americans had participated in the funding, development, and testing of the polio vaccine than had participated in the nomination and election of the president.":54 At least one hundred million people had contributed to the March of Dimes, and seven million had donated their time and labor as well. They included fund-raisers, committee workers, and volunteers at clinics and record centers.
Doris Fleischer, a disability historian, noted that O'Connor was willing to take whatever risks necessary to serve the purposes of the foundation. She writes, "When O'Connor realized that success seemed imminent, he allowed the foundation to go into debt to finance the final research required to develop the Salk vaccine. His 'passionate' devotion to this task became almost 'obsessive' when his daughter, a mother of five, told him that she had contracted the illness, saying, 'I've gotten some of your polio.'"
With the hopes of the world upon him, "Salk worked sixteen hours a day, seven days a week, for years . . .", wrote Denenberg. It had been, Salk later described, "two and a half years of drudgery and hard work.":44 The results of the tests were eventually deemed successful and, O'Neill wrote, "Salk had justified Basil O'Connor's faith."
On April 12, 1955, Dr. Thomas Francis, Jr., of the University of Michigan, the monitor of the test results, "declared the vaccine to be safe and effective." The announcement was made at the University of Michigan, exactly 10 years to the day after the death of President Roosevelt. Five hundred people, including 150 press, radio, and television reporters, filled the room; 16 television and newsreel cameras stood on a long platform at the back; and 54,000 physicians, sitting in movie theaters across the country, watched the broadcast on closed-circuit television. Eli Lilly and Company paid $250,000 to broadcast the event. Americans turned on their radios to hear the details, department stores set up loudspeakers, and judges suspended trials so that everyone in the courtroom could hear. Europeans listened on the Voice of America. Paul Offit writes about the event:
"The report", wrote The New York Times, "was a medical classic." Dr. Francis reported that the vaccinations had been 80 to 90 percent effective on the basis of results in eleven states. Overall, the vaccine was administered to over 440,000 children in forty-four states, three Canadian provinces and in Helsinki, Finland, and the final report required the evaluation of 144,000,000 separate items of information. After the announcement, when asked whether the effectiveness of the vaccine could be improved, Salk said, "Theoretically, the new 1955 vaccines and vaccination procedures may lead to 100 percent protection from paralysis of all those vaccinated."
Salk’s new vaccine was by transformed by Alan John Beale’s team, based in Glaxo, England into something which could be manufactured on the enormous scale which the widespread threat of poliomyelitis required. Within minutes of Francis's declaration that the vaccine was safe and effective, the news of the event was carried coast to coast by wire services, radio and television newscasts. According to Debbie Bookchin, "across the nation there were spontaneous celebrations... business came to a halt as the news spread. The mayor of New York City interrupted a city council meeting to announce the news, adding, 'I think we are all quite proud that Dr. Salk is a graduate of City College.'":46 "By the next morning", writes Bookchin, "politicians around the country were falling over themselves trying to figure out ways they could congratulate Salk, with several suggesting special medals and honors be awarded.... In the Eisenhower White House, plans were already afoot to present Salk a special presidential medal designating him "a benefactor of mankind" in a Rose Garden ceremony.
It was also declared "a victory for the whole nation." Jonas Salk became "world famous overnight and was showered with awards", writes O'Neill. The governor of Pennsylvania had a medal struck, and the state legislature gave him a chaired professorship. However, New York City could not get him to accept a ticker tape parade. Instead New York created eight "Jonas Salk Scholarships" for future medical students. He received a Presidential Citation, the nation's first Congressional Medal for Distinguished Civilian Service, and a large number of honorary degrees and related honors.:138
According to O'Neill, "April 12th had almost become a national holiday: people observed moments of silence, rang bells, honked horns, blew factory whistles, fired salutes, kept their red lights red in brief periods of tribute, took the rest of the day off, closed their schools or convoked fervid assemblies therein, drank toasts, hugged children, attended church, smiled at strangers, and forgave enemies.":138
By July, movie studios were already fighting for the motion-picture rights to his film biography. Twentieth Century-Fox began writing a screenplay and Warner Brothers filed a claim to the title The Triumph of Dr. Jonas Salk shortly after the formal announcement of the vaccine.
Six months before Salk's announcement, optimism and hope were so widespread that the Polio Fund in the U.S. had already contracted to purchase enough of the Salk vaccine to immunize 9,000,000 children and pregnant women the following year. And around the world, the official news prompted an immediate international rush to vaccinate. Medical historian Debbie Bookchin writes, "Canada, Sweden, Denmark, Norway, West Germany, the Netherlands, Switzerland, and Belgium all announced plans to either immediately begin polio immunization campaigns using Salk's vaccine or to gear up to quickly do so. "Overnight", she adds, "Salk had become an international hero and a household name. His vaccine was a modern medical miracle.":47 Because Salk was the first to prove that a killed-virus could prevent polio, medical historian Paul Offit wrote in 2007 that "for this observation alone, Salk should have been awarded the Nobel Prize. Virologist Isabel Morgan had earlier shown and published that a killed-virus could prevent polio, although she did not test her vaccines on humans. Morgan's work, nonetheless, was a key link in the chain of progress toward the killed-virus polio vaccine for humans later developed and tested by Salk.
By the summer of 1957, over two years later, 100 million doses had been distributed throughout the United States and "reported complications following their administration have been remarkably rare", noted the scientists at the International Polio Conference in Geneva. Scientists from other nations reported similar experiences: Denmark, for example, "reported only a few sporadic cases among the 2,500,000 ... who received the vaccine." Australia reported virtually no polio during her past summer season.
Other countries where the vaccine was not yet in use suffered continued epidemics, however. In 1957, Hungary, for example, reported a severe epidemic requiring emergency international assistance. By the first half of the year, it had 713 reported cases and a death rate of 6.6%, and the peak infection months of summer were still ahead. Canada sent a shipment of vaccine to Hungary by a refrigerated plane, and Britain and Sweden sent iron lungs. A few years later, during a polio outbreak in Canada, "masked bandits" stole 75,000 Salk vaccine shots from a Montreal university research center.
By the end of 1990, it was estimated that 500,000 annual cases worldwide of paralysis resulting from polio had been prevented due to immunization programs carried out by WHO, UNICEF, and many other organizations, and in 1991, transmission of polio was declared as "interrupted" in the Western hemisphere.
In developing countries, estimates in 1988 ran as high as 350,000 cases each year. As a result, in 2002, more than 500 million children were immunized in 93 countries,:112 and by December 2002, there were only 1,924 cases worldwide, mostly in India, with six other countries where polio was still endemic: Afghanistan, Egypt, Niger, Nigeria, Pakistan, and Somalia. By early 2014, however, the World Health Organization (WHO) listed only three remaining countries where polio was still endemic, Pakistan, Afghanistan and Nigeria, and declared Pakistan's city of Peshawar as the world's "largest reservoir," of polio. Some groups have attributed Pakistan's high numbers, in part, to the fact that because the CIA conducted a fake polio campaign to help track Osama bin Laden in May 2011, religious extremists can create fear that the vaccine is actually a western conspiracy to sterilise the population.
In 1993, China initiated a national immunization program, with over 80 million children getting vaccinated in just 2 days; by the following year, the country reported only 5 cases of polio.
In 1981, India reported over 38,000 cases of polio. By 1999, intensive vaccination campaigns had succeeded in eradicating the Type 2 strain of virus from India. Microsoft co-founder Bill Gates sponsored a campaign to eradicate polio, and the Bill & Melinda Gates Foundation committed nearly $1 billion to health and development projects throughout India. The last case of polio in India, in two-year-old Rukhsaar Khatoon, was confirmed on 13 January 2011. India was removed from the list of polio-endemic countries in 2012, and marked two years without a case of polio on 13 January 2013. As no new cases were found by January, 2014, the nation was officially declared polio-free.
During the 1970s, Latin America had an estimated 15,000 paralysis cases, with about 1,750 deaths each year from polio. By 1991, the last case of polio was reported in Latin America and the Caribbean, and polio has now been declared as fully eliminated from the region.
In 1988, numerous international medical organizations launched a campaign to eradicate polio globally, as had been successfully done for smallpox. By 2003, polio had been eradicated in all but a few countries, among them Afghanistan, India, Nigeria, and Pakistan However, mullahs in northern Nigeria began to oppose the vaccination program, claiming that it was a plot to spread AIDS and sterility, and prevented any vaccination. Polio cases in Nigeria tripled over the next three years.
Environmental scientist Lester Brown speculates that Nigerian Muslims may have spread the disease to Muslims of other polio-free countries during their annual pilgrimage to Mecca, in Saudi Arabia. With these same fears, Saudi Arabian officials imposed polio vaccination requirement on certain visitors.
In Pakistan in 2007, there was violent opposition to vaccinations in the Northwest Frontier Province where a doctor and a health worker in the Polio Eradication Program were killed. Since then, the Taliban has blocked all vaccinations in the Swat Valley of Pakistan. As a result, Pakistan was the only country in 2010 to record an increase in cases of polio, according to the World Health Organization, along with having the highest incidence of polio in the world. Meanwhile, the Gates Foundation, which has spent $1.5 billion, plans to spend another $1.8 billion through 2018 to help eradicate the virus.
Just two weeks after the vaccine was announced, Senator Hubert H. Humphrey (Democrat, Minnesota) urged President Dwight D. Eisenhower "to show the nation's gratitude to Dr. Jonas E. Salk for his new polio vaccine by 'loosening the purse-strings' on Federal medical research." Salk knew it would take time to verify his theories and improve the vaccine. "He still wants to find out a number of things about polio", wrote The New York Times that summer. Questions remained: "How long will the immunity last? Are there any children who cannot be immunized? What improvements can be made?" Beyond that, "he has far bigger goals—'more in the nature of dreams right now'—involving other diseases."
Over the next few years, while trying to perfect the polio vaccine, Salk had begun working unannounced, on a cure for cancer. A 1958 article in The New York Times confirmed "that he had been conducting experiments on cancer patients." The news was leaked after a Pittsburgh newspaper, the Sun-Telegraph, reported that he had been giving injections to children suffering from cancer. Salk stated afterwards, "It is true that we have been conducting experiments in many persons with a variety of cancer and cancer-like conditions ... but we have no treatment for cancer. Our studies are of a strictly exploratory nature..." In 1965, he also said "a vaccine for the common cold is a matter of time and of solving some technical problems."
Years before the Salk vaccine was officially announced as safe, Dr. Albert Sabin had joined in the search for a vaccine, using a live-virus, as opposed to Salk's killed-virus. Sabin, however, had been "openly hostile to Salk." Debbie Bookchin writes that he had been "perhaps accurately guessing that Salk was about to challenge him for ascendancy in the polio world." After one presentation that Salk made to a medical conference, "Sabin mounted a full-scale offensive, engaging in a piecemeal demolition of his presentation." However, the National Foundation "swiftly put its full weight behind Salk. Here, finally, was a polio researcher, they said, who had accomplished something."
By 1962, polio had become almost extinct, with only 910 cases reported that year—down from 37,476 in 1954. "It's a matter of principle", Salk said. "It is not a Salk versus Sabin controversy, a competition between two people... I had worked with influenza viruses, helping to establish the efficacy of a killed-virus vaccine... I demonstrated that it could be 100 percent effective if the quantity of virus in the vaccine was sufficient." That same year, the state of New York's Health Department recommended "that the Salk vaccine be given preference over the Sabin oral vaccine..."
On October 20, 1998, after eighteen years of using the Sabin vaccine, however, the federal government recommended that children use the Salk vaccine exclusively. Sabin's polio vaccine is no longer available in the United States.:127
While OPV is not recommended by the CDC, its website explained that Sabin's OPV is more suited to areas where polio is endemic, because of "its advantages over IPV in providing intestinal immunity and providing secondary spread of the vaccine to unprotected contacts."
On January 4, 2013, the World Health Organization called for the Sabin OPV, which contains the Type 2 strain of poliovirus, to be phased out as soon as possible; although the Type 2 strain has been eradicated in the wild, vaccine-derived strains still circulate in polio-endemic nations. A different OPV would continue to be administered, protecting against Types 1 and 3, which are both still endemic in the wild in Nigeria, Afghanistan and Pakistan. The WHO also called for the rapid introduction of the Salk IPV, which will be used along with OPV during a transition period. Once Types 1 and 3 cease to be endemic, the OPV will be phased out, and the Salk vaccine will be used exclusively.
In September 1962, public health officials in the U.S. and Canada faced a "major dilemma": whether to continue using the recently begun Sabin vaccine inoculations until further studies were conducted, due to reports of polio cases among persons who had received it. The U.S. Surgeon General, Luther Terry, recommended a temporary halt due to sixteen cases of confirmed polio in adults. And "the Canadian Federal Health Department recommended against mass use of the [Sabin] oral vaccine pending further study of its effects." One of the unfortunate results caused by the controversy was that "many authorities have deplored the confusion that has been created in the public mind."
Due to the American Medical Association's (AMA) "obstructive tactics, however, which caused numerous delays", writes O'Neill, the AMA had called for mass vaccinations in early 1962 employing Sabin's vaccine rather than Salk's. However, writes O'Neill, "as live-virus was more dangerous, it caused an unknown number of polio cases... [but] the medical establishment seemed not to mind, having gotten its own way at last." But, concludes O'Neill, "polio was conquered all the same, even if not so quickly and safely as it might have been.":139
In 1980, Salk pointed out the renewed interest in his killed virus vaccine, particularly in developing countries. "The live virus vaccine is highly effective in developed countries ...", he said, "but in the developing countries, where polio is on the increase, the drawback is that the live virus fails to establish the infection that leads to immunity because of intestinal inhibitors in the population." Recent evidence of this was found in Iran, where a number of children receiving the oral vaccine became infected with polio, leading Iranian researchers to recommend using the killed virus in the future.
Two months after the Salk vaccine was announced to the world, in 1955, Basil O'Connor found it necessary to respond to critics of the vaccine, especially Dr. Sabin. As the President of the National Foundation for Infantile Paralysis, he said, during a news conference before a Congressional group in Washington, that "criticism of the Salk vaccine program by Dr. Albert Sabin of the University of Cincinnati was 'old stuff'." According to The New York Times, "Dr. Sabin recommended at a hearing before a House Investigating subcommittee that Salk inoculations be suspended" until a safer preparation could be perfected. O'Connor responded in a prepared statement: (excerpt)
However, a year and a half after the Salk vaccine was introduced, a Sabin vaccine had still not yet been tested on humans. Sabin himself said, in October 1956, that "the Salk vaccine is still the only protection against polio available to the public." He was hoping to be able to start tests on humans by the end of the year or by 1957.
In 1955, Cutter Laboratories was one of several companies licensed by the United States government to produce Salk's polio vaccine. In what came to be known as the Cutter Incident, a production error caused some lots of the Cutter vaccine to be tainted with live polio virus. It was one of the worst pharmaceutical disasters in U.S. history and caused several thousand children to be exposed to live polio virus, causing 56 cases of paralytic polio and 5 deaths.
On April 12, 1965, leaders of the Senate and House presented Salk with a joint resolution expressing the nation's gratitude to him, his colleagues in the project and the March of Dimes, which helped to finance the work. President Lyndon B. Johnson called him to the White House to congratulate him personally. Dr. Luther Terry, Surgeon General of the United States, said in a statement marking the anniversary that only 121 cases of polio were reported the previous year, as opposed to more than 28,000 ten years before. "This represents an historic triumph of preventive medicine—unparalleled in history", Dr. Terry said.
On May 6, 1985, President Ronald Reagan proclaimed that day to be "Jonas Salk Day." His proclamation read, in part:
One of the greatest challenges to mankind always has been eradicating the presence of debilitating disease. Until just thirty years ago poliomyelitis occurred in the United States and throughout the world in epidemic proportions, striking tens of thousands and killing thousands in our own country each year. Dr. Jonas E. Salk changed all that. This year we observe the 30th anniversary of the licensing and manufacturing of the vaccine discovered by this great American. Even before another successful vaccine was discovered, Dr. Salk's discovery had reduced polio and its effects by 97 percent. Today, polio is not a familiar disease to younger Americans, and many have difficulty appreciating the magnitude of the disorder that the Salk vaccine virtually wiped from the face of the Earth.
Salk preferred not to have his career as a scientist affected by too much personal attention, as he had always tried to remain independent and private in his research and life. But this proved to be impossible. "Young man, a great tragedy has befallen you—you've lost your anonymity", the late television personality Ed Murrow said to Salk shortly after the onslaught of media attention. When Murrow asked him, "Who owns this patent?", Salk replied, "No one. Could you patent the sun?" However, lawyers from the National Foundation for Infantile Paralysis did look into the possibility of a patent, but ultimately determined that the vaccine was not a patentable invention because of prior art.
Author Jon Cohen noted that "Jonas Salk made scientists and journalists alike go goofy. As one of the only living scientists whose face was known the world over, Salk, in the public's eye, had a superstar aura. Airplane pilots would announce that he was on board, and passengers would burst into applause. Hotels routinely would upgrade him into their penthouse suites. A meal at a restaurant inevitably meant an interruption from an admirer... and scientists approached him with drop-jawed wonder, as though some of the stardust might rub off."
For the most part, however, Salk was "appalled at the demands on the public figure he has become and resentful of what he considers to be the invasion of his privacy", wrote The New York Times, a few months after his vaccine announcement. The Times article noted that "at 40, the once obscure scientist ... was lifted from his laboratory almost to the level of a folk hero." He received a Presidential citation, a score of awards, four honorary degrees, half a dozen foreign decorations, and letters from thousands of fellow citizens. His alma mater, City College of New York, gave him an honorary degree as Doctor of Laws. But "despite such very nice tributes", The New York Times wrote, "Salk is profoundly disturbed by the torrent of fame that has descended upon him.... He talks continually about getting out of the limelight and back to his laboratory... because of his genuine distaste for publicity, which he believes is inappropriate for a scientist."
During a 1980 interview, 25 years later, he said, "It's as if I've been a public property ever since, having to respond to external as well as internal impulses.... It's brought me enormous gratification, opened many opportunities, but at the same time placed many burdens on me. It altered my career, my relationships with colleagues; I am a public figure, no longer one of them."
"If Salk the scientist sounds austere", wrote The New York Times, "Salk the man is a person of great warmth and tremendous enthusiasm. People who meet him generally like him." A Washington newspaper correspondent commented, "He could sell me the Brooklyn Bridge, and I never bought anything before." Award-winning geneticist Walter Nelson-Rees called him "a renaissance scientist: brilliant, sophisticated, driven... a fantastic creature.":127
He enjoys talking to people he likes, and "he likes a lot of people", wrote the Times. "He talks quickly, articulately, and often in complete paragraphs." And, notes the Times, "He has very little perceptible interest in the things that interest most people—such as making money." That belongs "in the category of mink coats and Cadillacs—unnecessary", he said.
In the years after Salk's discovery, many supporters, in particular the National Foundation, "helped him build his dream of a research complex for the investigation of biological phenomena 'from cell to society'."[attribution needed] Called the Salk Institute for Biological Studies, it opened in 1963 in the San Diego neighborhood of La Jolla. Salk believed that the institution would help new and upcoming scientists along in their careers, as he said himself, "I thought how nice it would be if a place like this existed and I was invited to work there." This was something that Salk was deprived of early in his life, but due to his achievements, was able to provide for future scientists.
In 1966, Salk described his "ambitious plan for the creation of a kind of Socratic academy where the supposedly alienated two cultures of science and humanism will have a favorable atmosphere for cross-fertilization." Author and journalist Howard Taubman explained:
The New York Times, in a 1980 article celebrating the 25th anniversary of the Salk vaccine, described the current workings at the facility:
Beginning in the mid-1980s, Salk also engaged in research to develop a vaccine for another, more recent plague, AIDS. To further this research, he co-founded The Immune Response Corporation with Kevin Kimberlin, to search for a vaccine, and patented Remune, an immune-based therapy. The AIDS vaccine project was discontinued in 2007, twelve years after Jonas Salk's death in 1995.
In 1966, The New York Times referred to him as the "Father of Biophilosophy." According to Times journalist and author Howard Taubman, "he never forgets... there is a vast amount of darkness for man to penetrate. As a biologist, he believes that his science is on the frontier of tremendous new discoveries; and as a philosopher, he is convinced that humanists and artists have joined the scientists to achieve an understanding of man in all his physical, mental and spiritual complexity. Such interchanges might lead, he would hope, to a new and important school of thinkers he would designate as biophilosophers."
Salk describes his "biophilosophy" as the application of a "biological, evolutionary point of view to philosophical, cultural, social and psychological problems." He went into more detail in two of his books, Man's Unfolding, and The Survival of the Wisest. In an interview in 1980, he described his thoughts on the subject, including his feeling that a sharp rise and an expected leveling off in the human population would take place and eventually bring a change in human attitudes:
His definition of a "bio-philosopher" is "Someone who draws upon the scriptures of nature, recognizing that we are the product of the process of evolution, and understands that we have become the process itself, through the emergence and evolution of our consciousness, our awareness, our capacity to imagine and anticipate the future, and to choose from among alternatives."
The day after his graduation from medical school, Salk married Donna Lindsay, a master's candidate at the New York College of Social Work. David Oshinsky writes that her father, Elmer Lindsay, "a wealthy Manhattan dentist, viewed Salk as a social inferior, several cuts below Donna's former suitors." Eventually, her father agreed to the marriage on two conditions: first, Salk must wait until he could be listed as an official M.D. on the wedding invitations, and second, he must improve his "rather pedestrian status" by giving himself a middle name."
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