Horton has a point. Campaign supporters would have a hard time demonstrating that the quest for global polio eradication is the most cost-effective use of $1 billion a year -- compared to improved vaccination rates for more common diseases like measles, or promotion of breastfeeding, or increasing access to bed nets to reduce the burden of malaria.
But we do know two things: first off, even if it is not theoretically the most cost-effective approach, and even allowing for the risk of failure, the polio eradication program is likely to improve global health at a lower cost than many other health interventions in the developing world already receiving far more in the way of international resources. A study by Dr. Radboud Tebbens in the medical journal Vaccine suggested the polio eradication effort, if successful in the next five years, would save more than eight million children from being paralyzed between 1988 and 2035, along with reducing medical costs and increasing productivity enough to outweigh the cost of the eradication program by $40-$50 billion.
Of course, if we manage global eradication, we will never again have to spend money on polio vaccination -- or on supporting or burying the disease's victims. Conversely, if the effort to stamp out polio was scaled back, the disease would inevitably spread back into areas currently polio-free. Even campaign skeptics accept the disease would expand again to kill or cripple more than 100,000 children a year.
A second reason to continue the push is that polio eradication would send a powerful message to the world at a time when a little more belief in the power of global cooperation would be a very useful thing. Despite the complexity of the eradication program, and despite all of the poverty and corruption in the countries where polio remains, the campaign has already suggested that when the global community works together it can achieve incredible things.
If a billion-plus dollars seems a lot to spend on symbolism, compare it to the cost of hosting that other symbol of global goodwill: the $14 billion 2012 London Olympic Games. So here's hoping Pakistan and Nigeria can manage to follow India's lead in 2012, and that the world will be polio-free soon after.