Also important is the possibility of environmental reservoirs for the disease in nature. Hopefully not, but it is still possible.
Only continued vigilance can guarantee victory. Many areas were declared polio free once before, only to have it resurface.
...par for the course these days.
Throughout the world a child dies every 2 minutes from malaria.
I’ve been to South Africa twice. Most other Subsaharan countries have large malaria problems.
Looking forward to that not being a problem in my lifetime.
Mosquito release programs like this are now several decades old and have shown high efficacy with few environmental side effects where they have been tried. It is certainly more environmentally friendly than DDT. Meanwhile, the benefits are enormous and if done successfully in Africa could be directly measured in terms of human suffering.
> On July 1, 1946 the Communicable Disease Center (CDC) opened its doors and occupied one floor of a small building in Atlanta. Its primary mission was simple yet highly challenging: prevent malaria from spreading across the nation. Armed with a budget of only $10 million and fewer than 400 employees, the agency’s early challenges included obtaining enough trucks, sprayers, and shovels necessary to wage war on mosquitoes.
They are _now_ the centre for disease control and prevention
What do you mean?
What was the CDC's original mission?
Did it execute it competently?
Why is it now involved in areas other than communicable diseases?
Do people in organizations seek to increase their power and influence?
Do they do this by enlarging the scope of their organizations' missions?
How is this notionally science-based entity being influenced by other factors?
https://news.ycombinator.com/item?id=24293489 - my sibling comment to yours might clarify my opinion for you...
I actually suspect this role was thrust on the CDC because they are generally supported by everyone (everyone sane anyway). I'm not a fan of this having happened because they should be too important to get mixed into politically poisonous debates.
Still well within the realm of health and certainly affects communicable diseases (an unhealthy population is more prone to worse effects of disease).
That said, it'd kind of inevitable that they run a course like that because constantly doing good non-controversial work banks political capital and the politicians are gonna try to harness organizations like that for their own ends.
How, exactly, are folks (who are not versed in medicine) supposed to get this information from a trusted source?
Successful eradication in Florida and Italy was based on aggressive source control (stagnant water), control of re-importation, and use of insecticides (including DDT) for outbreak control.
Airborne spraying of more targeted larvicides continues to be used in Florida and other places.
Malaria rates in rural areas of Africa are much higher than urban areas so urbanisation also plays a role.
It was used in Africa, at least in 2016.
> Why don’t we use DDT today?
You mean for agriculture? Because using DDT for disease vector control was never internationally banned (only banned at the national level).
It's banned in agriculture because it kills stuff other than the mosquitoes. In particular, its use is restricted by the "Stockholm Convention on Persistent Organic Pollutants". Persistent Organic Pollutants are pretty much as bad as they sound, and DDT is one.
Despite the environmental damage of DDT the Africans wanted to wipe out malaria first but were not able to purchase it in the quantities needed.
As late as 2004 leading newspapers editorialized that eradicating malaria in Africa outweighed the environmental damage
> Carson has been targeted by some organizations opposed to the environmental movement, including Roger Bate of the pro-DDT advocacy group Africa Fighting Malaria and the libertarian think tank Competitive Enterprise Institute; these sources oppose restrictions on DDT, attribute large numbers of deaths to such restrictions, and argue that Carson was responsible for them. These arguments have been dismissed as "outrageous" by former WHO scientist Socrates Litsios. May Berenbaum, University of Illinois entomologist, says, "to blame environmentalists who oppose DDT for more deaths than Hitler is worse than irresponsible." Investigative journalist Adam Sarvana and others characterize this notion as a "myth" promoted principally by Roger Bate of the pro-DDT advocacy group Africa Fighting Malaria (AFM).
This doesn't make sense. Eradicating malaria in Africa is beneficial to the human species. Environmental damage applies to all other species. I don't understand how one could "outweigh" the other. They are just two different objectives.
We’re not (yet) beings of pure thought who can exist independent of our environment, so the damage to the environment does have to be counted before we decide if something is net-positive.
> DDT was less effective in tropical regions due to the continuous life cycle of mosquitoes and poor infrastructure. It was not applied at all in sub-Saharan Africa due to these perceived difficulties.
I'm reluctant to be playing god on this front, especially in light of the fact that it seems like the insect population is not doing well, globally, and forms the base for a complex food chain.
For decades we have been performing a semi-eradication effort for mosquitoes for decades, and we have not noticed a substantial change that can be considered a result of that.
I understand hesitation to muck with nature, but I think it's sort of a privileged position to have when you live in an area where malaria and West Nile are not a serious risk. Malaria kills a lot of Africans every year (400,000+ ), and I'm not sure how much hesitation I'd have towards eradication if anyone in my family died from it.
For me the equation is tilted pro-GMO because I see the alternative of letting nature run its course as a 100% certainty that a current tragedy continues to unfold.
So I'll continue to support GMO experiments like this. I just might have my fingers crossed, in case our D20 roll is bad and the kill gene jumps into the Zika virus and then into humans...
Horizontal gene transfer (HGT) or lateral gene transfer (LGT) is the movement of genetic material between unicellular and/or multicellular organisms other than by the ("vertical") transmission of DNA from parent to offspring (reproduction). HGT is an important factor in the evolution of many organisms
A similar story that I found absolutely amazing is the story of the screwworm and its eradication from the US. Not the whole world, mind you (which feels foolish long term).
I am not trying to make a point. This discussion made me think of it and I wanted to share.
See the "appeal to nature fallacy" 
"Life finds a way"
They are. Take a moment to celebrate this victory :)
Probably less than 100 globally in a few countries. Bill Gates will get it.
Anyway, while it’s great, and we should be happy, 400,000 kids will die from malaria in Africa this year.
We could do more to save millions of lives over the next 10 years.
His foundation has spent $2.9 Billion so far on it.
Well good thing you started with that since you are clearly not familiar with him at all. He is very very well read and highly involved with the charity.
I dunno: He played a crucial role in a long-term, industry-wide collaboration that resulted in practically every household having at least one computer. And for years he's been devoting his fortune and his intellect to solving global-scale problems. That has gotta be worth some redemptive value for past sins, yes?
I also remember how we laughed when his Encarta encyclopedia tried to sell Bill Gates as widely known as a philanthropist. It wasn't true then, but it is true now. He certainly deserves that credit.
"Antitrust" are the laws designed to break up monopolistic "trusts". So far as I am aware, Bill Gates only ever had costs from any antitrust operation, legal or illegal.
And overall, he stole from the rich and is giving to the poor.
That or finding ways to sterilize all anopheles mosquitoes, or do other mosquitoes carry it also
You might as well say that a person is too phlegmatic and needs bleeding when they have gallstones.
The world moves, move with it
In a worst case nature comes up with a similar one by mutating something similar, but then it is still a new thing.
Polio is an Enterovirus. There are many virus in that family, and most of them cause only a mild stomachache and fever. A week later you forget that you where ill. Moreover, in the 95% of the case the Polio virus only cause the same symptoms instead of the paralysis.
One of the other virus can evolve and start to cause an illness that is very similar to Polio and we can decide to call it Polio, or PolioII, or some acronym like SPGWSPLI or something like that.
Nobody is sure about the cause of Acute flaccid myelitis , but it is somewhat similar to Polio and it is probably caused by an Enterovirus too. If something like that cause a big outbreak, we will hopefully make a vaccine and eradicate it too.
 Where "difficult" means "almost impossible, but there is a chance".
 Old illness have cool names. I hope we can eradicate them all, but they have cool names like "Cholera". New illness get a bland acronym.
Malaria is different in that there was not the same level of eradication infrastructure to leverage and different because it touches on drinking water and food chains in the non-human environment. Malaria is not mostly a vaccine distribution problem.
It's the same reason that if Oprah took her billions to try and solve some global problem with her husband Stedman, many mentions of the work they were doing would not mention Stedman.
One is a famous individual who built up an obscene fortune, and the other person is married to them. And despite how involved their partner is deploying that wealth for the good of the world, people are just not going to mention the less famous one who didn't build up the fortune as often.
He did this (I assume) to imply the reason she was not mentioned was because she was a woman and not because of the large and obvious disparity in fame.
Bill Gates also regularly gives speeches. I checked and Melinda doesn’t have any on youtube since 2013.
So Bill is very much the public face of the foundation, even though Melinda is equally active and her name is in its name.
Not the only reason, but worth pointing out a prominent benign one.
For instance, a parallel example is how ycombinator is often mentioned as being founded by Paul Graham, and Jessica Livingstone is left out. Why? Partly sexism of course. But Paul also was the public face of YC with his essays.
And we have evidence it’s not just sexism, because YC had four founders
> by Paul Graham, Jessica Livingston, Trevor Blackwell, and Robert Tappan Morris.
I think the second two are even less well known than Jessica Livingstone, and this correlates with how much public writing and speaking she’s done as the face of YC and about startups.
(There’s a whole other discussion to be had about whether women are chased out of the public sphere, but this comment is long enough)
What "ism" is the reason reason Warren Buffett is more famous than Charlie Munger?
> He is best known for creating the Morris worm in 1988, considered the first computer worm on the Internet.
Would appreciate if someone could enlighten me. Surely there must be a good reason.
Celebrating the beneficial outcomes of Bill Gates' charity without reflecting on why he's able to give away billions of dollars without breaking a sweat invites us to ignore the fact that the system that enriched Bill Gates doesn't actually encourage him to do any good (and actually involved him doing quite a lot of harm).
In others words, we're extraordinarily lucky that this particular ultra-wealthy person has decided to do good things with (some) of their money. But grounding moral and humanitarian progress on a steady stream of luck seems shortsighted.
It's most certainly not a fluke that the mega rich are solving problem governments can't or won't.
There is no "can't or won't" on a global scale: some countries have, others haven't as a function of their means. The fact that ultra wealthy individuals have better means than entire countries is an indictment of the state of affairs, not praise.
Edit: To elaborate on the above: eradicating polio isn't something that democratic, liberal countries are uniquely good at. Autocratic and despotic governments have also historically been good at it and have aggressively pursued it, because paralyzed citizens just aren't very useful. Countries that don't pursue eradication are historically ones that just lack the means (whether that's money, or infrastructure, or whatever), not ones with specific political structures.
That is exactly "can't or won't". The USA or China certainly "can" fix these issues in Africa if they want to but they "won't". But the African countries themselves obviously don't have this capability thus they "can't" fix it.
> The fact that ultra wealthy individuals have better means than entire countries is an indictment of the state of affairs, not praise.
Why is this an indictment. This is not self evident at all to me. The opposite is true from my perspective. This story and initiatives like the giving pledge very clearly show me that that the mega rich are doing things no country is doing. And thus these problem would remain unsolved if they would not be here.
However, The Gates Foundation tends to fund programs in developing countries where those countries's governments are not capable of funding it themselves.
While I can understand and in some sense agree that it's unfortunate our current best solution to tackling some of these problems is for someone with a lot of resources and no bureaucratic entanglements to focus on solving the problem once and for all. I can also recognize that few governments are capable of solving it regardless of political philosophy.
I'm more than happy to celebrate a solution that works today over a hypothetical solution that hasn't been successfully deployed yet. Maybe I'm too pragmatic.
The UN? They (to me / personal viewpoint / citation needed) don't seem to have any power, influence, means or goodwill to handle a problem like this. I mean they have never been as silent as they are now, while China and the US have literal concentration camps, Russia is assassinating political opponents and is encroaching on other countries - directly (Ukraine) or indirectly (influencing governments, heavily influencing destabilizing decisions like Trump's election or Brexit), the US is in a civil war and on a crash course towards a fascist dictatorship, currently working towards a sham election, actively undermining postal services so mail voting will not work so that Trump can go "Well shit is fucked, I'll just stay on a bit longer to fix this for you" and declare national martial law so that the army can beat down whoever objects.
But that harm was done to competitors, on the business field. The people who became collateral damage could always go and get jobs at some other company. The companies suffered and sometimes died but such is the way of capitalism.
If the upside was that his money gets redistributed to the genuinely poor and needy, who don't have any opportunity to earn for themselves in some cushy IT job, then I'm personally OK with it.
(I forget the specifics, but a piece of ancient code we wrote included a dummy assignment to a variable called BILLGATESBOLLOCKS, to get around some MS devilment).
But the problem is that we are those rich people. We as tech people have suffered under the microsoft monopoly. Heck, we still suffer, from the horrors of windows 10, to browser incompatibilities, etc.
So we hate Microsoft. So it's hard to love Bill.
So what if he did "terrible" stuff 25+ years ago? I am sure no-one in this thread would give 90%+ of their personal wealth to humanitarian work such as these. People just like to complain.
Not true, for what some people want is power and they continuously dish out money to get it.
It's often used as a vector to create a lot of the world's problems. I'm pretty happy to see it used the other way. A win is a win.
Bill gates must really love swimming "uncle scrooge"-style in his billions. That's all he cares about. Everything he does must be to gain more billions, so he can swim in a bigger pool.
Bill was also super competitive, so let's focus on that and forget that he made his money providing value to users and businesses. It's better to act like he stole the money in an unfair way.
I personally feel very sad for a person that can't imagine that someone else could feel happy and satisfied by helping others, by having a huge impact on peoples lives in a positive way. I'm sure Bill and Melinda get more satisfaction of helping other people than looking at numbers on their bank account. But hey, that's not possible because he's rich, and therefore evil.
You could psychoanalyze this as acts of redemption, guilty conscience, seeking further world domination or whatnot, However it's undeniable he's helped many, many people and far, far,far more than his keyboard detractors ever would or could. And that's a very good thing IMHO.
I'm not really big on the idea of 'redemption' - my actions today do not erase what I've done in the past. But he has lived a pretty decent life since then, and tried to do good things. So good on him.
Others hold grudges longer.
Yeah, he was running a competitive business where he took advantage of his market position... just like any other business.
But oh, "I love my iPhone, and Steve Jobs is therefore my hero. So Apple is good because it loves it's customers".
A tangentially related matter I see cited more often than not in these circles, are about an uptick in vaccine-caused paralysis occurring in India, causing the foundation to be kicked out.
The argument being that an uptick in “non-polio acute flaccid paralysis” (NPAFP) was recorded in areas where the oral vaccine was distributed, and this subsequently got the foundation “kicked out of India” (quoted because, as source below states, this is false) 
Gates has done some shady things in his day, but I can't fault him for that one. His fortune is a drop in the bucket of the federal budget, but being able to control and target his charity makes a hell of a lot of difference in the world. It's not like the federal government was going to cure polio in Africa, but for a few billion more dollars in tax revenue.
A good act does not wash out the bad, nor a bad the good.
We also need to get rid of a vaccine-derived polio in Africa (and some places in Asia).
Summary: Whilst initial immunity is developing after vaccination, attenuated polio viruses can be excreted and cause a rare circulating vaccine-derived poliovirus (cVDPV) outbreak. 21 outbreaks have occurred in the last 20 years, with 760 cases, out of 3 billion vaccinated and 10 million polio cases averted. cVDPV is averted by getting as many people in the community vaccinated within a 12-month window as possible. It naturally stops being a risk as the vaccinated population approaches 100%.
I think the statistics about it might be overestimating since people constantly say they have malaria, but rarely if ever have it. It means just sick colloquially in Swahili.
1. Using malaria medication is advisable if you don't have access to good doctors and good hospitals. If you permanently live in a malaria area, it's not practical.
2. If you have quick access to a good doctors and good hospitals, it's often better to treat yourself once you are sick. ---> NO this is not travel advice <---. The malaria medications have a lot of side effects to use permanently; the expensive ones have less side effects and I believe pilots generally use such ones since risking getting sick has the potential side effect of a plane crashing.
3. The key is detection and treatment. You can easily die in an top EU or US or Singapore hospital if the doctor doesn't ever see malaria and you happen to have it. You have to test until you get a positive---even if it is a false positive, and then you test again. I personally know people who's parent died of malaria in a good hospital in South Africa, but in an area that is far from the malaria areas, and hence has doctors who don't test for it. I am not a doctor so I am not sure how one is treated once tested positive, but I do know many people who recovered very quickly due to the doctors being acutely aware of how to treat malaria.
4. Taking into account said things above, malaria is not a major threat. If you read stories about game rangers in the KNP of South Africa, many of them died from malaria in their later life because they were somewhere deep in the bush/lowveld and far from hospitals and couldn't be bothered with having malaria, yet again, and stopping their fun bush activities to go to the hospital 200km away.
5. My grandmother had malaria 6 or 7 times and died rather healthy in her mid 90s. My family actually actively avoided the malaria areas in the summer back in the late 1800s and early to mid 1900s by living on the higher escarpment. You could also read about Dr. Annecke and the efforts back then to combat malaria.
6. The countries to the north of South Africa don't have the facilities to treat malaria, generally, and with proper treatment and selective DTT application, you should be able to limit the ranges of the parasite. Yes, DTT is a bad chemical.
7. On that topic, malaria is caused by a parasite, so in terms of vaccines it's not clear what the mechanism behind it should be.
8. If you think about the Panama worm exclusion line that featured a while ago on HN, something like that would have made sense if Africa were a more developed continent. But in any case, the point is that the poor state of many things in Africa is part of the malaria problem.
9. Many other things about Africa is way cooler than the other continents. We still have lion and rhino, for one. There were many large predators on the other continents. So, "development" is something of a complicated word.
10. South Africa generally manages malaria well, so it is possible to contain it through holistic management. And no, holism is a word that belongs to Jan Smuts and you cannot steal it for your magic peanut oil business.
11. Yes, a silver bullet would be nice.
The rule with malaria medication is that either you take it consistently or you don't take it at all.
If you take it consistently, you don't get malaria.
If you don't take it, you get sick, you go to hospital, they put on a drop, you're largely fine.
If you take it inconsistently, you run the horrible risk of getting malaria, but not having proper symptoms, which means you don't go to hospital early enough, which means you end up with late-stage malaria, which is really bad.
If those plants are effective against malaria, it is inevitable that it should be applied in a practical way, which often turns out to be in the form of pills.
https://lucb1e.com/tmp/hn-whatsthisgraph.png What does this show?
Answer in rot13: Rnpu yvar vf n pbhagel, fubjvat yvsr rkcrpgnapl ng ovegu. Gurer ner fbzr boivbhf bhgyvref ohg 'orgjrra gur yvarf' vf nyfb n pbhagel gung qrpyvarq funecyl: Flevn. Yrg'f whfg abg qb jne ntnva, 'xnl?
You can find this graph interactively on the United Nations Development Programme website: http://hdr.undp.org/en/data (this graph can be found in (rot13) urnygu -> yvsr rkcrpgnapl ng ovegu).
And it was exactly because these tiny reservoirs were left, it came back to Karachi, and Mumbai.
Some of them we have no idea how to treat. Prions are 100% deadly.
> And there's another type of polio that's problematic. Sixteen African nations are currently battling outbreaks of what's called "vaccine-derived polio." This is a form of polio that stems from the oral polio vaccine used in lower income countries because it is cheap and easy to administer.
> The oral vaccine contains a live but weakened version of the polio virus. The virus replicates inside the child's intestine and eventually is excreted. In places with poor sanitation, fecal matter can enter the drinking water supply and the virus is able to start spreading from person to person.
Basically, the weakened form of polio that is in the vaccine, which usually survives in your GI tract for a couple weeks before being eliminated, can be passed onto others if there is a lack of basic sanitation (polio is primarily transmitted through infected fecal matter). If this is in a community with low immunization rates, the vaccine-derived virus can survive much longer than intended. This can actually provide a benefit to others, because they will achieve some level of immunity from the weakened virus. However, if the weakened virus is allowed to circulate for a long time (>1 year), it has the (unlikely) chance to mutate and become less weak.
Of course, the number of severe polio cases that have been avoided by the vaccine vastly outweighs the number of vaccine-derived cases. But I thought this was an interesting concept!
> ...more than 13 million cases of polio have been prevented, and the disease has been reduced by more than 99%. During that time, 24 cVDPV (circulating vaccine-derived polio virus) outbreaks occurred in 21 countries, resulting in fewer than 760 VDPV cases.
More here: https://www.who.int/westernpacific/news/q-a-detail/what-is-v...
Modern medicine has created a sort of utopia that humanity couldn't have imagined a few hundred years ago. But there is a dark side that includes conspiratorial thinkers like anti-vaxxers.
I have heard that it might not be crazy to apply DDT sparingly and appropriately to this problem. To my knowledge, it was a big part of how mosquito-borne disease was virtually eradicated in North America.
Wetland habitat destruction is a real concern, but so is the untimely deaths of hundreds of millions of people.
She actually told me when she first came to America a doctor asked why she was in a wheelchair and she said Polio. The doctor didn't believe her!
My grandfather had polio and was lucky to survive. He spent quite a bit of time in an iron lung. Apparently it changed his personality significantly for the worse.
Finding Nash equilibria for #4 isn't easy but it's a good set of guiding principles and if you believe them, you should think about surrounding yourself with others who do too.
As a past contributor, it brings me great joy to see this milestone today.
Salk spent a large portion of his later life pressing for the OPV to be delicensed because he considered any risk of live vaccine infecting immuno-suppressed persons or of the weakened virus becoming reactivated unacceptable.
As I understand it the OPV was still in use in the US until 1999. It was an interesting case study in the different forces that kept a vaccine proven to cause some cases of Polio every year in use.
They say that about cowpox and polio sanitation played a major role, etc. And that we don’t look at other variables.
Some of the other news coverage like the Reuters article is a little better at correctly pointing this caveat out: https://uk.reuters.com/article/uk-health-polio-africa/wild-p...
It's not even clear that it's poasible to actually eliminate polio in developing countries with this vaccine or any existing vaccines. The developed countries managed it but they had far better infrastructure to roll out first the oral vaccine and then the inactivated vaccine to everyone, and also far better sanitation, and it's likely both of these things mattered - under-vaccination makes this problem a lot worse, and whilst the inactivsted vaccine protects people from polio there's some doubt as to whether it can stop them spreading it via the oral-fecal route due to poor immunity in the gut. The current hope seems to be developing and deploying a new, better live vaccine which cannot easily regain its original virulence.
It's a problem, but one that can be managed by the existing tools which brought polio down to this level - many countries switched from trivalent OPV or removed OPV2 precisely to avoid this scenario, and a new OPV2 vaccine will hopefully eliminate the problem in the affected areas:
I've read about polio a few times, and every time I do I feel grateful to be born after they started vaccinating every child in the United States. It's a terrible disease and it would be amazing if it went the way of smallpox and (hopefully soon) Dracunculiasis.
If VAPP was the only problem it could easily be fixed just by eliminating polio and then ending the live vaccination program. Unfortunately, that would make the cVDPV problem worse because it's an actual, circulating virus that primarily infects people who haven't been vaccinated, and ending vaccination would increase the number of people at risk from it. As the document from 2015 you've found suggests, the folks trying to eliminate polio hoped that if they phased out the live oral polio vaccine carefully and in well-coordinated ways they could avoid major cVDPV outbreaks afterwards. This doesn't seem to have worked out as well as they hoped back then. In particular, this article and HN discussion from a few months ago which someone helpfully dug up is mostly about the failure of this endgame plan in Africa: https://news.ycombinator.com/item?id=21920406
In 2020 there were 102 wild cases, and 295 vaccine derived cases. You have to go back to 2016 for wild cases to outnumber vaccine cases.
He's getting downvoted for the tone: People are assuming he is discrediting the vaccine by saying that. I personally don't see that implication, I just see a bare, and correct, fact.
2015: 74 32
2016: 37 5
2017: 22 96
2018: 33 104
2019: 165 365
2020: 102 291
I think that it is misleading to call the last four years "a long time".
Ironically this fact is often used the anti-vaxxers as an argument against vaccines.. when it's only been true because polio vaccination has been so successful at eradicating the real virus which was causing considerably more problems.
It's not entirely clear why OPV is more effective, but perhaps it matters that you eat it (when I was a child it was administered as a sugar lump) and so the attenuated virus is entering the body via the gut, exactly where a real working polio virus infects people. The more expensive killed vaccine is injected into a muscle instead.
They may have some more precise method, but with this estimation 11 or 13 millions doesn't seams to be too off.
And to be clear about it, children are not getting it by getting vaccinated, unvaccinated people can get it from recently vaccinated ones.
Then in 2000, OPV was banned in the US. 
But the statement, while true, is misleading because of its intention to discredit the use of vaccines at all. Just check the graphs linked before the introduction of the vaccine. Night and day, as horrible as the vaccine caused cases are.
The idea is that the body will (hopefully) learn to identify the spike and mount an immune response to that spike protien.
Then, when a real coronavirus comes along, the body responds to the spike protien on that virus.
PS: I’m not in the field, I might have missed some vaccination effort that’s using the real virus itself.
However we are talking about there being 21 cases of this occurring compared to pre-eradication infection levels in the 100's of thousands per year. So whilst your statement is sort of true, it is willfully misleading.
Just before the first non-Russian CoViD-19 vaccine gets approved, so people can more easily accept its shorter/skipped testing phases.
Good to see wild polio is going down.