Marching towards completing second year sans polio

India is on its way to completing the second consecutive year without a single polio incident in any part of the nation.

It has taken strong strides towards this goal with immense dedication and relentless efforts from all quarters through the year. But the campaign as well as the milestones was not planned and implemented overnight, it took years with small but diligent steps and even now there isn’t any room for complacency.

From the world’s polio epicentre to be declared non-polio endemic nation in February 2012 -- India has come a long way in its fight against the infectious as well as crippling virus. The diligence, perseverance and hard work of the Indian government and its great partnership with UN and other voluntary agencies, civil society and volunteers managed to achieve the zero-case-in-one-year milestone.

With only three countries – Pakistan, Afghanistan and Nigeria -- now remaining polio-endemic in the world, there is a strong need to not only duplicate India’s successful campaign in these nations but also to continue India’s own efforts towards becoming polio free.  

India has learnt several critical lessons during its journey in achieving the non-endemic status which could be used as a manual for not just addressing other public health challenges in the country but also in serving as a model for the three endemic countries that to an extent have similar milieu and bottlenecks in their campaign to ending polio.

Pakistan and Nigeria could emulate, replicate or mold some of the winning formulas that India has adopted in improving coverage, efficiency of vaccinators, mass mobilisation and awareness.

Take the case of Pakistan. The country experienced the world’s largest nationwide outbreak of polio in 2011 with 198 reported cases. More than 30 cases have been reported in 2012 so far.

The country’s large population as well as sub-standard polio campaigns, as experts opine, have played a huge role in this as the immunisation drive is not able to cover each and every child.

Moreover, it takes doctors and health workers months to convince the illiterate population in the far-flung districts to get their children immunised. False notions and rumours such as polio vaccination being a “Western plot against Muslims” also contribute to the hurdles in the polio eradication campaign. 

In Afghanistan, the opposition from Taliban to vaccination and lack of funding are hurdles on the path. Vaccination drives in the areas along the Afghanistan-Pakistan border are especially weak due to security reasons. The virus is also transported between these two countries as there is a regular to and fro from across the borders particularly in the mixed populated regions of Federally Administered Tribal Areas (FATA).

Humanitarian efforts

Immense humanitarian efforts – both scientific and human resource - have made it possible to make the dream of a polio-free world a reality. Since the GPEI was launched in 1988, the Americas saw the last case in 1991. In the Western Pacific Region, the last case came from Cambodia in 1997 and in Europe, from Turkey in 1998.

Today, with India’s success despite the challenges posed by its 1.2 billion-population, the endemic countries are encouraged to accomplish the same feat. With increasing focus on these three countries and the global movement to end polio, there is a sense of urgency and strong commitment to ensuring each and every child is reached with the vaccine.

The Indian polio campaign is one of the biggest and one of the best public health initiatives in the country. In a nation that has a child born every two seconds, the challenge to eliminate a virulent and tenacious disease like polio is enormous.

Even as India continues to extend support to other countries, its own eradication programme cannot be complacent till the time the world has the polio virus. The threat of importation of the virus from across the borders is still a potent one as two of the three endemic countries – Pakistan and Afghanistan – are India’s immediate neighbours.

Though the country has not reported any polio case in the last almost two years, the polio immunisation activities still need to be strong and regular. In fact, stringent efforts need to be continued in high-risk blocks, in perennial polio-troubled states like Uttar Pradesh and Bihar so that the virus does not resurface. Every child is susceptible and must be reached with the vital drops either during polio immunisation days or through the routine immunisation.

Even after the sweet success achieved last year, we need to be on our toes as even one polio case can create a public scare and threat of widespread outbreak in an overtly populated country like ours. Not to mention, high population density dependent on poor sanitation and drinking water availability as well as increasingly malnourished children vulnerable to diseases.

Amidst these challenges, across borders and some still persistent within the country, India’s success thus far will be tested. How safe is India and how prepared it is to sustain the zero polio status will decide the fate of the campaign in the coming months. While we eagerly wait for our fate in 2014, the fight against the disease is on.

(The writer is chairman of Rotary International’s India PolioPlus Committee)