One more year of nil case and it willbe ‘Goodbye, Polio’RAMYA KANNANThe Pulse Polio programme was initiated in 1995-1996‘It is probably the biggest public health success story of thiscenturyIt is two years since India has had a polio case. One more before the countrycan say ‘Goodbye, Polio.’ The battle against the wild polio virus is poisedinterestingly in the nation that, not long ago, in 2009, accounted for nearlyhalf the world’s polio cases.An 11-member Regional Certification Commission from the WHO’s SouthEast Asia Region is meeting regularly to review reports submitted by India’s
National Certification Committee. Three years of absence of polio cases,caused by the wild polio virus (WPV), coupled with intense surveillance, isessential before India can be declared polio-free, in 2014.Naveen Thacker, past president, Indian Academy of Paediatrics, who hasbeen involved for nearly two decades in the fight against polio, says: “It isprobably the biggest public health success story of this century. For us, thisis very encouraging; it gives us a lot of confidence. It also gives other polio-endemic countries a lot of confidence.”Surveillance systemThe team had thought the task of eradicating polio from India would befairly easy, when the Pulse Polio programme was initiated in 1995-1996.“We had about 1,006 cases then, and we thought it was going to be reallyeasy. And then, my God! It was like the wild polio virus was always smarterthan us.”And now, after nearly two decades, the tide has turned. There is celebrationin the air, but it is muted with wide-eyed caution. “The price of freedom iseternal vigilance,” Dr. Thacker says. “We need to sustain the campaign, andimmunity. We also need to keep up our surveillance system. Our capacity torespond should be in place.”T. Jacob John, who was professor of clinical virology in the ChristianMedical College, Vellore, and has served on The National TechnicalAdvisory Group on Immunisation, says: “Last year, the question was, ‘Isthis for real?’ But two years is long enough to be sure that the WPV hasbeen conquered. There have been two high seasons (for the virus) — thesecond half of the year in North India, and no cases. All sewage sampleshave also tested negative for the WPV.”From a position in the past when Indians travelling abroad exported thepolio virus to many countries, it has come to India worrying about possibleimports from countries that are still endemic to polio. These nations arePakistan and Afghanistan, nearby, and Nigeria. Dr. John says, “But we areprepared. There are five border crossing areas with Pakistan — two inJammu and Kashmir, two in Punjab and one in Rajasthan. Anyone coming
across has to take the vaccine.” Additionally, every State has emergencyaction plans ready, along with good surveillance systems.To prevent polio from re-emerging, the government has planned to keep upintensive campaigns, especially in high-risk areas. Two nationwidecampaigns and four sub-national polio campaigns will take place in 2013.High-risk areas, including blocks in Uttar Pradesh and Bihar, and migrantpopulations, are being targeted. A mapping system has been developed toensure that all newborns in these areas are vaccinated, and that no one slipsthrough the net. While the success of the polio campaign is a model offocussed attention, the attention is now being turned on increasing routineimmunisation coverage, according to those involved in public healthadministration.A joint statement from the WHO, the CDC, the UNICEF, the End Polio Nowcampaign, and the Central government, indicates that the sensitivity ofsurveillance in India now surpasses the globally recommended standards.Over 35,000 health facilities are reporting cases of Acute Flaccid Paralysisas part of polio surveillance. Over 1,20,000 stool specimens are testedannually in the eight WHO accredited labs in India. Surveillance has alsobeen intensified along the international border, the statement adds.Credit is being accorded to the commitment of the Centre for pushingahead with the programme in the face of major hurdles. However, equallyimportant is the seamless partnership between the government, and theRotary International, the WHO, the UNICEF and private paediatricians –for it was the scale of this alliance that managed to mobilise vast quantitiesof field-level workers. In the final call, this probably swung the balance infavour of humans over the wild polio virus.Keywords: wild polio virus, pulse polio drive, polioimmunisation, UNICEF, polio epidemicWe must be careful to not treat the "polio-free" status as a sign that effortsof the anti-polio campaign can we slackened. We must continue to work hard with ourvaccinationdrives as, according to WHO officials working with Indias anti-poliocampaign, there
are chances of polio coming back in through our unsecured borders. It isanachievement that we should actively continue to take our pride in, byshowing ourdiligence.from: Sahil KiniPosted on: Jan 13, 2013 at 22:16 ISTBrilliant. A country with a billion plus population had proved that itcan get its act together. When some of our neighbours are stillstruggling to eradicate polio whose population is significantly lesserthan ours, our nation has done it.Media deserve the right credit as i still remember asking my parentswhen i was 10 ( i am 29 now), whether i was given the polio dropsafter looking at a TV advertisement.However long journey it had been, all the politicians, bureaucrats andhealth care workers involved in this landmark acheivement deserve therespect of the citizens.from: JohnPosted on: Jan 13, 2013 at 17:13 ISTThe comment by Deepak (Jan 13 2013) is remarkably insensitive. Yes,Jonas Salk (not "Sulk", as Deepak refers to him) did develop a safepolio vaccine, and he was a remarkable man. But the delivery of thevaccine across a country of 1.2 Billion people is a horrendous anddifficult task. I am sure that all of us have sat back and viewed theenormity of this task. It staggers the mind. Just as you can have afamine even when there is abundant food, so can you have a polioepidemic when there is plenty of vaccine. The solution in both casesis effective delivery.While Jonas Salk did produce a dead vaccine for poliomyelitis (Sabinproduced a live vaccine), the research for the vaccine was not carriedout by him. Nor did Salk win a Nobel for his work, although he wasnominated. While the Nobel Prize is not always a reliable indicator ofmerit or that of original discovery, it did award the prize for polioresearch to Enders, Weller, and Robbins in 1954.
India is to be congratulated.from: RatnamPosted on: Jan 13, 2013 at 15:17 ISTThis is a commendable landmark! Lets hope we remain polio free forthe next one year so that all the children of this country can hopefor a polio-free future.The program implemented in India is a GARGANTUAN one - the sheerscaleand complexity of this program is unimaginable, given the size andpopulation of our country. This makes me so proud that the peoplededicated to this program have, through dedication, science andperseverence, made it a success. Hats off!Now, if only we can achieve a similar miracle with a program to raisethe sex ratio, universal education for children..the wish list islong...but as hate campaign against polio has shown us, nothing isimpossible!from: AmPosted on: Jan 13, 2013 at 13:02 ISTCongratulations my nation!!Long live Indiafrom: Kumar PranavPosted on: Jan 13, 2013 at 12:53 IST