Nepal recognized childhood immunization as a cost effective health intervention and established the National Immunization Program. Nepal introduced the Expanded Program on Immunization in 1979 starting with three antigens in three districts, later expanding nationwide to include six antigens including polio vaccines by 1988-89. Wild polio cases in Nepal declined from 1999 to 2009 according to UNICEF. India reported the majority of polio cases in the South East Asia Region (SEAR) in 2009 and 2008, concentrated in Uttar Pradesh and Bihar. Currently, only four countries including Nigeria, India, Pakistan and Afghanistan remain polio endemic areas, down from over 125 countries in 1988 when the Global Polio Eradication Initiative was established.

1. SITUATION OF POLIOMYELITIS IN
NEPAL, SEAR AND GLOBE
-Presented by :Sabin Adhikari
-Roll No:97
-MBBS 3rd Batch
CMC, 2069

2. BACKGROUND
Government of Nepal (GON) recognizes that childhood
immunization is one of the most cost effective health
interventions and thus puts strong emphasis on
immunization in national policies and plans. The
National Immunization Program (NIP), the successor
to the Expanded Program on Immunization - EPI, is
the priority programs of the GON. Nepal introduced
Expanded Program on Immunization (EPI) in 1979
with three antigens in three districts. By the year
1988-89, the program expanded to all 75 districts of
the country and included all six globally recommended
antigens (BCG, DPT, Polio and Measles).

3. WILD POLIO CASES IN NEPAL (1999-2009)
Source: UNICEF Nepal

6. WILD POLIO CASES IN SEAR (2010-2011)

7. POLIO CASES IN SEAR
 In South East Asia Region (SEAR), India is the
country reporting large number of polio cases.
During the year 2009 a total of 741 cases of polio
were reported in India, as against 559 cases in
the year 2008. As in previous year the majority of
cases were reported from Uttar Pradesh and Bihar.

11. GLOBAL CASE COUNT

12. GLOBAL STATUS OF POLIO
 According to the Global Polio Eradication Initiative
(GPEI), only 4 countries (Nigeria, India, Pakistan
and Afghanistan) remain polio-endemic, an all-
time low. Egypt, which had been considered polio-
endemic, has remained free of poliovirus
transmission for over 22 months.

13. ABOUT THE GLOBAL POLIO ERADICATION
INITIATIVE
The Global Polio Eradication Initiative (GPEI) is the
largest ever public health undertaking in history.
Since 1988 - the year the Global Polio Eradication
Initiative was launched - the incidence of polio has
been reduced by more than 99%. At the time, more
than 350,000 children were paralyzed every year
in more than 125 countries. As at 31 December
2009, 1,548 cases have been reported worldwide.
Four countries remain endemic: Nigeria, India,
Pakistan and Afghanistan. Outbreaks in
previously polio-free areas are ongoing in West
Africa, Central Africa.

14. PHOTO SHOWING PERSON SUFFERING FROM
POLIOMYELITIS

15. REFERENCES
 Park’s Textbook Of Preventive and Social Medicine
 http://www.who.int/immunization_monitoring/en/glo
balsummary/timeseries/tsincidencepol.htm.