New Delhi: January 12, 2012
India today has touched a milestone of being polio free for one whole year. The lone case of polio in 2011 was detected in a two year old girl in Panchla block of Howrah, West Bengal, with the onset of paralysis on 13th January 2011.
Acknowledging the commendable effort at polio containment, the Union Minister for Health and Family Welfare, Ghulam Nabi Azad said “we are excited and hopeful, at the same time, vigilant and alert”. He cautioned that there is still no room for complacency and we need to ensure no case of polio infection for the next three consecutive years for India to celebrate eradication of poliomyelitis. The Minister noted that the progress is indeed remarkable considering in 2009, India with 741 cases accounted for nearly half the global cases. “This giant leap towards polio containment in a short span of two years is an endorsement of India’s tireless and persistent efforts. India has set an example with the highest level of political commitment to the programme which reflects in its resource allocation, continuous efforts to identify and reach out to the most vulnerable children with tailored strategies for maximum reach, optimum use of available vaccines under the guidance of top national and international experts, an extra-ordinary communication strategy and strong partnership”, he said.
In each National Pulse Polio Immunization round, 24 lakh vaccinators under 1.5 lakh supervisors visit over 20 crore households to ensure that the nearly 17.2 crore children, less than five years of age, are immunized with Oral Polio Vaccine. Mobile and transit vaccination teams immunize children at railway stations, at bus stands, market areas, construction sites etc. Around 50 lakh children are immunized by transit and mobile teams during every round in UP, Bihar and Mumbai alone. The polio campaigns during the rest of the year cover polio endemic states and other areas at risk of importation of poliovirus.
India has as yet spent more than Rs 12000 crores on the Pulse Polio Programme. India took a lead in introducing bivalent polio vaccine (bOPV) in January 2010. Despite global shortage of both bOPV and trivalent Polio vaccine, India tapped domestic market for timely supply of vaccine to ensure pulse polio rounds without interruptions. The prorgamme has been in the forefront of adopting technological innovations. The more efficacious monovalent oral polio vaccines were introduced in the Pulse Polio campaigns in 2005 which helped curtail the most dangerous type 1 polio strains to record low levels by 2009. In 2010 the bivalent oral polio vaccine was introduced which helped curtail both Type 1 and Type 3 polioviruses simultaneously and as efficaciously as the monovalent vaccines.
The surveillance for poliovirus in India is among the most sensitive in the world. As many as 35,325 reporting sites across the county report Acute Flaccid Paralysis cases for collection of stool samples and testing in the laboratories for poliovirus. The progress also results from focused and tailored strategies to vaccinate children in the highest risk areas and helped ensure 99 per cent coverage in each vaccination round.
The strategies and program response has also become sharper in the last few years. As per the recommendation of the India expert Advisory Group on Polio Eradication, every case, anywhere in the country is being responded to as a public health emergency. The lone case of polio in 2011 in Howrah is an example of rapid response – with the first immunization round being held within seven days and three rounds in seven weeks. In contrast, a case the same time in 2010 in Murshidabad, saw the first immunization response in five weeks and three rounds spread over 17 weeks. The rapid and intense response in Howrah helped stop polio transmission and no other case was reported. The program is also a shining example of successful partnership and collaborative work – the strong technical support from WHO – National Polio Surveillance Project (NPSP), communication lead by UNICEF and advocacy by Rotary International. The entire government machinery at all levels is geared towards pulse polio immunization.
While India has made unprecedented progress, the threat of polio persists. India exported poliovirus to other countries in the past and is now at risk of poliovirus importation into the country through the same migration. The program now not only needs to continue to maintain its present thrust and force, but also further strengthen efforts and be more vigilant. The key challenge now is to ensure any residual or imported poliovirus in the country is rapidly detected and eliminated.