Polio Elimination in Uttar Pradesh: Dream or Reality?

 

Although eradicated in developed regions of the world, such as the entire Western Hemisphere and Europe, poliomyelitis (or polio) never truly stopped effecting India. The international public health effort to eliminate all cases of polio and vaccinate infected persons began in 1988 via a collective effort on behalf of the World Health Organization (WHO), The United Nations Children’s Fund (UNICEF), the Rotary Foundation and The United States Centers for Disease Control (CDC). Each organization contributed differing yet complimentary resources and expertise in ultimately facilitating The Global Polio Eradication Initiative. Since 2012, an impressive 99.9% reduction of polio cases has been achieved. Yet, in spite of this substantial reduction rate some countries such as India continue to be at risk.

The Indian state of Uttar Pradesh in particular has succumbed greatly to polio. For instance, in 2002 alone, 1,242 of 1,600 cases of polio in India occurred in the Northern providence of Uttar Pradesh. Historically speaking, Uttar Pradesh has remained economically crippled, with large portions of its population living in poverty. The region’s status of healthcare services parallels such poverty – having the second highest prevalence of malnutrition in children less than three years of age in comparison to any other Indian state or territory. Given Uttar Pradesh’s population density as India’s most populous state and its prevalence of diarrhea-related illnesses, vaccine and immunization coverage have proven less effective.

By 1985, India as a whole exhibited high prevalence rates for polio and was in dire need of eradication efforts. In response, governmental campaign efforts to combat polio, predominately amongst children, and make vaccination readily available were coordinated and since implemented. These public health initiatives and vaccination programs yield some successes – but not without some adjacent concerns and limitations.

India’s polio immunization campaign began locally. WHO’s Southeast Asian regional office in New Delhi aimed to implement public health strategies that had proven successful in the Americas in India. However, the assumption that any supposed “best practice” method would function as one-size-fits-all program by which to implement is foolish thinking. Regional differences must be taken into consideration in order to execute more appropriate programs in the future. Also, the monitoring of house-to-house activities in terms of calculating immunization coverage may have been an ultimate waste of time and human resources. The mere 2-3% increased coverage may arguably fail to justify such efforts in the future. Additional limitations concerned the cold chain coordination and storage of an already limited vaccine supply.

Despite these hurdles, Utter Pradesh’s polio immunization campaign increased vaccination coverage and data surveillance. Recent developments pertaining to current polio rates in Uttar Pradesh and India in general are promising and reiterate the importance of how collaborative public health efforts can yield a considerable collective impact. In this way, polio elimination has made strides in India and in time the dream of a polio free India may eventually become a global health reality.

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