Polio Elimination in Uttar Pradesh – Individual impact in global health policy

The case of Polio Elimination in the Uttar Pradesh state in India serves to highlight the impact that specific individuals can have in any global health undertaking. Likewise with the smallpox elimination program administered in Africa as well as in India, individual will power serves as a great instigator and spur of driving action in global health policy – in this case of Polio eradication.

The theme of individualized leadership in global public health campaigns is signified through the work of two individuals throughout the course of the Polio Elimination program in Uttar Pradesh – Dr. Kaushik Banerjee and Dr. Jon Andrus.

The efforts of these two individuals quickly made in roads in the Polio fight in Uttar Pradesh. With collaboration with Global Polio Elimination Initiative (GPEI), a coordinated public health program compromising of Rotary International, WHO, the CDC, and UNICEF, Banerjee and Andrus were able to help establish a National Immunization Day (NID). The program helped foster greater immunization rates amongst children, and polio outbreaks in India became more localized. However, coverage gaps still existed amongst the northern portion of India, prompting Banerjee and Andrus to present a case for increased immunization rounds in India to six rounds in the North and four in the south, relying in surveillance data to augment their argument.

What became know as the 4+2 program, the impact was significant on India’s polio outlook – polio cases dropped from 1,126 in 1999 to 265 in 2000; however, a majority of these cases, over 200, were concentrated in the Utter Pradesh state, for a multitude of reasons – climate, public health conditions, etc. Ultimately, the success of the program was hinged on the arguments and persistence of Banerjee and Andrus.

When the pair left their respective posts within the Polio Elimination campaign in the summer of 2002, the Indian government decided to scale down it’s polio response within the northern region, using just two national and regional immunization days – which was against the recommendations of Banerjee and Andrus. In 2002, India Suffered a polio outbreak, and 1,600 Children came down with paralytic polio, including over 1,200 cases in the Uttar Pradesh region alone. This incidence found that past immunization campaigns were not robust enough in their strategies, leaving a “pool” of unvaccinated children contributing to the outbreak.

The main talking point here revolves around the significance and displays of influence Banerjee and Andrus held towards the Polio elimination campaign in Uttar Pradesh and India overall. Once their opinions, perspectives, and arguments were no longer voiced, the Indian government immediately took retroactive steps in the Polio elimination campaign. Likewise to an extent to the smallpox global eradication program, although many international and national organizations and institutions were behind this public health campaign, the realization of the elimination of Polio in Uttar Predesh is fundamentally tied to the efforts and insights of a few particular individuals. I feel it’s quite interesting to find such a relation – that problems so inherently tied to the well-being of millions individuals can rest on the capabilities of just a few individuals in global health policy.

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