Polio in India: Using the End as a New Beginning

India has successfully eradicated polio. India’s last polio case was reported in January 13, 2011. In 2009, India still reported half of the world’s thousand plus new cases but by March 27, 2014 was certified polio free by the World Health Organization[1]. The turnaround was incredible, unexpected, expensive, and required massive effort from multiple organizations including the Indian government, WHO, and Rotary International.

The road to elimination was tough with many challenges.

  • For one, India needed to vaccinate 172 million children twice each year.[2]  $2.3 billion in government funding was used. Although each vaccine cost only about 12 cents, they needed to be kept cold, and refrigerating them was a major problem. To combat this, refrigerators powered by kerosene were used to target remote areas without electricity.
  • Mobile units were also used to provide comprehensive coverage. These units set up quickly and then moved on after immunizing the children in the immediate area. Booths were set up in train stations and workers immunized children passing by and on the trains. A small percent of children were immunized by door to door efforts.
  • In addition, illiteracy and misinformation can create difficulties in communicating the importance of eradication. When the eradication program began in the 1980’s, religious tensions arose when Muslims believed the vaccination was a conspiracy to sterilize the men. Religious leaders, celebrities, and other social faces were included to increase understanding about immunizations.
  • Another challenge encountered was that the effectiveness of the polio vaccine was crippled if children had diarrhea. Therefore along with the vaccine, a more holistic approach was needed. Community volunteers emphasized the need for hygiene, sanitation, and diarrhea management.
  • In order to quantify which children had been immunized that day, a black mark was made on the child’s finger. This proved a simple and cost-effective way to estimate immunization rates, prevent wastage of supplies, and identify non-vaccinated children.

India is now in the phase of polio endgame. Children must keep getting vaccines due to the prevalence of the disease in countries that India shares borders with. Cross border infiltration could lead to polio resurgence without upkeep of vaccinations and surveillance. All states in India must also be prepared for any potential challenges and plans to implement a rapid responses to new outbreaks. Strong program management and community engagement is still needed.

However, India still has a long road ahead. These strategies that worked to eliminate polio are now being used to encourage routine immunizations. Avoidable illnesses like pneumonia and diarrhea claim the lives of 500,000 children each year.[3] Sanitation in India is also a huge problem with 60% of Indians not having access to sanitation facilities. The sanitation crisis increases the likelihood of diseases spreading and could lead to polio rebound.

[1] Basu, Moni. “India Beats the Odds, Beats Polio.” CNN. Cable News Network, 27 Mar. 2014. Web. 21 Nov. 2014.

[2] Weiss, Jonathan. “Polio Eradication Set For 2018, Why So Many Setbacks?” Medical Daily. N.p., 25 May 2013. Web. 23 Nov. 2014.

[3] Pneumonia and diarrhoea: tackling the deadliest diseases for the world’s poorest children. UNICEF, 2012.

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