Nearly 12 years have passed since India manged to eradicate polio. As per the government reports, by 2012, India recorded zero cases of polio in all regions of the country. In February 2012, WHO removed India from the list of endemic countries with active poliovirus transmission. In March 2014, the Regional Certification Commission for polio eradication certified Southeast Asia as polio-free including India.
The credit goes to the Indian government’s initiative of introducing the Pulse Polio Programme which provided oral pulse polio drops to children aged from infancy to five years across the nation.
The last case of polio was reported in Howrah, Kolkata in 2011. Polio or poliomyelitis is a highly infectious disease caused by a virus belonging to the Picornaviridae family. As WHO describes it, the virus transmits from one person to another via the fecal-oral route through contaminated water or food. The virus invades the nervous system and causes total paralysis within hours. The virus which largely affects children below the age of 5 years, is vaccine-preventable and that’s how India achieved its polio-free status via effective pulse polio vaccination through oral drops.
Happiest Health takes a look back at the efforts of the government and medical frontiers to eradicate polio.
Pathway to India’s pulse polio programme
For centuries, polio was the most feared disease in many countries. UNICEF reports that polio in children became endemic in the early 1950s when several countries across the globe reported cases of the disease.
India too was not far away from taking a severe hit from the rising cases of polio in the country. During the early 1970s, cases of polio were rampant in the country, according to Dr B K Vishwanath Bhat, Pediatrician at Radhakrishna Multispecialty Hospital, Bangalore. “The country lacked private hospitals in those days. In government hospitals, there were no advanced medical facilities to tackle the disease,” he explains. Six to seven acute polio cases were seen daily in children those days, he added.
Pulse polio campaign: India’s eradication efforts
A stringent immunization stance was realized in the 1970s to curb the rising cases of polio in children. In 1988, Rotary International formed the Global Polio Eradication Initiative (GPEI) to eradicate the polio virus globally. Over 200 countries and 20 million volunteers worked together to immunize over 2.5 billion children against polio.
In relation to the polio eradication efforts in India, National Immunization Day (NID) commonly known as the Pulse Polio Immunization programme was launched in India in 1995, by the government of India and is conducted twice in the early part of each year, especially in places of high risk. In these campaigns, children below five years of age are administered polio drops which is known as Oral Polio Vaccine.
Dr Upendra S Kinjawadekar, president of the Indian Association Of Pediatricians (IAP), says polio eradication was a slow process. “Polio eradication was not an easy process, our main focus was to ensure every child under five had the vaccine. However, there were setbacks in certain areas. Lack of awareness and accessibility regarding the vaccine made some parents hesitant to vaccinate their children. But we were able to gradually overcome these hurdles as government and NGOs accelerated the immunization process by reaching children on their doorsteps,” Dr Kinjawadekar explains.
In 2014, the Injectable Polio Vaccine was introduced in the Pulse Polio Programme which became the gold standard. The injectable vaccine is a trivalent (works against three strains of the virus) vaccine which is now part of a child’s vaccination calendar. “The trivalent vaccine was able to eradicate all three strains of polio and children were able to gain immunity, while oral polio vaccine was bivalent (works against two strains of the virus), meaning it was only able to eliminate one strain. However there were some cases of vaccine-associated polio as well caused by the second strain of polio, which gradually was eradicated through medical advancement,” said Dr Bhat.
As Director of Polio for the WHO’s Eastern Mediterranean Region, Dr Hamid Jafari explains the extensive measures taken by WHO to eradicate polio in India. “It was an enriching experience serving as the project manager of WHO India’s National Polio Surveillance Project (NPSP). I was responsible for poliovirus surveillance, mass vaccination campaigns, developing strategies and corrective measures for ensuring every child received sufficient vaccination to gain immunity,” he has been quoted by WHO, adding that “Polio eradication seemed impossible until it was done.”
Despite being a polio-free country, Dr Kinjawadekar advises that parents must provide polio vaccination for children below the age of five years without fail. “Parents must ensure their child takes two booster shots to boost immunity around the ages of four and five too, apart from initial doses given in the first 18 months,” he says.
Polio eradication: A global snapshot
Pakistan and Afghanistan continue to be the two countries that still have polio cases seen in children, while cases of polio have reduced by 99% globally. Dr Jafari stresses that polio eradication is a constant process of programme assessment and refinement. “There is more to be done if we are to prevent the virus from paralyzing another child,” says Dr Jafari.
- Cases of polio in children were rising rapidly in children around 1950 and was declared an endemic by 1970 by WHO.
- In 1995, the Government of India launched – the Pulse Polio Programme in which children below five years are administered polio drops known as the Oral Polio Vaccine, as a part of polio eradication. The last case of Polio in India was in 2011.
- By February 2012, WHO removed India from the list of “endemic countries with active poliovirus transmission.”