1. One more year of nil case and it will
be ‘Goodbye, Polio’
RAMYA KANNAN
The Pulse Polio programme was initiated in 1995-1996
‘It is probably the biggest public health success story of this
century
It is two years since India has had a polio case. One more before the country
can say ‘Goodbye, Polio.’ The battle against the wild polio virus is poised
interestingly in the nation that, not long ago, in 2009, accounted for nearly
half the world’s polio cases.
An 11-member Regional Certification Commission from the WHO’s South
East Asia Region is meeting regularly to review reports submitted by India’s

2. National Certification Committee. Three years of absence of polio cases,
caused by the wild polio virus (WPV), coupled with intense surveillance, is
essential before India can be declared polio-free, in 2014.
Naveen Thacker, past president, Indian Academy of Paediatrics, who has
been involved for nearly two decades in the fight against polio, says: “It is
probably the biggest public health success story of this century. For us, this
is very encouraging; it gives us a lot of confidence. It also gives other polio-
endemic countries a lot of confidence.”
Surveillance system
The team had thought the task of eradicating polio from India would be
fairly easy, when the Pulse Polio programme was initiated in 1995-1996.
“We had about 1,006 cases then, and we thought it was going to be really
easy. And then, my God! It was like the wild polio virus was always smarter
than us.”
And now, after nearly two decades, the tide has turned. There is celebration
in the air, but it is muted with wide-eyed caution. “The price of freedom is
eternal vigilance,” Dr. Thacker says. “We need to sustain the campaign, and
immunity. We also need to keep up our surveillance system. Our capacity to
respond should be in place.”
T. Jacob John, who was professor of clinical virology in the Christian
Medical College, Vellore, and has served on The National Technical
Advisory Group on Immunisation, says: “Last year, the question was, ‘Is
this for real?’ But two years is long enough to be sure that the WPV has
been conquered. There have been two high seasons (for the virus) — the
second half of the year in North India, and no cases. All sewage samples
have also tested negative for the WPV.”
From a position in the past when Indians travelling abroad exported the
polio virus to many countries, it has come to India worrying about possible
imports from countries that are still endemic to polio. These nations are
Pakistan and Afghanistan, nearby, and Nigeria. Dr. John says, “But we are
prepared. There are five border crossing areas with Pakistan — two in
Jammu and Kashmir, two in Punjab and one in Rajasthan. Anyone coming

3. across has to take the vaccine.” Additionally, every State has emergency
action plans ready, along with good surveillance systems.
To prevent polio from re-emerging, the government has planned to keep up
intensive campaigns, especially in high-risk areas. Two nationwide
campaigns and four sub-national polio campaigns will take place in 2013.
High-risk areas, including blocks in Uttar Pradesh and Bihar, and migrant
populations, are being targeted. A mapping system has been developed to
ensure that all newborns in these areas are vaccinated, and that no one slips
through the net. While the success of the polio campaign is a model of
focussed attention, the attention is now being turned on increasing routine
immunisation coverage, according to those involved in public health
administration.
A joint statement from the WHO, the CDC, the UNICEF, the End Polio Now
campaign, and the Central government, indicates that the sensitivity of
surveillance in India now surpasses the globally recommended standards.
Over 35,000 health facilities are reporting cases of Acute Flaccid Paralysis
as part of polio surveillance. Over 1,20,000 stool specimens are tested
annually in the eight WHO accredited labs in India. Surveillance has also
been intensified along the international border, the statement adds.
Credit is being accorded to the commitment of the Centre for pushing
ahead with the programme in the face of major hurdles. However, equally
important is the seamless partnership between the government, and the
Rotary International, the WHO, the UNICEF and private paediatricians –
for it was the scale of this alliance that managed to mobilise vast quantities
of field-level workers. In the final call, this probably swung the balance in
favour of humans over the wild polio virus.
Keywords: wild polio virus, pulse polio drive, polio
immunisation, UNICEF, polio epidemic
We must be careful to not treat the "polio-free" status as a sign that efforts
of the anti-
polio campaign can we slackened. We must continue to work hard with our
vaccination
drives as, according to WHO officials working with India's anti-polio
campaign, there

4. are chances of polio coming back in through our unsecured borders. It is
an
achievement that we should actively continue to take our pride in, by
showing our
diligence.
from: Sahil Kini
Posted on: Jan 13, 2013 at 22:16 IST
Brilliant. A country with a billion plus population had proved that it
can get its act together. When some of our neighbours are still
struggling to eradicate polio whose population is significantly lesser
than ours, our nation has done it.
Media deserve the right credit as i still remember asking my parents
when i was 10 ( i am 29 now), whether i was given the polio drops
after looking at a TV advertisement.
However long journey it had been, all the politicians, bureaucrats and
health care workers involved in this landmark acheivement deserve the
respect of the citizens.
from: John
Posted on: Jan 13, 2013 at 17:13 IST
The comment by Deepak (Jan 13 2013) is remarkably insensitive. Yes,
Jonas Salk (not "Sulk", as Deepak refers to him) did develop a safe
polio vaccine, and he was a remarkable man. But the delivery of the
vaccine across a country of 1.2 Billion people is a horrendous and
difficult task. I am sure that all of us have sat back and viewed the
enormity of this task. It staggers the mind. Just as you can have a
famine even when there is abundant food, so can you have a polio
epidemic when there is plenty of vaccine. The solution in both cases
is effective delivery.
While Jonas Salk did produce a dead vaccine for poliomyelitis (Sabin
produced a live vaccine), the research for the vaccine was not carried
out by him. Nor did Salk win a Nobel for his work, although he was
nominated. While the Nobel Prize is not always a reliable indicator of
merit or that of original discovery, it did award the prize for polio
research to Enders, Weller, and Robbins in 1954.

5. India is to be congratulated.
from: Ratnam
Posted on: Jan 13, 2013 at 15:17 IST
This is a commendable landmark! Let's hope we remain polio free for
the next one year so that all the children of this country can hope
for a polio-free future.
The program implemented in India is a GARGANTUAN one - the sheer
scale
and complexity of this program is unimaginable, given the size and
population of our country. This makes me so proud that the people
dedicated to this program have, through dedication, science and
perseverence, made it a success. Hats off!
Now, if only we can achieve a similar miracle with a program to raise
the sex ratio, universal education for children..the wish list is
long...but as hate campaign against polio has shown us, nothing is
impossible!
from: Am
Posted on: Jan 13, 2013 at 13:02 IST
Congratulations my nation!!
Long live India
from: Kumar Pranav
Posted on: Jan 13, 2013 at 12:53 IST