core sector communique

A Year Without Polio in India Is Progress Toward Eradication

By Charlene Porter

Staff Writer

Washington - A full year has passed without a single case of polio in India, an occasion that marks "unprecedented progress" in that nation's campaign to overcome polio, but also in the Global Polio Eradication Initiative (GPEI) first mobilized in 1988.

A GPEI press release touts India's success and calls the polio-free year a "major milestone" for a campaign that has reduced the incidence of polio by 99 percent worldwide. India made rapid progress against the viral disease after 741 cases were reported in 2009, more than any other country. Only 41 cases appeared in 2010, and one lone case was reported January 13, 2011, with no cases since then.

"We are excited and hopeful, at the same time vigilant and alert," said Indian Minister for Health and Family Welfare Ghulam Nabi Azad in a statement released by the Indian government. Testing for wild poliovirus will continue through this month, and if all of India's results remain negative, it could be considered a non-endemic country by February. India has been listed as one of four countries where polio remains endemic, along with Afghanistan, Pakistan and Nigeria.

"Polio's history contains many cautionary tales," said Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC). He explained why India must remain vigilant: "Polio anywhere in the world is a risk everywhere in the world, and to protect itself from a setback, India is appropriately planning to continue meticulous monitoring and intensive childhood vaccination against polio."

The CDC is a principal partner in the GPEI, along with the World Health Organization, UNICEF, the service organization Rotary International, and the Bill & Melinda Gates Foundation. The effort also has backing and financial assistance from national governments, private donors and volunteers.

Since 2006, wild poliovirus has been circulating in only the four endemic countries. But frequently over the last decade, the virus has been reintroduced in countries that had gone three years or longer without a case, the point where eradication is considered achieved. In some cases, sample analysis has proven that India was the source of virus that appeared in countries considered polio-free. Reaching non-endemic status will mean that India no longer poses a threat as a source of wild poliovirus, which is "a massive boost" to the global polio eradication program, according to GPEI documents.

Intensive vaccination programs have been a key tactic in India's strategy to beat polio, and a government press release says they will continue. National Immunization Days mobilize nearly 2.3 million vaccinators who spread out to towns and villages, administering vaccine to more than 170 million children during each immunization event. The Indian campaigns have also taken vaccination to nontraditional settings, such as trains, border crossings and the trail of nomadic populations, actions that demonstrate the high level of political commitment to the effort, according to the government press release.

The CDC often sends experts to help out in these events, and Rotary International has sent parties of volunteers to assist in the many logistical details involved in shipping containers of vaccine to remote villages.

Worldwide, some 620 people were stricken with polio in 2011, a significant decline from 921 cases in 2010 and more than 1,350 in 2009, according to GPEI's accounting. Despite the global improvement, 2011 brought a bump up in cases in endemic countries, with India as the one exception. In response, GPEI reports that it is now operating on an emergency basis to mount faster responses to outbreaks and to concentrate resources.

When the global campaign against polio began in 1988, 350,000 children were paralyzed or killed by the disease each year in 125 endemic countries. Sponsors hoped eradication could be achieved by 2000, yet 11 years later the goal remains just out of reach. The GPEI monitoring board says the organization is not on track to stop wild poliovirus transmission globally in 2012.

But falling short of a goal is not defeat. Assessing the achievements of the long campaign in a January fact sheet, GPEI says that 7 million people have been spared from the disease since the campaign began.

(This is a product of the Bureau of International Information Programs, U.S. Department of State. )