A boy is given a dose of oral polio immunization by a woman.

The Journey to a Polio-Free India

Without a single new infection in the past two years, India can claim to be polio-free.

Nicole Deutsch, head of polio operations for UNICEF in India, called it a "monumental milestone".

The World Health Organization (WHO) has yet to certify that the disease has been eradicated, which requires that there be zero cases after a period of three years. Nevertheless, the enormous accomplishment serves as inspiration to tackle other highly infectious diseases, such as measles.

"India has now set other important public health goals as a result of the confidence that the country has got from the successful eradication of polio," Hamid Jafari, global polio expert at the WHO, told the AFP news agency.

The Journey to a Polio-Free India

In the 20th century, as many as 150,000 cases of polio were reported every year in India. Easily transmitted in communities lacking proper sanitation facilities, the virus was particularly prevalent in the impoverished and densely populated regions. The effects – paralysis and death – will be seen for a generation.

India began administering polio vaccines in 1978 and joined the global effort to eradicate the disease (spearheaded by the WHO, UNICEF, Rotary International and national governments) a decade later. But mass vaccination campaigns did not reach a critical mass until 1997 with the formation of the National Polio Surveillance Project, which came to dominate the public-health surveillance system.

UNICEF worked hand in hand with the government since the beginning of its polio program, accelerating its contribution in 2001 with the creation of the Social Mobilization Network, which sought to eliminate social and religious barriers to vaccination and ensure universal coverage. The 7,000-strong army of trained community mobilizers using rudimentary monitoring and tracking has spent the past decade going house to house to identify high-risk neighborhoods and penetrate pockets of resistance.

Without this network of committed health workers and dedicated advocates India could not have won the fight against polio. Continued surveillance and unflagging political will from government officials are the only guarantee that the most recent child to have contracted polio in India, will indeed be the last.

Three Stubborn Challenges and One Looming Threat

India’s polio-free status means there are just three countries left where the virus is endemic. They are Nigeria, Pakistan and Afghanistan, and India is heavily invested in their eradication efforts.

"India’s success is arguably its greatest public health achievement and has provided a global opportunity to push for the end of polio," said WHO Director-General Margaret Chan last year, when India was dropped from the list of endemic countries.

Polio anywhere poses a threat everywhere, which is why UNICEF takes the recent emergence of a handful of new cases in Syria and an outbreak in the Horn of Africa so seriously.

But it is also true that polio’s eradication anywhere poses an inspiration everywhere. India’s story is an important lesson and guidepost on the journey to global polio eradication.