Once considered the most stubborn of breeding grounds for the crippling disease, India has made tremendous strides in eradicating a killer that is in retreat worldwide.
"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.
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 pestilent in the impoverished and densely populated regions of Uttar Pradesh and Bihar. The effects – paralysis and death – will be seen in the human landscape 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 would in come to dominate the public-health surveillance system.
UNICEF’s contribution began early this century with the creation of a Social Mobilization Network, the goal of which was to eliminate social and religious barriers to vaccination and ensure universal coverage. A 7,000 strong army of trained community mobilizers using rudimentary monitoring and tracking, the SMNet 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.
Polio anywhere poses a threat everywhere, which is why UNICEF takes the recent emergence of a handful of new cases in Syria so seriously.
But it is also true that polio’s eradication anywhere (particularly somewhere as complex and challenging as India) poses an inspiration everywhere. India’s story is an important lesson and guidepost on the journey to global polio eradication.