Just a few decades ago, over a thousand children were paralyzed by polio every single day globally. It took years to find a cure – a safe, efficient vaccine was produced, and countries throughout the world resolved to eradicate polio from the planet.
The Global Polio eradication movement marks over 30 years of perseverance, commitment and a vast public health undertaking that has since become a model for conquering health challenges under the most complex conditions.
How was this progress made?
On 27 March, 2014, WHO South-East Asia Region including India was certified polio free by “The Regional Certification Commission (RCC)”. India reported its last polio case from district Howrah, West Bengal on 13 January, 2011. On 24 February, 2012, WHO removed India from the list of “endemic countries with active polio virus transmission” Rotary International, UNICEF, and Global Polio Eradication Initiative (GPEI) partners — set an ambitious goal of eliminating polio from the world. The results were remarkable: polio has been reduced by 99 per cent, and approximately 19 million people who would have been paralyzed otherwise are now walking, thanks to immunization. This push to vaccinate every child is what ended polio in India.
While the journey of defeating polio was a long one, it certainly wasn’t easy. Keeping in mind that the virus has not been completely eradicated from the face of earth, till date, the Centre maintains herd immunity through high quality national and sub national polio rounds each year. An extremely high level of vigilance is carried out through surveillance across the country for any importation or circulation of poliovirus and VDPV. Environmental surveillance (sewage sampling) has been established to detect poliovirus transmission
Pandemic continues to impact progress on vaccine-preventable diseases
When COVID-19 struck in 2020, it affected routine immunization programs across the world. Parents were unable to bring their children to health facilities for immunization, and healthcare workers were unable to visit the homes of children to vaccinate them. Government data reflects that in January 2020, the number of children vaccinated against polio were 160,960,861, however, this number has reduced to 159,169,202 in January 2021, i.e., more than 1 million less children vaccinated as compared to the previous year.
As a result of ongoing disease surveillance, the Global Polio Eradication Initiative (GPEI) recently confirmed a case of type 1 wild poliovirus (WPV1) in a child suffering from paralysis in Malawi. Analysis has shown the virus is genetically linked to WPV1 that had circulated in Pakistan’s Sindh province.
The GPEI is supporting health authorities in Malawi to conduct a thorough assessment of the situation and begin urgent immunization activities to mitigate any risk of spread. Environmental surveillance measures are also being expanded in Malawi and neighbouring countries to detect any other potential cases.
Detection of WPV1 outside the world’s two remaining endemic countries of Pakistan and Afghanistan is a serious concern and underscores the importance of prioritizing polio immunization activities in countries such as Malawi to prevent future instances of importation.
Rotary has continued strong financial support to Africa since the most recent previous case in Nigeria. During the last two years, 54 per cent of the Rotary PolioPlus budget has supported disease surveillance, outbreak response, the purchase of vaccines and operational expenses throughout Africa. In more than three decades since Rotary launched its PolioPlus program and formed the GPEI, we have repeatedly stressed that polio anywhere is a threat to children everywhere. The case in Malawi imported from Pakistan underscores the importance of that statement.
How to continue immunization despite COVID-19
COVID-19 has also revealed how quickly, and dangerously viruses can spread around the world. Hence, we must focus on immunization so that polio and similar infections don’t come roaring back at us. It is imperative that we close the gap by continuing vaccinations by following COVID-19 protocols.
Prioritizing full immunization for children born pandemic
In the history of public health, vaccination has been one of the most powerful and fundamental disease prevention methods. More children are now protected against vaccine-preventable diseases in more nations than at any other time in history. This improvement was temporarily jeopardized because that posed as a danger of disease resurgence. However, as covid numbers decrease and the virus moves from pandemic to endemic immunization programmes can be carried out again.
This month, India also launched the largest immunisation programme, Mission Indradhanush 4.0, which will annually cover more than 3 crore pregnant women and 2.6 crore children. The programme will make lasting gains towards Universal Immunization by immensely contributing to filling the gaps. IMI 4.0 will ensure that Routine Immunization (RI) services reaches the unvaccinated, partially vaccinated children and pregnant women. The activity will be conducted in 416 districts across 33 states/UTs. This initiative has been planned to emerge from the brief hiatus of routine immunization that COVID-19 pandemic caused.
Elimination ≠ Eradication: the fight against polio continues till everyone is safe
Vaccination is essential for preventing infections and diseases; be it for the coronavirus infection or the resurgence of other vaccine-preventable illnesses such as polio. It's the most important step toward herd immunity: the more people who are immunized against a disease, the less likely that disease will spread, and the "herd" or community will eventually become immune to that pathogen.
Now is the time for all parties –including, communities, government leaders, and global partners – to recommit ending all forms of polio for good. It is critical that we ramp up our efforts to raise awareness for the importance of reaching all children with polio vaccines and continue raising the funds necessary to carry out critical eradication activities to protect vulnerable children and prevent further outbreaks.
Donate now at endpolio.org/donate.
Deepak Kapur is chairperson, Rotary International’s India National Polio Plus Committee (RI-INPPC)