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Polio is one nation closer to being wiped out
January 13, 2012
Polio-free ... it's been one year since the last reported case of the disease in India. Four-month-old Krishna is vaccinated against polio in northern India. Photo: Ben Doherty
DELHI: Polio could be wiped from the face of the earth within two years, with India - long regarded as the epicentre of the global epidemic - on the verge of being declared free of the virus.
Today marks one year since the last case of polio was recorded in India, when the virus paralysed an 18-month-old girl in Howrah, near Kolkata.
If pending test results return absent of the virus in coming weeks, India will be removed from the list of endemic polio countries, leaving only Afghanistan, Pakistan and Nigeria as countries where the virus has never been eradicated.
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But India still remains at serious risk of fresh outbreaks if the virus is brought back into the country from overseas, and polio experts say the country's massive immunisation regimen must be maintained.
''This has been a monumental effort,'' said Hamid Jafari, head of the World Health Organisation's National Polio Surveillance Project in India.
''From a global perspective, India was a major source of the international spread of wild polio virus over past decades … but, also, there is no longer an excuse that polio cannot be eradicated. If it can be eradicated in India, it can be done anywhere.''
The global polio eradication program was now being set up on an ''emergency operations framework'', Dr Jafari told the Herald. ''The progress in India had given impetus to that. Now very few countries remain and within that emergency operations framework, they are really looking at interrupting transmission within 18 to 24 months, certainly within 2013.''
Just two years ago, experts were stating polio could never be eradicated from India. In 2009, India accounted for half the world's polio cases with 741 reported.
The country is an ideal breeding ground for the virus, with a massive and growing poor population, hundreds of millions of people living in close proximity with poor sanitation, and a monsoon season in the north that helps the virus flourish.
In addition, health infrastructure is weak, and health services for the poorest children, those most at risk of polio, are almost non-existent.
The push to eradicate polio has been one of the country's largest public health initiatives.
India now consumes half the world's polio vaccine; 1 billion doses are given to Indian children each year. During biannual national immunisation drives, 2.3 million vaccinators immunise 172 million children in a week.
The World Health Organisation's assistant director-general for polio, Bruce Aylward, said the significance of India moving towards being declared polio-free - three years without an outbreak - ''is a huge milestone which almost can't be overstated''.
But he said the remaining endemic countries faced different challenges to India.
In Nigeria, there remain pockets of resistance to the vaccine, in the belief it causes infertility, while the violence in Afghanistan and Pakistan means vaccinators can't safely get to children, particularly those who live in restive border areas.
But Dr Aylward said another country, perhaps another continent, could be free of endemic polio by the end of this year.
''If we can truly apply the lessons of India globally and the political will is truly there, you're going to see another continent come off the map this year.
''That means getting Nigeria and Pakistan stopped this year.
''The world wants this done, and with India having gotten over the line … the odds, now, are in favour of the success of the program.
''They've shifted substantially by India getting to a year [without transmission].''