India is on the verge of being declared polio-free.
For the first time in history, India will be free from the viral disease for a full year as of 13 January and could be taken off the “endemic” country list by the World Health Organization as early as mid-February.
“This is absolutely unprecedented, there’s no denying it,” said Deepak Kapur, chairman of the Rotary International PolioPlus Office. “However, the biggest threat is reimportation of the virus and complacency. We must remain extremely vigilant if India is to remain polio-free.”
India will be removed from the list subject to pending samples of people suspected of having the disease turning negative and if no further cases of polio are detected in the coming weeks.
Immunization drive: A file photo of a Pakistani girl getting polio drops at the Attari railway station in Punjab. Even if India achieves non-endemic status, there are threats of re-importation from neighbouring countries.(HT)
Caused by a virus transmitted primarily through contaminated food and water, polio is a highly infectious disease that can lead to irreversible paralysis. More than half its victims are children under the age of three. The fatality rate among those who become paralysed is 5-10%. Nigeria, India, Pakistan and Afghanistan are the only countries where the disease (Types 1 and 3) is still endemic. Type 2 has already been globally eradicated.
In order for a country to be taken off the endemic list, they must be polio-free for at least 12 months. India’s last reported polio case was of a two-year-old girl in West Bengal on 13 January 2011. In 2010, there were only 42 reported cases, down from 741 in 2009. If India successfully achieves the 12-month milestone, it will be the first country to be taken off the endemic list since Niger and Egypt in 2006.
Lieven Desomer, Unicef’s chief of polio, credits the leadership of the Indian government, which dedicated nearly $2 billion towards eradication efforts, cooperation among partners Rotary, Unicef and the World Health Organization, the introduction of bivalent vaccines (that immunize against both the T1 and T3 virus), and recent strategies targeting vulnerable population such as migrants and Muslims as critical factors contributing to the success.
“The leadership and partnership on the part of the government of India has been critical,” Desomer said. “India contributes more than 80% of the budget needed to do this—and that’s quite extraordinary.”
Also See | India Nears Polio-free States (PDF)
India is, however, far from being safe in the fight against polio. Even if it achieves non-endemic status, there are threats of re-importation from neighbouring countries. While India may not have any reported cases in 2011, Pakistan had roughly 189, Afghanistan 74 and China reported 21 cases, according to data made public by the Polio Global Eradication Initiative.
Desomer also sounds a warning on complacency.
“It’s not finished. We know there’s a lot of movement across borders, so India needs to work very hard to make sure that if the virus finds its way over the border, it does not result in an outbreak,” Desomer said. “The government of India has to treat every case of polio as a public health emergency. This is not the time to lower our guard.” While India may be declared a non-endemic state this year, it will have to remain polio-free for an additional two years in order for the region—which includes Nepal, Bangladesh, Bhutan, South Korea, Indonesia, the Maldives, Myanmar, Sri Lanka, Thailand and Timor West—to be officially declared polio-free. “This progress is very encouraging and has reassured us and the world that with intense, focused efforts polio virus transmission can be stopped and the strategies applied are sound,” said Hamid Jafari, project manager for the World Health Organization’s National Polio Surveillance Project. “India must now capitalize on this progress and secure polio eradication. Complacency is not a luxury the programme can afford; continued high-level vigilance for polio, emergency preparedness and ongoing intense immunization will be essential for rapid detection and elimination of any circulating polio virus.”