Path to polio eradication in India: A major milestone

Abstract

The global polio eradication initiative was established in 1988 by the World Health Organization to achieve eradication of wild polioviruses (WPVs) by the year 2000. More than a decade later India achieved a major milestone when in 2012 it crossed one full year without any WPV detection. India’s achievement is positive encouragement for GPEI and a sign of hope that global eradication is achievable. Technically the absence of WPV for three years in the face of high quality surveillance is necessary for global acceptance of elimination. However the quality of India’s surveillance is exemplary as supported by the evidence of improved antibody prevalence in infants. Several agencies contributed to this success – GPEI Immunization Division of the Ministry of Health Uttar Pratesh and Bihar State Governments district personnel health workers and families. Success can be attributed to several factors including sustained intensive vaccination programs diligence in finding and vaccinating children of migrant families and the use of monovalent and bivalent oral polio vaccines (OPVs). In guiding India’s future plans for action concerns about complacency and transmission must be kept in mind. The risk of undetected WPV circulation is especially important when targeting migrant mobile and underserved communities. Though a globally firm strategy for the immediate post-WPV eradiation phase has not been finalized options are currently being discussed and debated. The GPEI has been exploring ways to reduce the cost of inactivated poliovirus vaccine after which the government must be prepared to introduce to achieve high coverage after the elimination of WPVs in India.