The Times of India

Tomorrow, India will be given poliofree certification by the World Health Organisation (WHO) Southeast Asia wing. Dr Nata Menabde, WHO representative to India, spoke with Rohit E David on the steps India took to eradicate the deadly polio virus, how the country must guard against it resurfacing – and who deserves credit for this remarkable accomplishment:

• What global significance doesIndiabeingpolio-freehold?

India has reached a major landmark by not reporting a polio case for nearly three years. This has brought the entire Southeast Asia region of WHO closer to polio-free certification. In 2012, India was taken off the global list of polio-endemic countries which reduced to three. With the certification of the Southeast Asia region now, four of the six WHO regions will become polio-free, leaving only WHO’s African region and East Mediterranean region to be certified.

India’s polio-free status has demonstrated that global eradication of polio is an achievable goal. Best practices and lessons learned from India’s initiative are being applied by polio-endemic countries like Nigeria, Afghanistan and Pakistan. The programme now serves as a model for health programmes globally – it’s demonstrated that it’s possible to achieve ambitious health goals through high vaccination coverage, even in areas with weak health systems.

• How did WHO help India eradicate polio?

WHO, in collaboration with the government of India, established the ‘National Polio Surveillance Project’ (NPSP) in 1997 to provide technical support in key areas of surveillance for polio and mass vaccination campaigns.

Over the years, NPSP’s role expanded to include additional areas such as routine immunisation, polio-free certification and end-game strategy. Cross-cutting areas include evidence generation, research and immunisation monitoring, programme strategy development, capacity building of government staff, accreditation of laboratories and providing timely feedback to government for action at all levels.

• How was the campaign spread amongst large, diverse populations?

Mass awareness was created by banners, posters, hoardings and engaging celebrities through television and radio. Newspaper advertisements in local languages also created awareness. Vaccinators were trained to enhance their interpersonal skills, so they could mobilise communities better.

In some areas where communities remained hesitant, special efforts were made through the involvement of local, religious and opinion leaders.

• What measures should be taken to prevent further cases now?

With continuing transmission in Afghanistan, Pakistan and Nigeria and outbreaks in Syria, Somalia, Ethiopia, etc, India faces the risk of resurgence due to an importation from any of these countries. Since 2000, more than 45 countries that were poliofree suffered from importations of wild poliovirus. To ascertain that no case emerges here, the programme in India is maintaining high population immunity through mass vaccination campaigns and surveillance to pick up any importation – India is in a state of emergency preparedness to respond urgently to any importation.

The government also recently made polio vaccinations a prerequisite for travellers of seven polioaffected countries coming to India to mitigate importation risks.

• Who would you like to credit for India achieving this remarkable feat?

The strong will of political leaders and support of international partners like WHO, Unicef and Rotary International played a critical role in the initiative in India. The contribution of committed, hardworking frontline workers, who implemented innovative strategies for improved vaccination coverage, and the involvement and support of communities also can’t be ignored.