Polio eradication is fraught with challenges in Uttar Pradesh.
Some cases of immunised children developing polio in the minority-dominated western Uttar Pradesh have prompted the state government to declare the vaccine ineffective.
This will be among the grievances heard by Health Minister Anbumani Ramadoss on September 21, when he meets health ministers and health secretaries from affected states like Uttar Pradesh, Bihar, Uttaranchal, Jharkhand, Madhya Pradesh, Haryana and Delhi. “Apart from meeting health ministers and officials from the high-risk states, I will meet minority religious leaders in the coming week to request them to convince their community to get their children vaccinated,” Ramadoss said.
Expressed concern over the rise in polio cases despite the eradication campaign, the minister said, “Everyone is concerned about the spurt in polio cases — up to 297 in 2006 from 66 in 2005. The programme needs urgent attention to make eradication possible.”
Western Uttar Pradesh has reported 279 of the country’s 297 cases because of several reasons. Experts from the World Health Organisation (WHO) and UNICEF are government’s partners in the pulse-polio programme and are working closely with the ministry to examine the causes.
They insist there is nothing wrong with the quality of vaccine. “It takes several doses of the vaccine to build a pool of protected children and if there is some slippage and a few children are missed for some reason, the virus attacks,” says Dr Jay Wenger, project manager, National Polio Surveillance Project in India, WHO.
According to the WHO, one of the reasons for the vaccine not working is the abysmal environment hygiene in Uttar Pradesh.
Poor hygiene causes frequent bouts of diarrhoea among children, making it difficult for them to retain the oral vaccine in their body long enough to develop immunity. Complicating matters is the varying quality of coverage in different districts. “All districts have to implement the vaccination programme in a consistent manner to keep the virus away,” says Dr Wenger.
“Districts such as Meerut, Muzzafarnagar and Ghaziabad had zero cases last year but have reported polio cases this year because the virus spread from the neighbouring districts.”
One of the causes of erratic coverage is the Muslim community’s suspicion that the vaccine is a form of birth control — which is fuelled by rumours.
“Most people from the community are very cooperative, but even if a few — the number does not cross double digits — resist, it provides enough leeway for the virus to attack,” says Michael Galway, chief programme communication, UNICEF. “Several children could not be vaccinated either because their houses were locked or they were away from home.”