India was the turning point in the fight against Polio
Five years ago, I was fortunate enough to witness firsthand one of the world’s greatest public health achievements: The South-East Asia Region (SEARO) of the World Health Organization (WHO) — a collection of 11 nations that are home to one-quarter of humanity — was declared polio free. India was the final piece of the puzzle in the region, and its success in eliminating polio set the stage for the celebration.
Critics asked, “How can we possibly eliminate a virus that thrives on extreme poverty, poor sanitation, and social marginalisation?” India delivered the answer. It showed us that smart strategy, political leadership, effective partnerships, and public will can overcome even the toughest of microbes.
Just 12 years ago, India accounted for nearly 70% of wild polio cases worldwide, and the last communities in India in which polio held a foothold were in some of hardest-to-reach places on earth.
But those working to tackle polio refused to give up. Ending polio required extraordinary effort and coordination by the Indian government, far-reaching vaccination campaigns, and the tireless dedication of millions of community health workers and volunteers. It was hard work, but it yielded an amazing result: a region where nearly 3 billion people are now living free of the threat of wild polio virus.
None of this would have been possible without the strong bond that India forged with the Global Polio Eradication Initiative (GPEI), a partnership between Rotary International, UNICEF, the US Centers for Disease Control and Prevention, WHO and the Bill & Melinda Gates Foundation.
The Indian government, in collaboration with the GPEI, developed a surveillance network with more than 40,000 reporting sites, deployed a workforce of 2.3 million vaccinators during national immunisation days, and gave out 900 million doses of oral polio vaccine in 2011 alone, the last year India saw a case of the disease.
The programme continues to leave its mark. The infrastructure, strategies, and workforce developed by the programme are helping to deliver essential health services, including the introduction of other life-saving vaccines, with support from Gavi, the Vaccine Alliance.
Vaccinators still work tirelessly to identify and vaccinate children, and as long as polio exists in the world, these efforts will remain essential to sustain India’s success. Front-line workers from the polio programme also counsel pregnant women on breastfeeding and help facilitate routine immunisation for newborns.
The fifth anniversary of a polio-free SEARO region is an opportunity to reflect on lessons learned and the progress we’ve made globally over the past five years. India’s success has provided technical guidance for eradication efforts in the world’s three remaining endemic countries — Afghanistan, Pakistan and Nigeria. In these countries, health workers have developed strategies to identify, track and vaccinate hard-to-reach populations, coordinated trainings for community mobilisers, and established innovative systems for conducting door-to-door campaigns. All these strategies were pioneered in India.
Years from now, when WHO holds another ceremony to certify the world polio free, we will look back to India as the final turning point in the fight.
The author is president, global development, Bill & Melinda Gates Foundation
The views expressed are personal