Comment – Building on India’s Success on Polio by Seth Berkley

Wall Street Journal
Accessed 27 October 2012

India Edition
October 24, 2012, 4:41 PM IST

Building on India’s Success on Polio
By Seth Berkley

More than 26 million children were born in India last year, many of them in remote parts of the country or in areas of poverty, poor sanitation and weak infrastructure.

Yet, nearly every one of these children received vaccines that protected them against polio.

Today, on World Polio Day, we recognize India’s achievement.  The country has not seen a case of polio in more than 18 months. This is a tremendous blow against a disease that has crippled and killed countless Indian children. India’s success is one of the biggest public health achievements in recent history. It has brought us closer than ever to eradicating the disease. There are now only three countries where natural polio transmission continues: Pakistan, Afghanistan and Nigeria.

India’s success against polio is a model of remarkable progress against all odds. It shows that even in the toughest circumstances—despite poverty, high birth rates, a large population and hard-to-reach migrant communities—polio can be defeated. It also provides a lesson that overcoming polio can pave the way to reach nearly every child with immunizations and protect them against other vaccine-preventable diseases.

Political commitment has been critical to India’s achievement. In 2009, when India had the highest number of polio cases in the world, the polio program implemented an aggressive strategy to target highest-risk populations, which was supported by all levels of government. India has also contributed significant financial resources to end polio: by 2013, the government will have invested $2 billion to defeat polio, supplemented by assistance from external partners. The program has ensured that more than 170 million children are vaccinated in two national polio immunization campaigns each year.

To reach nearly every child with polio vaccines, India used innovative strategies. India has implemented a system to track newborns to ensure they are reached with polio vaccines and other health interventions. Health workers have worked tirelessly to vaccinate children wherever they were— around brick kilns, on trains and boats and on the Pakistani border.  The government has partnered with traditional and religious leaders to convince parents to have their children vaccinated, and social mobilizers  have effectively delivered these messages across the country.

India can now apply the lessons learnt from the polio eradication effort to effectively provide routine immunizations to all, including children who live in remote areas beyond the reach of adequate healthcare facilities. Nomadic families are among the most challenging populations to reach. By using local community workers and mapping technology, India’s polio program identified nomadic settlements in the states of Bihar and Uttar Pradesh and was able to reach these communities not just with polio vaccines, but with routine immunizations that protect against a range of diseases.

India’s polio program has built a robust surveillance network consisting of 33,700 reporting sites, an army of 2.5 million vaccinators that are deployed during national immunization days, and effective strategies to vaccinate children in the country’s farthest reaches. The program also manages measles immunization campaigns and surveillance for other diseases, and delivers other health services to children.

Reaching this polio milestone provides a tremendous opportunity for India to strengthen its routine immunization and ensure that every child is protected from vaccine-preventable diseases.

Vaccines are cost-effective tools that can save lives and India is the world’s largest producer of these powerful low-cost vaccines. Yet, nineteen million children in developing countries, including in India, still do not receive life-saving vaccines that parents in wealthy nations take for granted, such as immunizations to protect against severe diarrhea and pneumococcal disease.

On World Polio Day, it is important to recognize India’s impressive achievement on polio. It provides a model for Nigeria, Pakistan and Afghanistan to stop the disease. And it demonstrates that with sufficient political commitment and funding, India and other countries can provide life-saving vaccines to all children who need them, wherever they are.

Seth Berkley, M.D., is a global advocate on the power of vaccines and CEO of the GAVI Alliance, a public-private partnership that focuses on promoting vaccination for children. GAVI last year worked with the Indian government to roll out vaccines to protect children against five life-threatening diseases in one shot. A medical epidemiologist by training, Dr. Berkley is also the founder and former President and CEO of the International AIDS Vaccine Initiative.