The world celebrated as India made history in 2014 — a hard-fought battle with polio led to India and the entire South-East Asia Region of WHO being certified polio-free on 27 March.
January 2022 marks the completion of 11 years since the last polio case was reported in the country. As recently as 2009, India constituted over 60% of all global polio cases. The challenge seemed insurmountable. Yet, the impossible was made possible, thanks to the singular commitment of the Indian government at all levels and partners of the Global Polio Eradication Initiative, notably WHO, Rotary International and UNICEF.
The infrastructure and groundwork laid to combat polio, in time, has enabled India to achieve many public health goals and respond to emergencies. The WHO National Polio Surveillance Project (NPSP) has transitioned into the National Public Health Support Programme, which has been working in tandem with the Indian government to support high-priority initiatives.
The polio eradication tools — micro-planning to reach every child, case-based surveillance, use of data, accountability mechanisms etc. — have been deployed to validate the elimination of maternal and neonatal tetanus from the country in 2015; improve immunization coverage; roll-out of new vaccines; and elimination of neglected tropical diseases like lymphatic filariasis, leprosy and kala-azar.
“The Government of India (GoI) in partnership with WHO, UNICEF and other agencies began leveraging the knowledge and infrastructure built around polio eradication to step-up routine immunization and priority public health programmes. More recently, the WHO-NPSP network (now) with a field presence of nearly 2600 personnel comprising medical officers and field monitors, has been actively involved in working with the government to respond to COVID-19 pandemic,” says Dr Roderico H. Ofrin, WHO Representative to India.
As we complete another year of being polio-free, Dr Qaisar Nezami, a WHO Surveillance Medical Officer based in New Delhi, looks back at the hectic days of working with the government and other stakeholders on polio elimination.
“In October 2008, I joined the WHO-NPSP as a Surveillance Medical Officer in Moradabad district in the state of Uttar Pradesh. Moradabad was considered the last bastion of polio transmission in the country and my job was to provide oversight on surveillance, immunization, microplanning etc. The district authorities did an excellent job in ensuring results,” says Dr Nezami.
“I firmly believe that beyond science, the key to beating polio was through well-coordinated efforts, between the government, partner agencies and communities. We recognised that the support from community members would bring incremental gains, and it did. India’s victory over polio demonstrates that everything is possible if we work together,” he adds.
Dr Nezami and his team in Delhi work with the state government on routine immunisation and now also on pandemic response. Five districts in Delhi are among the top 10 densely populated in India, with three districts at the top of the list, making their task both complex and challenging. The WHO team is part of rapid response teams and state technical committees and supports implementation of health measures at major points of entry; surveillance; public health and social measures; diagnosis; containment; capacity building of health workers.
“Being posted in some of the most challenging areas of the country provided me the experiences and opportunities to learn to overcome obstacles to attain public health goals.It’s great to come back home every night to my family knowing, that what I do makes my country and people, a little safer and healthier each day,” says Dr Nezami.
The victory over polio in India demonstrates the importance of strong surveillance systems, intensive vaccination drive and targeted social mobilization efforts and the public health gains in the long-term.
But we cannot rest on our laurels. Until polio is eradicated, India must remain vigilant.
Meanwhile, it’s time to take a moment to salute our public health heroes and rejoice, as India completes yet another year of being polio-free.