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Can the Polio Elimination Success Story Breed More Successes in India?
Overcoming formidable biological and sociocultural barriers, India eliminated wild polioviruses from its territory in January 2011. Looking back, it is obvious that the best policy would have been to introduce the inactivated poliovirus vaccine to prevent polio in every vaccinated child, and to use oral poliovirus vaccine by pulse campaigns to eliminate WPVs rapidly. This would have eliminated polio decades ago. Now that WPVs have been eliminated, IPV must be introduced as a prelude to withdrawing OPV. The road ahead is bumpy, but with the important lessons learnt so far, India can no longer pretend that it is too difficult to design a permanent public health infrastructure to control other communicable and non-communicable diseases.
India has eliminated wild polioviruses (WPVs) from its territory, a feat that was predicted to be impossible by many global experts because of formidable biological and sociocultural barriers. In spite of intensive surveillance, no child with WPV polio has been detected since 13 January 2011. Sewage samples from multiple sites in Mumbai, Delhi, Kolkata, Patna, and Punjab have been consistently free of WPVs during the last three years. The Indian Council of Medical Research (ICMR) has ascertained that no laboratory is keeping WPVs in freezers. Certification of WPV elimination by the National Certification Committee is imminent. India is one of 11 countries in the South-East Asia Region of the World Health Organisation (WHO), and on 27 March 2014, the WHO’s regional certification commission for polio eradication certified the South-East Asia Region as polio-free.
The distinction between elimination and eradication is in geographic extent. When one or more countries bring down WPV transmission to a zero level and sustain it for three years, we know WPV-polio is eliminated. Global-level elimination is eradication.
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