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A decade of India’s achievement of polio-free status

Context:

India marked a significant milestone in 2024, completing a decade of polio-free, a status it achieved in 2014 when the World Health Organization (WHO) declared the country free of polio. India’s Polio-Free Status:

  • Achieved in 2014 through sustained efforts over decades.
  • Resulted from participation in the Global Polio Eradication Initiative (GPEI) and Universal Immunization Programme (UIP).
  • Collaborative effort with organizations like UNICEF, WHO, Gates Foundation, Rotary International, and CDC.

Immunization in India:

  • The Expanded Programme on Immunization (EPI) started in 1978, renamed to Universal Immunization Programme (UIP) in 1985.
  • UIP provides vaccines for 12 diseases to 2.67 crore newborns and 2.9 crore pregnant women annually.
  • Polio elimination was one of the first targets of UIP.
  • The National Rural Health Mission (NRHM), was launched in 2005 to enhance the health of rural populations.

Key Milestones in Polio Eradication:

  1. Pulse Polio Programme Launch (1995):
    • A national campaign started in 1995 using the Oral Polio Vaccine (OPV).
    • Slogan “Do Boond Zindagi Ki” became iconic.
  2. Routine Immunization & Strengthening:
    • UIP provided vaccines against multiple diseases, maintaining immunity levels.
    • Improvements in cold chain management and logistics, including eVIN and NCCTE.
  3. Introduction of Inactivated Polio Vaccine (IPV) in 2015:
    • IPV was added to the vaccine schedule after the global switch tobivalent OPV (bOPV), ensuring protection against type 2 poliovirus.

Surveillance and Monitoring:

  • Acute Flaccid Paralysis (AFP) Surveillance to monitor unexplained paralysis.
  • Environmental Surveillance to check sewage for poliovirus.
  • High surveillance sensitivity helped track and control any outbreaks.

Political Will and Community Engagement:

  • Strong political commitment from central and state governments.
  • Local leaders, health workers, and volunteers ensured wide public awareness and door-to-door immunization, especially in remote areas.

Certification and Final Leap:

  • Last wild poliovirus case in 2011 (Howrah, West Bengal).
  • WHO certification process required 3 years without cases, robust surveillance, and destruction of remaining virus stocks.
  • India declared polio-free on 27th March 2014.

Post-Certification Measures:

  • Annual Polio Campaigns and Surveillance continue to maintain immunity and prevent re-emergence.
  • Border Vaccination to prevent polio re-importation.
  • New vaccines like Rotavirus, Pneumococcal Conjugate Vaccine (PCV), and Measles-Rubella (MR) were added to the immunization program.
  • Mission Indradhanush (since 2014) aims to increase immunization coverage to 90%, focusing on hard-to-reach areas.

Conclusion:

  • India’s success in polio eradication is a model of collaboration, leadership, and innovation.
  • Ongoing efforts in immunization and surveillance ensure the country remains polio-free and supports the global goal of eradication.
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