Polio Eradication in India: The Lessons Learned

Naveen Thacker; Vipin M. Vashishtha; Deep Thacker

doi:10.1542/peds.2016-0461

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Abbreviations:

GPEI —: Global Polio Eradication Initiative
OPV —: oral polio vaccine
WPV —: wild polio virus

India completed a full 5 years as a “polio-free nation” on January 13, 2016.¹ It was a remarkable feat considering the odds against achieving this status. The Global Polio Eradication Initiative (GPEI) considered India to be the most difficult region of the world to eliminate wild polio virus (WPV) transmission and then maintain that status for 5 years. Significantly, India borders on Pakistan, which is still experiencing intense WPV circulation.² India’s progress in becoming polio-free was a great confidence booster for all the stakeholders of the GPEI. The many lessons learned during this arduous exercise are helping strategists, program managers, and health workers of other countries still grappling with uninterrupted WPV transmission.

The Challenges

India, a vastly diverse country with a 27 million birth cohort, undertook the largest vaccination drive against WPV in the world. With high population density, poor civic infrastructure, poor sanitation, an almost nonexistent public health system, rampant malnutrition and diarrhea, difficult-to-reach locales, high population mobility, and extremely high force of WPV transmission in few states,³ the interruption of WPV transmission was extremely difficult and demanding. The interplay of these challenging factors provided a perfect milieu for the WPV to circulate, and the prospect of achieving …

Address correspondence to: Naveen Thacker, MBBS, MD, Deep Children Hospital & Research Center, Gandhidham, Kutch, Gujarat, India, PIN 370201. E-mail: drnaveenthacker{at}gmail.com