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PolioPlus Programme in India

It was in the year 1986, PolioPlus programme made a formal debut in India when Rotary International provided a US $ 2.6 million grant to Tamil Nadu for the purchase of Polio vaccine. The nation-wide focus on PolioPlus began a year later, when US $ 20 million were made available for the purchase of Oral Polio Vaccine, surveillance activities, social mobilization and cold chain support.

Between 1991 and 1994, immunisation drives in the form of Shishu Suraksha Diwas (Child Protection Days) were organized all over India by Rotary Clubs and Rotarians in their respective areas. Besides this, Rotary started vigorous and consistent advocacy efforts and eventually succeeded in convincing the Govt. of India about the need for launching Pulse Polio immunisation all over the country, to emulate what had been successfully done in several other countries.

The Govt. of the National Capital Territory of Delhi took the initiative of launching the first Pulse Polio Immunisation in 1994. The Govt. of India followed suit a year later in 1995-96, by designating two National Immunisation Days (NIDs). Since then series of NIDs have been conducted successfully. In 1999, this programme was intensified in order to meet the global deadline. The number of NIDs were increased and "House to House" strategy was adopted to reach every child. In 2001 the strategy of intensive Mop-up immunisation was also introduced to interrupt the wild Polio virus circulation in endemic districts. In 2001-02 as many as 159 million children between the ages of 0 to 5 were immunised. In 2002 again, 1600 cases were reported which was a major outbreak that originated in western Uttar Pradesh and spread to many other states, most of which had been free of polio for more than one year.

The Polio eradication partnership in India, under the leadership of the Government of India, mounted a tremendous response to this outbreak. Since then, strong efforts have been made to improve the quality of NIDs and strengthen supplementary immunisation activities in the country. The outbreak was controlled and the disease curtailed in just two years from 1,600 cases in 159 districts in 2002, to 136 cases in 44 districts in 2004. The programme continued to build on these achievements and reduced the number of polio cases to the lowest level ever recorded in India. Only 66 cases of polio were reported throughout the country in 2005.

The programme faced many challenges in achieving this but responded strongly to them. The programme reached out to ensure that all children throughout India were protected against Polio, by revising the strategies to reach the underserved children in the most difficult and high-risk parts. The surveillance mechanism to rapidly detect polio transmission throughout the country was also established. Collaboration with the scientific community and vaccine producers was also put in place to add new tools for the fight against polio. The progress since 2003 is the most significant in the history of polio eradication in India since the 80s and 90s when every day as many as 500 polio victims used to be reported.

Unfortunately, this trend got reversed in 2006 due to the alarming increase in the number of cases in western U.P and Bihar, posing the biggest threat to the realization of the goal of a polio free India. From three percent of the global cases in 2005, India soared to 26 percent of the global cases reported. Out of the all-India total of 676 cases in 2006, 548 were reported from Uttar Pradesh alone, the highest in the country, and out of which an estimated 59 per cent were from the Muslim community. In 2007 the INPPS of Rotary International formed a state level committee comprising of very learned and highly respected Muslim Ulemas and scholars in U.P. to help address issues like myths, fallacies and resistance in the minority communities against the programme. As a result 90 per cent of the myths and fallacies associated with Polio Eradication Programme amongst the Muslim communities were erased and there was increasing participation by members of the community.

Furthermore, in the same year, the lowest number of P1 cases was recorded due to sustained efforts with the use of more effective mOPV1 in successive rounds of immunisation in the endemic state of U.P. However, this triumph turned out to be rather incomplete with the sudden spurt in P3 cases in the country in late 2007 and early 2008. Fortunately, the outbreak was brought under control with the subsequent use of monovalent type 3 vaccine (mOPV3) along with mOPV1.

The progress thus made, especially in containing virulent P1 virus in U.P. and Bihar was the result of aggressive immunisation campaign coupled with intense efforts to prevent the importation of polio virus from endemic to polio-free states. Further were steps taken to ensure that even the migrant families and people on transit do not miss the immunisation rounds.

Today, most parts of the country have become polio-free and widespread transmission is restricted to the states of U.P. and Bihar. However, despite this unprecedented progress, taking such a massive campaign to its finishing line requires continued commitment in terms of finances, man-power and resources as well as overcoming physical, logistical and cultural barriers.

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