India was officially declared polio-free by the World Health Organization last week, bringing the world a significant step closer to the global eradication of this crippling childhood disease.
When the effort to eradicate polio in India was launched in 1988, the disease crippled over 200,000 children a year. Two decades later, in 2008, half of the world's polio cases still came out of India. The country was considered one of the toughest places to eradicate polio due to poor sanitation and large numbers of people living in close proximity.
How India Became Polio Free
Four-year old Rukhsar Khatoon was the last person to be diagnosed with polio — in 2011, when she was 18 months old. Though it is a questionable honor, little Rukhsar marks the end of an era. The World Health Organization declared that 80 percent of the world's population now lives in areas that are certified as polio free.
Just how is this certification obtained — and how are we really sure that polio is gone from an area? Before an area can be declared polio-free, it must meet the following requirements:
- No confirmed cases of indigenous wild poliovirus for a minimum of three years
- Excellent laboratory-based surveillance for the poliovirus
- A demonstrated ability to detect, report and respond to cases of polio
- The assurance of safe containment of polioviruses in laboratories
To review these requirements, an independent panel of 11 experts met for two days. The South-East Asia Regional Certification Commission for Polio Eradication (SEA-RCCPE) consists of "experts in public health, epidemiology, virology, clinical medicine and related specialties", the WHO reported.
Because there were no polio cases since Rukhsar was diagnosed, the SEA-RCCPE declared India and 10 other countries in the South-East Asia region polio free on March 27. This region is home to a quarter of the global population, and mass vaccination programs have made this large corner of the world a whole lot safer.
Dr Poonam Khetrapal Singh, Regional Director for the WHO South-East Asia Region, said: "This is a momentous victory for the millions of health workers who have worked with governments, nongovernmental organizations, civil society and international partners to eradicate polio from the Region. It is a sign of what we can bequeath our children when we work together."
This great achievement — certainly one of the most important global health successes in recent times — is not a reason for Dr Singh to be satisfied, however. The Indian polio eradication program inspired health workers to locate and reach children in remote areas and to collect reliable data as well as developing ways to access remote populations.
"There is no excuse not to go back with other critical health services, from how to have a safe birth, to where to get access to tuberculosis treatment and how to prevent HIV infection," Dr Singh said.
Vaccines: The Key To A World Without Polio
Meanwhile, it is important to remember that polio crippled 35,000 people annually in the United States alone not that long ago, in the late 1940s and early 1950s. The last case of wild (naturally-occurring) poliovirus was recorded in 1979 or possibly even earlier, the Centers for Disease Control and Prevention (CDC) say. The WHO region the United States is part of was declared polio-free in 1991.
The reason the global polio-eradication program has been so successful is simple — mass vaccination. India's success reminds us that crippling diseases do not disappear naturally or due to factors such as improved sanitary conditions.
Eighty percent of the world now lives in polio-free regions, but if we forget how serious the disease is and neglect to vaccinate our children, it doesn't have to stay that way. In the US, all parents have to do to protect their kids from polio is take them to get their four doses of inactivated polio vaccine (IPV).