“The polio endgame has to start”

As India on January 13 declared itself polio-free for the third year in a row and braced for a March-end review by World Health Organization ( WHO) to declare the entire Southeast Asia region polio-free, Dr Cyrus Poonawalla, chairman of India’s largest vaccinemaker Serum Institute of India, strikes a cautionary note. In a conversation with Senior Editor GAYATRI JAYARAMAN, he says we must switch to the injectable Salk IPV (inactivated polio vaccine) because the oral polio vaccine leaves the virus in the atmosphere. Excerpts:

Q. Will India be polio-free by March, as WHO has declared?

A. Yes, I do believe India is truly polio-free because no case has been reported in the last three years. This fortunate data will enable India, in March, to be declared polio-free by WHO.

Q. They keep saying polio is going to be eradicated shortly and then one hears of a new case.

A. One of the reasons I didn’t revert to OPV (oral polio vaccine) was they said that polio would be eradicated in 1995; then they said 2000, 2010, now it’s 2015. But it looks realistic now that polio will be eradicated. How long it will take for the virus to be removed is difficult to say.

Q. So, polio is being eradicated from people but not the atmosphere?

A. OPV leaves the virus in the drainage through the stool of the immunised child. Anytime it can give the disease back to a partly protected person. It also gives, as the four cases reported in India in 2013 showed, a vaccine-derived polio. These two aspects are taken care of by Salk IPV. Because it is inactivated and injectable, there is no chance of reversion or excreting of the virus. Therefore, I have

stuck to IPV. When the only company making IPV outside of the US, Bilthoven Biologicals, was available, we bought it. When India decides to change over in 2014 to at least one dose of IPV, we are going to give the vaccine at less than if not half the prevailing price.

Q. What makes such low price financially viable for you?

A. I am not spending any money on advertisement, promotions, or pampering stockists, chemists or governments, and am giving this benefit in the price. We may not be able to price the vaccine as low as we would like to, but as soon as we start providing them in large numbers, we will give it at a lower cost.

Q. The eradication of polio is subject to switching to IPV?

A. The endgame has to start. The quicker the government does it, the better for the country and the finances of the health ministry.