India marks polio milestone
It’s a milestone for a crowded country rife with poverty. Experts say fight is not over.
The country has gone a year without a recorded case of the disease. Above, a child is vaccinated.
India has gone a full year without recording a new case of polio, a significant benchmark for the South Asian nation and an encouraging development for health professionals fighting to eradicate the stubborn disease worldwide.
But experts warned that premature declarations of victory could lead to complacency among Indian parents, who might stop immunizing their children. That would increase the risk of another outbreak, particularly in a nation where about 26 million babies are born each year. India will not be officially certified as poliofree until at least three years have passed without a new case.
“It’s an incredible milestone for polio eradication,” said Rod Curtis, a New Delhi-based specialist with UNICEF. “But complacency is perhaps the biggest threat to the program today. You could get down to the last three children in the world, but unless you [immunize] those kids, it could explode again.”
The last Indian victim, 2year-old Ruksana Khatun, fell ill near Kolkata in West Bengal state on Jan. 13, 2011.
Though no new cases have been reported since, health agencies still need to process January data on nationwide paralysis cases and sewage test results over the next few weeks to confirm that it has been a poliofree year.
India is also in a bad polio neighborhood. Two of three other countries where the disease is endemic — Pakistan and Afghanistan — are neighbors (the third is Nigeria). And China on its northern border was reinfected in 2011.
“The potential risks are huge,” said Deepak Kapur, chairman of Rotary International’s India National Polio Plus campaign, who has been working on the program for more than a decade. “It’s only a flight away, maybe a bus ride away. Or it could come from Afghanistan, Nigeria or anywhere.”
Children younger than 5 are most at risk of contracting the disease, which attacks the nervous system and within hours can lead to irreversible paralysis, muscular atrophy, deformation and death. The disease tends to spread where sanitation is poor, although it can be arrested with a few drops of an inexpensive oral vaccine.
Most health experts gave India relatively little chance of getting this far given its huge population, poor infrastructure, widespread poverty and infamous bureaucracy. When the global eradication effort was launched in 1988, with a goal of eradication by 2000, India had nearly half of the estimated 350,000 cases worldwide, and as recently as 2009 it had the highest number of cases in the world with 741.
Government officials welcomed the news. “We are excited and hopeful, at the same time, vigilant and alert,” Health Minister Ghulam Nabi Azad said in a statement Thursday.
Experts credit new, more effective vaccines provided under a $300-million annual eradication program and a focus on India’s 107 most vulnerable districts, concentrated in the northeastern states of Bihar, Uttar Pradesh and West Bengal.
Officials, donors and international health experts have been giving one another muted praise.
“Success breeds success, and everyone loves a winner,” Kapur said. “There are so many fathers of polio eradication now, although it was pretty lonely in the beginning.”