Why is it in the news?

• October 24 is observed as World Polio Day, established by Rotary International to commemorate the birth of Jonas Salk, who led the first team to develop the polio vaccine in the 1950s.
• India has successfully eradicated polio, a highly infectious viral disease primarily affecting children and causing paralysis and death. While there is no cure for polio, vaccination is an effective preventive measure.
• In 2009, India reported 741 polio cases, the highest globally. By January 2011, the last case was recorded in Howrah, West Bengal. This remarkable turnaround, achieved amid significant challenges, highlights a major success for India’s healthcare system and has provided valuable insights for recent COVID-19 vaccination efforts.

An Analysis

• India’s large population, along with millions living in overcrowded settlements with poor hygiene, posed considerable challenges in combating polio. Geographic accessibility was also difficult, compounded by vaccine-related fears rooted in religious beliefs and government mistrust.

Vaccination Campaigns

• Polio vaccination in India began in 1972 and expanded through the Universal Immunisation Programme (UIP) in 1985. Nationwide immunisation days were established alongside extensive awareness campaigns. The oral polio vaccine, which requires no special training for administration, proved particularly advantageous.
• Vaccination drives were strategically held during festivals and in crowded locations, such as railway stations. Special awareness camps were organized for mothers, led by community women speaking in local languages.
• Celebrities like Amitabh Bachchan were enlisted to promote awareness, and UNICEF integrated polio messages into popular soap operas, enhancing outreach. The campaign’s tagline, “do boond zindagi ki” (two drops of life), remains memorable.

Public Health Education

• Polio spreads primarily through contact with the faeces of infected individuals, contaminating food and water. Therefore, vaccination campaigns were complemented by educating the public on handwashing, boiling drinking water, and breastfeeding infants under six months.
• Efforts were spearheaded by central and state governments, supported by the World Health Organization (WHO), UNICEF, the US Centres for Disease Control and Prevention (CDC), Rotary International, and donors like the Bill and Melinda Gates Foundation.

Targeted Interventions

• By 2008, polio cases began to decline, with a UNICEF report indicating that over 80% of cases in 2009 occurred in just 107 blocks of Uttar Pradesh and Bihar. This prompted targeted interventions.
• A robust surveillance and monitoring system was critical. Leveraging WHO expertise, India established an effective framework to monitor acute flaccid paralysis cases in children, often indicative of polio.
• This involved a network of informers, including community health workers, local residents, doctors, and faith healers, to ensure that no cases among hard-to-reach populations were missed.

Addressing Seasonal Migration and Vaccine Hesitancy

• Seasonal migration for work, especially in Uttar Pradesh and Bihar, complicated monitoring efforts. To address this, vaccination drives were organized at migrant residential camps. Camps were scheduled around the work hours of daily wage workers to ensure they could participate without missing income.
• Vaccine hesitancy was prevalent, fuelled by rumours suggesting the vaccine could lead to impotence and objections from the Muslim community. Community leaders, including imams and maulanas, were engaged to promote awareness.
• Institutions like Aligarh Muslim University and Jamia Millia Islamia contributed to these efforts. For instance, a rumour claimed that the oral polio vaccine was produced using pig blood, considered haram in Muslim culture. In response, influential Islamic leaders issued fatwas clarifying that the vaccine was halal.
• India’s comprehensive and coordinated approach to eradicating polio serves as a model for public health initiatives, demonstrating that targeted efforts can effectively overcome significant health barriers.