Saturday, October 11, 2014

Pulse Polio Programme: success in India

Poliomyelitis often called polio or infantile paralysis, is a disease caused by a the spread from person to person of the polio virus. 
Most patients suffering from polio dont have any symptoms however in about  1% of cases, the virus enters the central nervous system leading to muscle weakness and acute flaccid paralysis which most often involves the legs. The legs of the affected person are paralysed for life.
Government of India launched the Pulse Polio programme, an immunization campaign which deals with vaccinating all children under age of 5 years against polio virus,   to eradicate polio in India. The programme started in India in 1978 and the last polio case was seen in 2011. In 2012, India was removed from the list of polio endemic nations and in 2014 , India was declared polio free. This is a big feat for a developing nation like India which has a population of over 1 billion people.
The success story of polio eradication is a story of innovation,  perseverance, dedication, commitment and partnership.  This programme has been successful due to participation of both the civil society and the government.

This project deals with the ways to fight poliomyelitis through a large scale immunisation programme, co-operating with various international institutions, state governments and Non Governmental Organisations, as part of the Global Polio Eradication Initiative, spearheaded by Rotary International, the World Health Organization, UNICEF, and the U.S. Centers for Disease Control and Prevention.

Major Success Factors are:
1. Strong, political and financial commitments
2. Meticulous planning, execution and monitoring
3. Generation of high quality data and objective evidence
4. Ongoing tactical and scientific innovations based on data analysis and research
5. Perseverance and resilience to overcome the range of challenges
6. Strong, enduring, effective partnership.

The programme required detailed microlevel planning such as house to house vaccination, tools to collect data child vaccination of every household ,putting a mark on every vaccinated childs finger in  order to identify unvaccinated children, putting a mark on every house in which children remain unvaccinated. In a population of over one billion people this was a tedious task but through combined efforts it was accomplished.

Two major challenges which have been seen and tackled during the programme are (1) failure to vaccinate (2) vaccine failure

The first challenge i.e., failure to vaccinate was tackled by massive human resource development for community mobilizations, reaching out to community leaders etc.

For example, the Kosi river belt in India is an area which constantly experiences heavy floods thereby making the area inaccessible. Thus it was a challenge to eliminate polio from this area and 10-15%  children were always missed during campaigns. This area was identified during surveillance programmes and a multipronged approached was taken to achieve high coverage in this area.

The second challenge i.e., vaccine failure was tackled by observing response to the three available vaccines i.e., monovalent, bivalent and trivalent. On realising that bivalent vaccine was most effective, this vaccine was used to achieve high elimination rates.

Many such road blocks were tackled effectively and timely to make india completely polio free. The last case of a polio patient a young girl called Ruksana was seen in 2011. Since 2011, no news cases have been detected however surveillance continues as unless polio is eradicated around the world , possibility of eliminating the virus from India completely is  distant possibility.

The success story of polio programme in India sets an example for the other countries which have not been able to root out polio completely. It is a testament that much can be achieved by concerted efforts of both thd civil society and thd government.

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