Marking a "Polio Free" Year in India
Sitting by a makeshift immunization booth in Baramati Taluka, Maharashtra, India, in an old government owned off-road vehicle with 4 vaccine carrier boxes, I was not thinking of halting wild polio transmission in India.
On that hot dusty day in 1995, it all seemed to be a great big “tamasha1”, especially to a newly minted medical graduate on his first field experience – running around with additional vaccine carrier boxes, checking the labels, ensuring all babies under 5 were being counted, coaxing people to come to the booth… yes, polio was preventable, with just a drop of the vaccine; indeed it needed to be, but did we have to do all of this? And in all of India at one go?
The answer slowly sank in: Yes, and much more, as the last 17 years of work has taught us. Tackling polio on a massive scale in a country that was not doing too well on its universal immunization program seemed counter-intuitive, but it has demonstrated what well thought out and funded programs can achieve at the grassroots level.
On the way, it enabled a better understanding of how communities need to be engaged in health programs, and how clear and honest communications formed the bedrock of relationships between a public health program and the beneficiary communities.
It also paved way for innovations in delivery of health services, from the use of micro-planning techniques, GPS technologies to track teams and vaccine consignments, team building and retention of talented people, and dedicated funding within the national budget. It showed what Indians and their government could do if they put their will to it. Through Rotary, thousands of middle class Indians came out onto the streets to be part of the delivery mechanism on pulse polio Sundays.
The proof is here today to see: A year has passed by since the last wild polio case was detected in India. Indian investment and global support have brought things so far, a critical watershed moment. The next challenge is to maintain another 24 months of polio free status to truly be able to say that endemic wild polio transmission in India is a thing of the past, and to use the experience and infrastructure to raise the rates of immunization coverage among all children for the other diseases for which vaccines are available.
Meeting this challenge with enthusiasm, both for maintaining wild polio free status and covering other vaccine preventable diseases will set India up on the path to reducing its infant mortality numbers.
Dr. Bobby John
Global Health Advocates India
1Tamasha: Hindi word for light hearted entertainment