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Could this be the end for polio in India?

Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, cases of polio have been reduced by more than 99 per cent. In 1988, over 350,000 people contracted this cruel disease. In 2009, there were fewer than 2000 cases and last year, just over 1,000 infections were recorded.

In the last months of 2010, a huge immunisation programme was launched across the African continent. Oral vaccine drops were provided for around 72 million children living in 15 countries. The programme included 29 million children in Nigeria, the only African country where the disease remains endemic. Now in 2011, attention is focusing on Asia, where polio remains endemic in 3 remaining countries – Afghanistan, India and Pakistan.

In late January, India began a huge drive against the disease. 2.5 million government workers, with assistance from international non-governmental organisations (NGOs), began visiting 68 million homes to deliver oral vaccination drops to children. This immunisation programme will vaccinate 172 million Indian children against the disease.

The GPEI organisation says India is “standing on the edge of a dream”. Polio infections in the country are at an all time low, with just 40 cases reported in 2010 (as at 17th November), compared to nearly 400 in 2009. Experts believe the Indian government has a window of opportunity to extinguish the last pockets of the wild poliovirus remaining within its borders. The highest risk regions are Uttar Pradesh and Bihar, but even these states have gone for their longest period of time without any new cases being reported.

But the battle against the disease will not be straight-forward. Even if villages and towns in high-risk areas are covered by the immunisation programme, there is a risk that some migrant workers continue to carry the disease. Polio virus (of types 1 and 3) has been found in sewage samples taken in Delhi as recently as August, suggesting children of construction workers may carry the disease. When they move back with their families to other states, polio outbreaks could reappear.

However, agency and government workers are optimistic that all efforts possible are being made to eradicate the disease. As well as the scheduled immunisations, any reported cases of polio will trigger a rapid large-scale taskforce to target the surrounding area. Nigeria and India have been the two most consistent sources of polio outbreaks worldwide. In 2010 alone, the Indian virus infected people in Nepal, Tajikistan, Kazakhstan, Turkmenistan, the Russian Federation and the Republic of Congo. Success in eradicating the disease in India, will not only therefore be a hugely important for the country, it could also help to spell the end of polio worldwide.

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