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India celebrates eradication of polio, sets sights on new disease

The vaccination program in India offers lessons for other nations, reports Leigh Nicholson.

Image: Polio vaccination in Mumbai

In what Bill Gates has called a ‘fragile achievement’, in January the World Health Organization declared India polio-free as it marked three years since the last reported case of the disease. An incredible feat, considering that in 2009 India had the highest number of reported polio cases worldwide. The success was the result of not only overcoming the logistical obstacle of multiple polio strains, but also an innovative method of resolving anti-vaccination reluctance.

Deepak Kapur, the head of Rotary International’s anti-polio campaign in India, claimed one of the top challenges facing the campaign’s success was social and religious hesitation by individuals to get themselves and their children vaccinated. Kapur said there were originally rumors circulating that the polio vaccine was designed to make children infertile, but also that the vaccines were not allowed under Islamic faith due to the containment of banned substances by religious scriptures. To overcome this, the campaign enlisted the help of Muslim clerics to aid in education and awareness about the benefits of vaccination, with the help of the Rotary Muslim Ulema Committee.

Another contributor to the campaigns’ success was the methodical nature of the programs, taking place multiple times each year, involving approximately 2 million vaccinators going door to door. This made it easier to communicate the risks of polio and the benefits of the vaccine on a more local scale.

The three remaining countries with a polio epidemic are Pakistan, Afghanistan and Nigeria; however, recent reported cases in Syria indicate the disease has been reintroduced, likely due to the foreign conflict in the country.

In 2011, Pakistan had the most recorded cases of polio worldwide and has been attempting to implement an eradication campaign similar to that of India’s, but has been faced with massive obstacles in anti-vaccination ideologies. The religious opposition to the campaign is similar to that which India faced, but the manifestation of that opposition has been to a greater extent. In 2011, the US used a Pakistani vaccination campaign to gather information on Osama Bin Laden. The resulting rise in tensions between anti-polio workers and the Taliban caused violence and death threats inhibiting the initiative. In June last year, the Taliban announced a ban of polio vaccinations, severely affecting the campaign. Early this year, the killing of three anti-polio workers in Karachi prompted the halting of vaccination efforts in the area.

The next eradication campaign in India is an attempt to fully vaccinate against measles. The disease is currently one of the leading causes of death in young children because when it lowers immunity in sufferers, it also increases the risk of other illnesses taking hold.

The success of India’s polio eradication program resulted from the integration of social and religious considerations, as much as it was the medical accomplishment of the combined polio strain vaccines. In an interview with the New York Times, Kapur emphasized that the success of India’s program was by bringing together political authorities and the Ulema, Muslim clerics, and getting them to communicate together. The longevity of this success, he says, is very much dependent on trying to ‘rapidly get rid of the virus from the rest of the world so we don’t have to fear reintroduction’.

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