ERADICATING THE
MENACE OF POLIO
The initiative
to eradicate polio from India was taken in 1995. Since then significant
progress was achieved by 2001 in limiting the spread of the virus
in western and central Uttar Pradesh and Bihar. It appeared as
if the disease in the country would be eradicated by the end of
2002. However, polio eradication efforts in India had a major
setback due to its large-scale outbreak in Uttar Pradesh spilling
over to other States.
India had around
83 per cent of the global cases of polio during 2002. July 3 this
year India has reported 87 out of 183 cases reported globally.
In 2001, 11 States
had reported 268 cases spread across 63 districts. The number
of polio cases in 2002 increased to 1600 in 159 districts spread
over 16 States. Till July 3, 2003, 87 cases were reported from
52 districts in 11 States.
Current Scenario
To review the
polio situation in the country and recommend strategies to accelerate
the pace of its eradication, meetings of the India Expert Advisory
Group (IEAG) for polio eradication were convened at Lucknow in
November 2002 and February 2003. The expert group observed that
the increase in cases in 2002 was because of a major outbreak
of poliovirus in Uttar Pradesh that spread into Bihar and other
States. The factors contributing to the situation varied.They
included the decrease inState-wide immunization campaigns during
the low season from six during 1999-2000 to four during 2000-2001
and to only 3 during 2001-2002. There was a wide gap between large-scale
supplementary immunization activities in most parts of the country
resulting in the accumulation of susceptible children, especially
in the age group of under 0-2. The timing of the supplementary
immunization activities was not appropriate to cut down the viral
transmission in the pre-epidemic period.
The year 2002
saw the re-establishment and circulation of poliovirus in West
Bengal, Rajasthan, Madhya Pradesh, Gujarat, Delhi, Jharkhand and
Haryana. These States had either completely interrupted polio
transmission or reduced it to very low levels by 2001 but saw
its resurgence during 2002 due to the accumulation of a large
number of susceptible children because of the failure to reach
all children with polio drops during the immunization campaigns
and routine immunization. Children in western Uttar Pradesh, particularly
in the Muslim community, had been consistently missed because
of their non-cooperating attitude during the earlier immunization
campaigns.
Initiatives
In view of these
findings, the expert group recommended the essential activities
to combat the wild poliovirus transmission in India. Two rounds
of National Immunization Days (NIDs) were proposed in January
and February 2003 besides another two-rounds of Sub National Immunization
Days (SNIDs) between April-June 2003 in Uttar Pradesh, Bihar,
Delhi and in the high-risk areas of West Bengal, Gujarat and other
States based on the epidemiological situation.
Two rounds of
SNIDs are further proposed between September-November 2003 in
Uttar Pradesh, Bihar, Delhi, West Bengal and Gujarat based on
the epidemiological situation. Large-scale mop-ups in all areas
other than the SNIDs areas are also being introduced following
detection of wild poliovirus. To improve the quality of the immunization
campaigns, the expert group has recommended taking up remedial
actions to address the operational problems.
The Cabinet approved
the recommendations of the expert group in its meeting on July
28, 2003 and has also approved an expenditure of Rs. 605 crore
for the implementing the strategy.
The Prime Minister
in his meeting on January 16, 2003 with the Chief Ministers of
Uttar Pradesh, Bihar, Madhya Pradesh and Rajasthan specially stressed
on the need for concerted efforts to eradicate polio. In a high-level
meeting, the Union Health and Family Welfare Minister, the State
Health Ministers and senior officers of the ten high-risk States
of the country reviewed the preparedness of each State for the
campaigns prior to the April Sub National Immunization Days (SNIDs).
A Regular monitoring and reviewing of the situation in all States
by senior officers of the Central Government has been made mandatory.
Extra efforts
have been made to improve social mobilization for a better involvement
of the Muslim community. Social mobilisers are being deployed
in focused areas where the acceptance of polio drops was low due
to misinformation of the community.
Microplans have
been revised to ensure that all houses are visited and every child
immunized besides ensuring that the composition of teams is modified
suitably to have community members as part of teams. Each campaign
is flagged off on a Sunday which is termed "polio ravivar".
The coming Sunday, i.e., September 14, 2003 is the next SNID.
This would ensure not only better participation of the volunteers
but also of the community.(PIB Features)
