Polio Eradication in India

Getting to the Verge of Victory--and Beyond?

India’s struggle against major health challenges in the past few decades has been a white-knuckle ride, with India illustrating some of the best, as well as the worst, of the health problems of the developing world. But now—even though those closest to the effort are unwilling to declare victory prematurely—there is a good chance that India’s polio eradication campaign will tell a more inspiring story. In 1988, when the World Health Assembly formally adopted polio eradication as a global goal, WHO data recorded 23,800 cases of polio in India. At this writing, it has been a year since the last case was identified, in West Bengal on January 13, 2011.

If this milestone endures, it will be the result of a persistent and focused effort and unprecedented collaboration among Indian scientists, administrators, and their international counterparts. The campaign has combined cutting-edge research on vaccines, old-fashioned door-to-door follow-up, public and private outreach, political drive, and relentless surveillance. It has had to overcome what the program’s Indian and international leaders regard as a unique combination of biologic and epidemiologic challenges, as well as classic speed bumps in navigating India’s bureaucracy. The effort’s ultimate legacy—beyond the unquestioned benefit of reducing or eliminating paralytic polio—will depend on how India’s health leaders consolidate their victory, and how they embed the institutional sources of their apparent success into the country’s remarkably diverse health system.

Teresita C. Schaffer