Eradication of Polio in India: Pulse Polio Programme

Polio. A word that caused havoc. A word that brought immense fear to mind. A word that people lost their loved ones to.

The Global Challenge of Polio

During the 20th century, the polio virus was rampant all over the world. The virus paralyzed children in the hundreds of thousands every single year. The virus spread from person to person through contact with the faeces of an infected human or droplets of a cough or sneeze of an infected person. It was a major problem. Thankfully though, the issue was tackled with everything the world could give it.

Pioneering the Pulse Polio Initiative

In India, the Government undertook The Pulse Polio Initiative on a national level to eradicate poliomyelitis, better known as polio. The programme was introduced in 1998, following the worldwide investment in the elimination of polio. India’s initiative essentially followed a programme of targeting children below 5 years and administering polio medication to those in high-risk areas. They conducted this drive every year in National and Sub-national bouts of immunization. India has now been declared a polio-free country by the World Health Organization since there have been no cases of wild polio since 2011. However, this feat was not achieved overnight. No, it took India over 10 years to get to this stage. And Pulse Polio was her path.

Objectives and Strategies of Pulse Polio

The Pulse Polio Initiative has a clear objective. 100% eradication of polio. Indian researchers tried to understand how exactly to go about this process. Unlike developed countries, parents in underdeveloped countries aren’t as motivated to bring their children in for routine check-ups and vaccines. That’s when a virologist from Vellore suggested the usage of Pulse vaccination. Pulse immunization essentially eradicates an epidemic by repeatedly inoculating an at-risk group until the virus or pathogen has been stopped. According to Pulse Polio, they “aimed to immunize children through improved social mobilization, plan mop-up operations in areas where poliovirus has almost disappeared and maintain a high level of morale among the public.”

Implementation Challenges

In a country like India, with population numbers extremely high, it was a huge task and commitment to administer the vaccine. Pulse Polio dispensed the polio vaccine in the form of oral drops called OPV (Oral Polio Vaccine). All children within 5 years of age were provided with this twice a year. Children under the age of 1 were provided with IPV (Inactivated Polio Vaccine). The Government began declaring 2 days of the year as National Immunization Days (NIDs). Apart from this, Sub-National Immunization Days were also conducted in areas where there was a considerably higher risk of the poliovirus. Since the conception of the campaign, 17.4 crore children have been the beneficiaries of the OPV.

Community Engagement and Awareness

India aspired to reach all sectors of society, especially those in remote areas. They did not want any child to be overlooked in the process and potentially risk being infected. In order to conduct their campaign successfully, they needed to address preventive measures as well as contain the virus wherever there was an outbreak. Hence, they amped up surveillance everywhere. Desks and booths were set up all across the country. Vaccines were made sure to be available at all times in cold rooms close by enough to be brought to booths as and when required. Employers and volunteers were arranged all over, and children that weren’t present during immunization were spotted. Marketing and publicity of the campaign were a must in order to reach to the masses, garner support and raise awareness about the dreadful poliovirus.

Overcoming Obstacles

While poliovirus immunization helped the country take a step in the right direction, there were many difficulties that were faced along the way. In rural sections of the society, many people refused to help in the campaign because of caste-based discrimination they were facing by the health officials. In most developed countries, the polio vaccine was required to be administered some three times in order to immunize kids. However, in India, and other developing countries, they began facing a different type of issue wherein just 3 doses of the vaccine did not really protect the children. Instead, Indian children required anywhere between 8 to 10 doses to be fully immune to the virus. There was a pressing concern when it came to Indian children because many of them were too weak, constantly battling diarrhoea, which diminished the power of the vaccine in and of itself. This, coupled with issues such as open defecation, monsoons, and poor treatment of water, led to the virus being spread further. Parents began doubting the drops as they saw that the number of cases of polio was actually increasing and so were the dosage amounts. The polio vaccine actually consists of a weakened but live poliovirus. In a rare few cases, this vaccine was actually the cause of paralytic polio. There were many more problems throughout the duration of the campaign, such as battling rumours about the vaccine being made out of dog blood or pig fat, poor support from the community, including doctors and other healthcare professionals, and problems in the maintenance and procurement of the vaccine, etc.

A Legacy Achieved: Continued Vigilance

Despite the challenges India faced, they managed to make sure that they reached the 100% eradication goal of the Pulse Polio Initiative. However, this does not mean that the virus can never resurge. This is why India still maintains surveillance of poliomyelitis and administers the OPV on NIDs. Pulse Polio was a success, one that had many bumps along the way, yet one that smoothed them over to reachthe end. The last noted case of polio in India was in 2011 when Rukhsar Khatoon was infected.