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How India became polio-free

Rotarian Dr. Scott Leckman immunizing a child against polio in Madurai, India.
Rotarian Dr. Scott Leckman immunizing a child against polio in Madurai, India.
Frances Johnson

This week marks three years since India’s last reported case of polio. This milestone puts the country on course for being declared polio-free by the World Health Organization later this year.

Being declared polio-free is a tremendous achievement for India, which reported 200,000 new cases in 1988, and as recently as 2009 still reported 741 cases, more than any other country in the world according to the Global Polio Eradication Initiative. The victory now has experts asking how India defeated polio, and how it could be repeated in other countries.

One answer is complex, large-scale logistics and highly organized vaccine teams that operated in staggering numbers. In just one campaign last January, 2.3 million vaccinators administered the polio vaccine to an estimated 172 million children — a number equivalent to about half the population of the United States — over the course of five days, according to the New York Times.

Teams went door-to-door administering vaccine by oral drops to infants and children. Dan Morrison of the New York Times reported that vaccination teams sometimes worked 24 hours a day at roads and intersections where they approached parents, and they vaccinated an estimated 100,000 children on moving trains alone.

“India’s successful war on polio shows what can happen when its government sets clear policy goals backed with proper funding and real accountability,” noted Morrison, who pointed out that health officials and frontline workers alike faced disciplinary action if they failed to perform.

Addressing local concerns also helped close the gap. Some districts resisted vaccination because parents didn’t think polio was a risk, or had heard rumors that vaccines had adverse effects like impotency, according to the BBC.

Community workers stressed the importance of hygiene, sanitation, breastfeeding up to the age of six months, and routine immunization. The campaign gathered momentum, reports the BBC, when it sought out marginalized groups and worked with religious leaders in Muslim communities to promote vaccination.

Nicole Deutsch, head of polio operations in India for UN children's charity Unicef, told the BBC that the partnership of government, partnerships with Rotary clubs, WHO and Unicef were to thank for India’s success, “and above all, the tireless hard work of millions of frontline workers — vaccinators, social mobilizers, and community health workers," Deutsch said.

Polio remains a health risk in other countries, including some of India’s neighbors, and “India needs to stay extremely vigilant” to continue to protect children from polio," Deutsch told the BBC. She said that India has already planned six more campaigns for 2014 and 2015, with another 2.3 million vaccinators in each campaign.