World Polio Day: Will babudom and prejudice undermine India’s internationally acclaimed polio success story?  

India was problem, everyone agreed. Forty years ago, World Health Organisation’s (WHO) apex body, World Health Assembly (WHA), resolved to ericate polio. It was a deeply controversial decision because, to many, it seemed wildly ambitious. re were at least 1,000 cases a day around world and, of those, more than half occurred in India. In one part of Tamil Nu, two of every thousand children under of five developed polio every year. annual cost to nation was estimated Rs 45,000 crores.  

It was never said explicitly but attitude of global community hn’t shifted much since 1948. India was vast, chaotic and often ungovernable. Democratic, yes; mirable, sometimes; infuriating, often; but evidently t capable of dealing with a hyperepidemic that was fiendishly complex and tied to intractable problems of poverty and sanitation. Controlling polio depended on reaching every child in every remote vill with a series of polio drops or injections in coordinated campaigns.  

India’s many gods seemed, to gared experts, symbol of a country where -one was in charge and -one ever could be. Pakistan, on or hand, was authoritarian but resolute and a firm ally of America in everything from defeating communism to defeating polio.

In a 1994 interview, officials from US Centers for Disease Control (CDC) predicted total polio erication in Pakistan within two to three years. And, y reassured mselves, Pakistan would soon oversee Afghanistan too. 

This week marks World Polio Day (WPD) and things seem very different. At an international press conference today, all eyes will be on Pakistan and Afghanistan, last two countries where polio is endemic.

As of today, re h been just 20 cases globally so far this year. press conference will see videos of heroic women and men who struggle every day to reach every last child in Federally ministered Territories and in Kandahar.

Some of se polio workers have died and ors have been wounded terribly -- usually by criminal gangs claiming to act in name of fundamentalist Islam. would-be fundamentalists love polio -  it is a magnet for international funds and it gives m lever with embarrassed governments. Few of polio workers are paid regularly and fewer still are recognised properly, but still y fight on. When polio is finally history, it will be thanks to se decent, dedicated men and women. 

On our side of border, Rukhsar Khatoon, of Shahpara vill, near Kolkata was only eighteen months old when she me history. In January 2011 she was last Indian child to contract polio. In 2014, country was declared officially free of polio. Many rushed to claim credit -- in early 2012, Gates Foundation dispatched an American writer to find Rukhsar who h h a mild case of polio, recovered fully and sensibly dived under her mor to avoid attention. But, this was an Indian success story. 

Polio showed what vast, chaotic fractious India could achieve when it wanted to. Epidemiologists plotted epidemic and countered it like chess grand masters. Prime ministers such as Atal Bihari Vajpayee and chief ministers such as Dr Harsh Vardhan in Delhi cajoled and encourd health system. Geniuses like former President A.P.J. Abdul Kalam applied techlogy to helping polio survivors.  And, after over 30 years of grind, it was gone.  

Today, polio risks showing or side of this kind of national resolve: what happens when mission is over and focus shifts. 

re is this month, a continuing national scandal over “tainted” oral polio vaccine (OPV) from an Indian vaccine manufacturer, Biomed. scandal is t that vaccine was dangerous -- although it was -- or that Biomed’s directors immediately went on run from investigators -- although y did. Rar, it is that India continues to use a vaccine designed to ericate polio, rar than one designed to keep country polio free.  

OPV may or may t have been right way to ericate polio. WHO and India’s 'babus' convinced mselves that it was, even though oral vaccine includes weakened but still living polio virus. So, it carries a small risk of causing polio-like disease, especially in some communities where many children miss some of ten or twelve doses that are often necessary. (That’s why news reports always talk of “wild” polio; y mean cases that weren’t caused by vaccine).  Many say it was science that convinced bureaucrats - some are more inclined to think that it was that OPV was produced by state-linked enterprises in many countries, including India. 

Everyone agrees, though, that OPV will have to be ditched as soon as last case of wild polio has occurred. Professor T Jacob John of Christian Medical College (CMC) Vellore, one of world’s foremost authorities on polio,  wrote five years ago, that Vaccine-Derived Poliovirus (VDPV) “…may silently circulate for many months, even 1-2 years, before showing up with polio cases … day OPV is discontinued, silent transmission of VDPV may alrey be happening in community.” solution, he pointed out, was to start introducing injectable, inactivated polio vaccine (IPV) that has been used for deces to protect children in Europe and rth America. IPV can protect children from both wild and vaccine-derived viruses. Professor John was right as we still hear reports of VDPV every year in India. 

IPV has been in India’s routine immunization programme for two years but I’m told that progress is achingly slow. H every Indian child been protected by IPV, that Biomed error would have been much less of a threat.

Officials mutter about shorts but, in vance of Monday press conference, I asked Safi Pasteur, world’s largest IPV producer, if re were any supply problems. re aren’t - vials don’t even have far to travel. y are produced in Hyderab.  

India has defied global expectations and achieved something remarkable. We cant let bureaucratic inertia and prejudice undermine it.