As India celebrates a decade of being polio-free, the nation’s journey remains a beacon of hope. The fight against polio was not just about defeating a disease but about empowering a generation with the promise of a healthier, brighter future.

For years, India was regarded as the most formidable battleground in the global fight against polio. Critics called it the “last country” to ever eradicate the disease, a feat deemed near impossible. Yet, what unfolded was a testament to human resilience, strategic innovation, and the power of global partnerships. By 2014, India achieved what once seemed unthinkable: the eradication of polio.

The Early Challenge: Polio’s Grip on India

In 1988, when the Global Polio Eradication Initiative (GPEI) was launched, an estimated 350,000 children worldwide were paralyzed or killed by poliovirus annually. Of these, over 200,000 cases were in India. Polio’s reach was exacerbated by the country’s vast population, inadequate sanitation, and the sheer density of urban areas, creating fertile grounds for the virus to thrive.

India’s first significant step in combating polio came in 1995 with the launch of the Pulse Polio Immunization Programme. Using the oral polio vaccine (OPV), the campaign aimed to reach every child under five years old. The program’s slogan, “Do Boond Zindagi Ki” (Two drops of life), became synonymous with the fight against the disease.

A Herculean Effort: Reaching Every Child

The scale of India’s immunization campaigns was unprecedented. Twice a year, National Immunization Days (NIDs) targeted over 170 million children in a span of just five days. Supplementary Sub-National Immunization Days (SNIDs) covered high-risk areas, reaching nearly 75 million children up to eight times annually.

To ensure no child was missed, health workers meticulously mapped every dwelling, from urban slums to nomadic settlements. Mobile teams vaccinated children at train stations, bus stops, and even on moving trains. Special strategies targeted underserved populations, including migrant workers and those living near international borders.

Innovation in Action

• Microplanning: Localized plans tracked every household, including pregnant women and newborns, ensuring timely vaccinations.
• Surveillance Systems: Acute Flaccid Paralysis (AFP) monitoring and environmental surveillance of sewage provided critical data to detect poliovirus hotspots.
• Community Engagement: Religious leaders, volunteers, and local influencers helped build trust in communities skeptical of vaccinations.

The Turning Point: The Case of Rukhsar

On January 13, 2011, in a small village in West Bengal, a two-year-old girl named Rukhsar became paralyzed by poliovirus. This marked the last reported case of wild poliovirus in India. Despite never leaving her village, the virus had traveled 1,500 kilometers from Delhi, underscoring polio’s tenacity.

India’s response was swift and decisive. Within five days, an emergency immunization campaign blanketed neighboring villages, effectively cutting off the virus’s transmission route. This level of rapid mobilization demonstrated the program’s strength and adaptability.

Behind the Success: Partnerships and Policies

India’s polio eradication success was a collaborative effort led by the Government of India and supported by international partners, including the World Health Organization (WHO), UNICEF, Rotary International, the Centers for Disease Control and Prevention (CDC), and the Bill & Melinda Gates Foundation. These partnerships brought technical expertise, funding, and innovation.

The government’s political will played a critical role, ensuring consistent support and resources. The Universal Immunization Programme (UIP), launched in 1985, provided the backbone for routine immunization, targeting over 2.67 crore newborns and 2.9 crore pregnant women annually. Over time, the UIP expanded to include new vaccines, strengthening the country’s overall immunization infrastructure.

Key Innovations in India’s Polio Campaign

• Cold Chain Management: Efficient vaccine storage and distribution ensured quality despite the country’s vast geography. Tools like the Electronic Vaccine Intelligence Network (eVIN) modernized logistics.
• Introduction of IPV: In 2015, India adopted the Inactivated Polio Vaccine (IPV) as part of the global strategy to address type 2 poliovirus.
• Mission Indradhanush: Launched in 2014, this initiative aimed to improve immunization coverage for hard-to-reach populations, reinforcing India’s broader public health goals.

Certification and Vigilance

In 2014, the WHO certified India as polio-free after three years without a single case of wild poliovirus. This was a moment of triumph, celebrated globally as a landmark achievement in public health. However, the victory was not the end of the journey.

To safeguard against re-importation, India maintained robust surveillance systems and continued annual immunization campaigns. Vaccination at international borders and monitoring sewage for poliovirus ensured continued vigilance.

Lessons and Legacy

India’s polio eradication saga is a story of determination and innovation. It showcased how targeted, community-centric interventions can overcome seemingly insurmountable challenges. The campaign’s success offered valuable lessons for global health initiatives, proving that even in the most challenging environments, diseases can be eradicated with the right strategies and commitment.

As India celebrates a decade of being polio-free, the nation’s journey remains a beacon of hope. The fight against polio was not just about defeating a disease but about empowering a generation with the promise of a healthier, brighter future. With continued vigilance, India is not just polio-free – it is a symbol of what humanity can achieve when it works together.

Image: UNICEF