Samnani AA
Following successful elimination of smallpox globally, international health agencies united for eradication of polio. In 1988 World Health Assembly (WHA) passed a resolution to launch Global Polio Eradication Initiative (GPEI). India adapted GPEI in 1994 based on evidence of successful campaigns in regional countries. Program was piloted in 1994 and launched nationwide in 1995 as Pulse Polio Program (PPI) with the initial objective of eliminating polio by year 2000 and achieve polio free certification by year 2005. GPEI was spearheaded by World Health Organization (WHO), and worked in collaboration with different international agencies and was also supported by Government of India (GoI). From the very beginning PPI was publicized and supported by local health officials, politicians and celebrities. India was polio hyper-endemic country reporting almost 5000 polio cases annually in 1995. Until 1999 PPI relied on vaccinating children under 5, by conducting National Immunization Days (NIDs). National Polio Surveillance Program (NPSP) was established in 1997 for capacity building and reporting of disease. Over the years program faced many programmatic and implementation challenges leading to delay in achieving targets. Most important challenge was failure to vaccinate among few key challenges. To confront these challenges multiple innovative midcourse corrections were made including missed house strategy, transit point vaccination, new born tracking, vaccination of migratory population and vaccinating at special festivals like Eid, Diwali. Teams were trained to answer myths and beliefs of people regarding vaccine and approached religious leaders also for help. Research in field of vaccine was encouraged and more efficient monovalent OPV and later bivalent OPV were introduced to overcome vaccine failure. India reported last case of polio in 2011. Despite enormous and diverse population, unhygienic conditions and many other challenges India succeeded to eliminate polio by proper planning, sustained funding, clearly defined roles and responsibilities and timely monitoring and feedback.
