Towards a Polio free World – the End Game Plan

Abstract

Poliomyelitis, the dreaded cause of lameness, was ravaging the world in 1988; when more than 125 countries were endemic with the disease and about 350,000 new cases were reported every year. It could have been fanciful to consider eradicating the disease in any future. It was a resolve bold enough at the 41st World Health Assembly then to do it. The disease did provide epidemiological opportunities to make it a possible candidate for eradication and the idea was first realized soon in 1997; when the American region was certified as polio free; the last case being reported from Peru in 1994 (Louis Fermin Tenorio). Other regions did not fall short much; Mum Chanty of Cambodia was the last case from Western Pacific region in 1997 and the region was certified as polio free subsequently in the year 2000. Europe was the third region in the list; Melik Minas from Turkey had the disease in 1999; and the region got the same certificate in 2002.Meanwhile the story in India and South East Asian region was more protracted. Of the three types of polio viruses, the weakest one, wild type 2 was reported last from Aligarh in India in 1999. But it took another thirteen years to put a stop to the next type, wild type 3 (Pakistan in 2012). The last wild polio virus case of India and South East Asia region (onset on January 13) was found at Howrah in 2011 when poor Ruksar Khatun had contacted the disease. In 2012 India was declared no longer a polio endemic country. Later on the South East Asian region was certified as polio free on March 27, 2014. But in Africa and two countries of Eastern Mediterranean region ( Pakistan and Afghanistan ) transmission of wild polio virus continued. On July 24, 2014 last wild polio virus of Africa was detected in Nigeria. Subsequently the country interrupted wild polio virus transmission and was declared non endemic in 2015 leaving only two countries from the 125 when the journey had started. The latest of such glorious milestones was achieved when WHO certified that type 2 wild polio virus has been eradicated on September 20, 2015. The success story in India has been lauded greatly by the international community as technically speaking; the scenario had been most challenging in this country. But elsewhere, like in Afghanistan and Nigeria, things still pose problem – a huge number of children are still unreachable and the health workers being targeted with physical assaults even in 2012 and 2013.