Polio-free India: a fantastic achievement

A lasting memory from my recent holiday in India is recalling the pride that people took in telling me that a polio-free subcontinent was expected to be declared by the WHO in February 2014. The world’s largest democracy had gone from being one of the most affected countries in the world - with the last case in 2011 - to achieving this monumental feat through public support and conviction, political will and an ambitious public health campaign.

That’s some achievement in a country of 1.2bn people, 70% of whom live in rural areas. It’s not surprising however, because during each of the two yearly national immunisation days 640,000 vaccination booths with 2.3 million vaccinators (doctors, nurses, lab workers, surveillance medical officers, trainers, vaccinators, teachers, students, health and community workers, religious leaders, volunteers and local NGOs at national, state and district levels), 200 million doses of vaccine and 6.3 million ice packs, visited 191 million homes and immunised 172 million children.

I think that’s impressive in anybody’s books and something they should rightly be proud of. I’m sure President Roosevelt - probably the most famous person to have contracted polio - would’ve been equally proud of them, were he alive today!

I was particularly interested in this achievement because I think that here in the west we’ve almost forgotten how dangerous measles, mumps, rubella, polio, whooping cough and so on can be - infectious diseases that are prevented through our excellent, voluntary, childhood vaccination programme by achieving herd immunity. We may have even become complacent.

Yes, we remember the terrible years in the 1990s when measles was reported to be a causal factor in autism due to Dr Wakefield’s well publicised but ultimately base-less research, and when the uptake of MMR dropped to a low 80% because parents were terrified of the possible consequence of the vaccine for their children. Levels of around 95% are needed to prevent outbreaks of disease.

But the 2012-13 measles outbreak in Wales lingers in our recent memories because of its seriousness: the death of a 25-year-old man and confirmation that the majority of those who became infected were not immunised as infants during the MMR scare.

Polio has almost receded from memory in the UK too, although we remain vigilant and still routinely vaccinate babies against polio as part of the childhood immunisation programme in which nurses and doctors play a vital role. The disease is spread by poor sanitation, such as faeces-infected drinking water. The injectable polio vaccine was discovered in 1955 by Dr Salk and the oral version was developed in 1961 by Dr Sabin.

The last reported case of polio in the UK was in 1982, but many nurses will have encountered people living with the consequences of it - still usually degrees of paralysis in the legs.

I’m pleased to have played a small part in another major achievement: the smallpox eradication and immunisation campaign in Ethiopia in the 1970s. Alongside Somalia (as it was then) and Kenya, Ethiopia was one of the last countries in the world to report a case, in 1976. Kenya and Somalia reported their last cases in 1977 and smallpox was declared officially eradicated by the WHO in 1979.

Since then, the only known cases were caused by a laboratory accident in 1978 here, in Birmingham. This killed one person and caused a limited outbreak.

Let’s hope polio will soon be consigned to history, just like smallpox has been. It’s still endemic in Pakistan as well as Afghanistan and Nigeria however, and until transmission of the virus is interrupted in those countries, all others remain at risk. Perhaps the development that India is experiencing will become the trigger for theirs also?

About the author

Bríd Hehir is a fundraising manager for Do Good Charity which sponsors nurse training and education in Africa. She worked in the NHS until 2011 - as a nurse, midwife and specialist heath visitor and latterly a senior manager. She is a regular contributor to spiked and is a Battle of Ideas Committee member.