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Letters to the Editor

Indian Pediatrics 2003; 40:1101-1102

Polio Eradication: Future Strategies


I was interested to read the special article by Dr. Jacob John in the May issue of the Journal on the above-mentioned subject(1). Dr. Jacob John gives an excellent background of the problems, and the present situation of polio eradication in India. He is right in predicting that the wild virus will be eliminated very soon, perhaps in one or two years (the number of cases of polio until 21 June this year were down to 84 as compared to 1600 over the same period in 2002). He has very correctly mentioned the future concerns. It is quite probable that once the country is certified as polio-free, there will be a feeling of great achievement and complacency would follow with neglect of the (iv) to (vii) "milestones", listed by Dr. Jacob John(1).

I agree that the "IAP will not be found wanting in any responsibility assigned to it or voluntarily assumed". Indeed the past cannot be re-enacted. However, before we embark on redesigning the future, we should examine the role IAP has played in the planning and execution of the polio eradication program. Did IAP experts (and other national experts) have meetings with the Government and other agencies and give clear and firm advice? Does IAP have records of such meetings? Dr. Jacob John cites a newspaper report to mention that "the Health Ministry refused to approve IPV for use in India". Did IAP experts protest and raise a hue and cry? Is that on record? Dr. Jacob John’s highly critical views on the subject of polio eradication in India and the role of International agencies are of course well known.

IAP must now ensure that future strategies are well thought of, discussed and debated, and a consensus obtained. IAP experts should then interact with the Government and other agencies give their advice. This must be an ongoing, continuous process. Records of such meetings should be maintained and periodically presented to IAP members. Indeed such an exercise would be necessary in relation to various other vaccine preventable diseases. In future the IAP must put its might behind what is right. It would be extremely useful to have a branch office of the IAP at Delhi headed by a Vice President whose chief function will be to interact with the Government and a host of national and international agencies with their headquarters at Delhi. I have pleaded for that for several years.

I must also emphasise that many other issues need attention of the IAP and activism by IAP members. I cite from an item appearing in the Times of India of 8th April, 2002. According to statistics made available to the UN Secretary-general’s report. We the children, out of every 100 children born in India: 25 will not be immunised against any disease, 47 will suffer from malnutrition in the first three years of life, 15 will never go to school and of every 100 who begin first class, only 52 will reach fifth class. Pediatricians do not need to be reminded that 25 million babies are born every year. Let the IAP not be obsessed by single issues, but consider all matters that adversely affect child health and development and welfare.

R.N. Srivastava,
Past President IAP,
487, Mandakini Enclave,
New Delhi 110019,
India.

Reference

1. John TJ. Polio eradication in India: What is the future? Indian Pediatr 2003; 40: 455-462.

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