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Letters to the Editor

Indian Pediatrics 2003; 40:1099-1100

Polio Eradication in India


The excellent and honest assessment of polio eradication in our country(1) and acceptance of failure of polio experts and advisors "who misread the science", need introspection by all pediatricians, because Academy has been a party to the government as advisors. We can not be absolved of the responsibility by just blaming the government for "failure to assert its autonomy", and brush away our conviction and approach towards increasing NIDs for polio eradication.

The case for switching over to IPV is convincing, but "the government has been urged to develop a clear policy and plan of action in terms of IPV"(1) need consideration of the logistic and economic burden of providing minimum 2 doses of IPV to 25 million births per year(2), which would further stretch a flail economy of the country.

The observation of low coverage of UIP vaccines to the tune of 15-25% in UP and Bihar, is no exception. Surprisingly, a survey conducted in December 2002 in children <3 years of age at Udaipur, showed that only 66.04% had received 3 doses of OPV/DPT and 0.92% of these never received any dose of polio vaccine in spite of passing through repeated NIDs.

The efforts of government agencies to project "achievement of targets" in terms of polio vaccine, is of serious concern for polio strategy planners. The table of proposed milestones is a wishful dream because in presence of 81 cases till 24, May 2003, and still higher number of cases expected in next 3-4 months, the eradication target to be achieved till end of 2003 is unimaginable.

All efforts would fail in view of lack of consumer participation, overbearing cost of repeated pulse polio immunization days, decreasing routine immunization rates, and overburdened staff-and campaign fatigue(3) because of frequent NID-which has caused a great loss of initiative and enthusiasm amongst them, leading to low coverage and defeating the purpose of NID.

In view of reports of number of countries eradicating polio with 2 NID-conducted efficiently with good coverage(3) we need to review the scientific facts of eradication in light of behavioral barriers of population/providers of polio services of UP and Bihar, to plan revised methodology for IAP polio eradication move.

A.P. Gupta,
Associate Professor,
Department of Pediatrics,
RNT Medical College,
Udaipur, Rajasthan, India.

References


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

2. Mathew JL, Gera T, Mittal SK. Eradication of Poliomyelitis in India-future perspectives. Pediatr Today 2000; 3: 647-660.

3. Gera T, Mathew JL, Mittal SK. Poliomyelitis in India: Past perspective and current scenario. Pediatr Today 2000; 3: 604-612.

 

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