Friday the 13th is a day known for superstition, fear, and bad luck. But today, the global health community in India attained a milestone that will ensure that we remember this Friday the 13th as a day of progress and hope. As of today, India has gone an entire year without a case of polio. In technical-speak, this means that India has officially interrupted transmission of the virus and is no longer considered an endemic country, leaving only three countries (Pakistan, Afghanistan, and Nigeria) remaining in the world with endemic status.
Experts have long considered India to be one of the toughest places in the world to fight and eradicate polio. After all, India is neither a small nor homogenous place, and just two years ago, India had 741 cases of polio—the most in the world. How did they achieve this milestone?
- They immunized, and they immunized again: India held two National Immunization Days (NIDs) in 2011, and during each NID, an amazing 2.5 million vaccinators delivered polio vaccines to more than 172 million children. For children who weren’t reached by the NIDs, India organized 7 Sub-National Immunization Days to focus in on more remote and high-risk areas.
- They innovated: Indians didn’t just rely on traditional vaccine education and delivery methods. They met parents and children where they were—at bus stops, in construction sites, on motorbikes. They also fostered pressure and incentives for their health care workers, ensuring accountability and consistency in their delivery program.
- They fought stigma and misconception: Particularly in Muslim sections of India where concerns about vaccines were more common, polio eradication programs engaged religious leaders at all levels to build trust among parents for this safe, effective health intervention.
- They led from within: Though the role of groups including the GPEI partners and the Gates Foundation can’t be overstated, India is a success story because Indians have also stepped up. Since the National Polio Surveillance Project was established in 1997 by the Indian Government and the WHO, the program has grown, become more effective and targeted, and has built a platform that now allows for greater progress on other diseases. Local stakeholders including teachers, religious leaders, and health workers have been on the front lines of the fight. And critically, the Indian government has financed the vast majority of the eradication effort with its own resources—an example for other emerging economies to follow.
And why, as an Africa-focused organization, should we pay so much attention to this achievement? For many in the global health community who often feel like the challenges are endless, this shows that real progress is possible—and not just in the “easy” places. This milestone should rejuvenate global efforts to eradicate polio, including from the last remaining endemic country in Africa (Nigeria) as well as other countries which had once eliminated the disease but have seen a resurgence in recent years (including Angola, Chad, and the DRC). At a time when vaccination rates are on the decline in some regions, each successful immunization campaign—and the press generated around it—also helps to reinforce the safety and value of vaccines for parents around the world. The tactics India used to achieve this goal should also serve as a lesson for other countries and other global health challenges; persistence, innovation, and country ownership are fundamental to effective development programs, and will remain so long after polio is eradicated.
Please join me in congratulating the millions of people who have dedicated time, resources, and political will toward making this a momentous—and happy—Friday the 13th!