NEW DELHI, India–The World Health Organization officially certified India as polio-free this year. To eradicate this disease, India received support from more than 2.4 million volunteers who administered 170 million vaccinations every immunization campaign. Volunteers travel door-to-door to conduct these six-day campaigns. Indian Health Minister Ghulam Nabi Azad commends this dedication:
“This monumental milestone was possible due to unwavering political will at the highest level, commitment of adequate financial resources, technological innovation…and the tireless efforts of millions of workers.”
India plans to sustain this commitment, arming its people battle the next opponent: measles.
Measles poses a formidable threat to India, whose failure to act further exacerbates its risks. The World Health Organization, Pennsylvania University, and the US Centers for Disease Control and Prevention report measles mortality declining by 74 percent between 2000 and 2010. Yet India reduced this rate by 26 percent, significantly less than every other region.
At 76 percent, Africa far exceeds India in the race to eradicate measles. Dr. Peter Strebel serves the Department of Immunization, Vaccines and Biologicals at the WHO. He faults “delayed implementation of accelerated disease control.” Measles spreads rapidly through India, with a reported 30,000 new cases and 65,500 deaths in 2010. This trend continued in 2011. That year, the disease claimed the lives more than 56,000 children. As NPR reports, this translates to an estimated 156 deaths a day.
Classified as “highly contagious,” measles threatens the health of the nearly 134 million unvaccinated children. Coupled with malnutrition, this virus reduces immunity to other diseases such as pneumonia, encephalitis and diarrhea.
But Highly Treatable
The measles vaccine stands as one of the most effective. Two doses provide “lifelong protection” and successfully reduced the global death toll by 390,000 from 2000 to 2011. A successful campaign immunizes 95 percent of children.
Yet these two doses must occur, because an estimated 15 percent of vaccinated children fail to develop immunity from the first dose. If 80 percent receives lifelong protection, the remaining 20 percent may suffer from widespread infection. This risk of an epidemic rises significantly.
Targeted Relief in India
More than a third of measles deaths occur in India. International agencies, however, learned from the polio campaign. In the initial campaign, volunteers administered two drops of the polio vaccine to infants. Today in Moradabad, health professionals join this effort to provide a second shot for measles.
Dr. Anisure Saddique directs the polio interventions in this region for UNICEF, and considers measles a greater challenge for India. Measles requires an injection, rather than drops. Volunteers administering the polio vaccine need one half-hour training. Measles, though, requires professionals comfortable with injecting the vaccine.
“We need trained manpower and these health workers within the government [are]limited,” reports Dr. Saddique.
The World Health Organization successfully implemented its first two phases. International and local professionals vaccinated more than 102 million children in 344 districts. This accounts for more than 87 to 90 percent of the youth population.
This success differs region to region. Gujarat, for instance, has dramatically improved coverage. In 2010, more than 1000 children required vaccination and by 2012, the threat fully dissipated.
Lessons From Polio
Dr. Nata Menabde represents WHO in India and credits the polio vaccination framework. Its “laboratory-based field surveillance network” helped agencies measure progress and intensify the program. The previous campaign “motivated local governments to train more people” and as a result, promise further expansion of vaccination programs.
Researchers note “synergistic links” between vaccination for polio and other diseases; the rate of children immunized against standard childhood diseases tripled with the expansion of polio efforts. In 2005, 18.6 percent of children in the state of Bihar received these routine vaccinations. By 2010, this rate grew to 66.8 percent.
The success of its polio campaign means India has the potential to eradicate other threatening diseases. Armed with these tools and knowledge on vaccination, a network of volunteers promise to protect future generations.