Tomorrow India observes another year without reporting a single case of wild poliovirus for the second time in history. This was possible in part due to great progress made in the polio eradication programme of India, which was until 25 Feb 2012 the only polio endemic country among 11 countries of the World Health Organisation's (WHO) South-East Asia Region.
As we recognise the tremendous achievements made and milestones reached, we need to emphasise how we reached this milestone and why we need to continue our efforts without faltering.
The success which brought us to this point was a collective effort and needs to be highlighted as proof that partnerships, when designed and implemented robustly, yield measurable results and have a positive impact on public health problems.
The commitment of all levels of government, from federal to state, provincial down to local levels of all governments proved to be a critical lesson learned. The close communication and collaborative efforts between governments and polio partners mainly CDC, Unicef, WHO, Rotary International and the Gates Foundation were critical in ensuring high performance of the programmes across the region.
Another important factor which was recognised earlier this year during a meeting of WHO's 65th Regional Committee was the dedication and hard work of the health workers and volunteers, civil society and nongovernmental organisations involved in the intensive campaigns carried out in all countries year after year. Often working under difficult circumstances due to challenging terrains, extreme weather conditions and civil unrest, these workers even put their lives at risk to reach children with polio vaccinations.
One of the most important lessons learned was the significance of establishing a strong accountability framework to ensure evidence-based data generated following the implementation of campaigns would get analysed and used for corrective action in future activities.
Other important success factors were the introduction of more efficacious oral polio vaccines in specific environments where transmission was linked to certain environmental factors such as levels of hygiene and water and sanitation issues.
As we prepare to celebrate the tremendous progress made over the past years in India as well as the region, we need to remind ourselves the need to sustain these efforts for the near future at the same if not a higher level of performance. Although not all countries face the same risk, most countries in the region remain at risk of a polio resurgence through a distant or cross-border importation of the wild poliovirus from countries where the virus continues to circulate.
All countries need to ensure high immunity levels against the virus are maintained throughout all populations. Surveillance needs to remain highly sensitive in order to detect any importation. Some countries have also made the provisions and developed emergency preparedness plans of action in order to react in case an importation occurs.
Now is the time for maximum vigilance, high levels of preparedness, high-quality surveillance and maintenance of high immunity against polio among all children under five years old. This must be done through intensified routine immunisation and supplementary vaccination campaigns when and where needed. The recent outbreaks in Asia - Tajikistan in 2010 and China in 2011 - have provided important lessons in maintaining high population immunity as protection against importations.
The polio infrastructure, expertise and operational experience are being used to guarantee the gains made towards eradication by strengthening routine immunisation and improving integrated vaccine preventable disease surveillance. Lessons from polio eradication should be used to strengthen the existing health systems and provide a legacy for the decades of hard work.
As India completes two years without any cases of wild poliovirus, WHO's South-East Asia Region is firmly on track for polio-free certification in early 2014. The South-East Asia Region will be the fourth WHO Region to be certified as polio free, the first region in more than 12 year after the European Region was certified in 2002.
Dr Samlee Plianbangchang is Regional Director, WHO South-East Asia Region.
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Writer: Samlee Plianbangchang