India defeats polio with army of more than two million vaccinators

An Indian Sikh boy receives polio vaccination drops from a medical volunteer during an immunisation drive outside the Golden Temple in Amritsar on February 24, 2013.

India marked three years since its last reported polio case Monday, meaning it will soon be certified as having defeated the ancient scourge in a huge advance for global eradication efforts.

India's polio program is one of the country's biggest public health success stories, achieving something once thought impossible thanks to a massive and sustained vaccination program.

Health Minister Ghulam Nabi Azad, along with global groups who have been working to eradicate the virus, hailed Monday's anniversary as "a monumental milestone."

"We have completed a full three years without a single polio case and I'm sure that in the future there won't be any polio cases," Azad told reporters in the capital.

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Smiling and flashing a V for victory sign, he added: "I think this is great news not just for India but the entire globe."

With the number of cases in decline in Nigeria and Afghanistan, two of only three countries where polio is still endemic, world efforts to consign the crippling virus to history are making steady progress.

"In 2012, there were the fewest numbers of cases in endemic countries as ever before. So far in 2013 (records are still being checked), there were even less," Hamid Jafari, global polio expert at the World Health Organization, told AFP.

"If the current trends of progress continue we could very easily see the end of polio in Afghanistan and Nigeria in 2014."

Success and caution

Despite the success, isolated polio outbreaks in the Horn of Africa and war-wracked Syria emerged as new causes for concern in 2013.

There are also reasons for caution in India, with the virus still considered endemic in neighboring Pakistan, where vaccinators are being killed by the Taliban which views them as possible spies.

A fake vaccination program was used by the CIA to provide cover for operatives tracking Al Qaeda chief Osama Bin Laden, who was killed in Pakistan by US special forces in May 2011.

Countries are certified by the WHO as being polio-free if they go 12 months without a case, and are then said to have eradicated it after a period of three years without new infections.

India will likely receive this endorsement only in March, which will trigger more exuberant celebrations than on Monday.

The wretched sight of crippled street hawkers or beggars on wheeled trolleys will remain, however, as a legacy of the country's time as an epicentre of the disease.

In the absence of official data, most experts agree there are several million survivors left with withered legs or twisted spines who face discrimination and often live on the margins of society.

Million of vaccinators

The country's success was built on a huge vaccination program that began in the mid-1990s with the backing of the central government and a coalition of charities, private donors and UN agencies.

An army of more than two million vaccinators, supported by religious and community leaders, canvassed villages, slums, train stations and public gatherings in even the most remote parts of the country.

India reported 150,000 cases of paralytic polio in 1985, and it still accounted for half of all cases globally in 2009, with 741 infections that led to paralysis.

In 2010, the number of victims fell to double figures before the last case on January 13, 2011, when an 18-month-old girl in a Kolkata slum was found to have contracted it.

The girl, Rukshar Khatoon, is now attending school and leads a "normal life," although she still suffers pain in her right leg, doctors and her parents told AFP.

"She can now stand on her feet and walk, but can't run," her father Abdul Saha said. "When her friends play, she remains a spectator."

Saha, a father of four, said he had taken his son to get immunized but not two of his daughters. "It was a grave mistake," he said.

Wider benefits

Jafari from the WHO highlighted the immense knock-on benefits for India, which is still afflicted by other preventable diseases, widespread malnutrition and poor sanitation.

"India has now set other important public health goals as a result of the confidence that the country has got from the successful eradication of polio," he said, citing a new measles eradication goal.

Health Minister Azad said the next priorities were tackling non-communicable diseases such as a cancer and diabetes but he conceded that the government needed to spend more on improving health services.

"In proportion to the GDP (gross domestic product), unfortunately we don't spend that much money, as much as we should spend," he told AFP.