A Global Polio Resurgence and the Need for Revaluation

Syllabus: GS2/ Health

Context

• WHO has reported that Poliovirus had been detected through routine surveillance of wastewater systems in five countries: Finland, Germany, Poland, Spain, and the United Kingdom since September this year.

What is Polio?

• Polio (poliomyelitis) is a highly contagious viral disease caused by the poliovirus. 
• It primarily affects children under the age of 5 and can lead to severe complications such as paralysis, disability, or even death. 
• Spread: Polio spreads mainly through fecal-oral transmission. 
  • It can also be spread via respiratory droplets from coughing or sneezing.
• Symptoms: Most cases are mild or asymptomatic.
  • A smaller percentage of infected individuals develop paralytic polio, which can cause paralysis, usually affecting the legs or respiratory muscles.
• Vaccination: There is no cure for polio, it can only be prevented.
  • Polio vaccine, given multiple times, can protect a child for life. 
  • Vaccines available: Oral polio vaccine and inactivated polio vaccine. Both are effective and safe.
• There are three types of wild poliovirus (WPV): type 1, type 2, and type 3. 

State of Polio Eradication

• Eradication:Type 2 wild poliovirus was declared eradicated in September 2015 and Type 3 wild poliovirus was declared eradicated in October 2019.
  • Only type 1 wild poliovirus remains.
• The WHO South-East Asia Region was declared free of poliovirus in 2014 and the WHO African Region was certified free of wild poliovirus (WPV) in 2020.
  • India was certified polio-free in March 2014 and continues to be so. 
• According to the WHO, Pakistan and Afghanistan are the only countries in the world where polio remains endemic.

Vaccines for Polio Eradication 

• Oral Polio Vaccine (OPV): A live-attenuated vaccine used for its ease of administration and mucosal immunity induction. However, it may lead to Vaccine-Derived Poliovirus (VDPV) and continued transmission.
• Inactivated Poliovirus Vaccine (IPV): A non-live vaccine protecting against all three poliovirus types without causing disease or transmission.
  • Researchers advocate an OPV-to-IPV switch for expedited eradication.

Global  Efforts in Polio Eradication

• Global Polio Eradication Initiative (GPEI): The goal is to complete the eradication and containment of all wild, vaccine-related, and Sabin polioviruses, so no child suffers from paralytic poliomyelitis ever again.
  • GPEI’s four pillars include Routine Immunization, Supplementary immunization, Surveillance, and Targeted mop-up campaigns.
  • At the 2022 World Health Summit in Berlin, Germany, global leaders pledged $2.6 billion to GPEI to end polio.
• The Global Polio Eradication Strategy 2022-2026 outlines the roadmap to achieving and sustaining a polio-free world, serving as a strategic guide for GPEI stakeholders, partners, donors, and affected governments.
• World Polio Day is observed on 24th October, the birth date of Jonas Salk, who led the first team to develop a vaccine against poliomyelitis. 

India’s Efforts in Polio Eradication

• Pulse Polio Programme Launch (1995): It used an Oral Polio Vaccine (OPV) strategy, reaching over 1 million children and ensuring every child under five was vaccinated.
  • The campaign became iconic, with the slogan “Do Boond Zindagi Ki” (Two drops of life).
  • The Pulse Polio campaigns also relied heavily on door-to-door efforts, reaching children in difficult-to-reach areas.
• Routine Immunization and System Strengthening: The UIP provided free vaccines against polio, diphtheria, pertussis (whooping cough), tetanus, measles, hepatitis B, and tuberculosis.
• Inactivated Polio Vaccine (IPV) Introduction (2015): IPV provides additional protection against polio, especially against type 2 poliovirus.

Way Ahead

• There is a need to strengthen routine surveillance systems globally, particularly in countries reporting poliovirus in wastewater.
• Address vaccine inequities by ensuring all children, especially in conflict zones and remote areas, receive immunization.
• Gradually shift from OPV to IPV to eliminate the risk of Vaccine-Derived Poliovirus (VDPV).

Concluding remarks

• As long as a single child remains infected, children in all countries are at risk of contracting polio. 
• Failure to eradicate polio from these last remaining strongholds could result in a global resurgence of the disease.

Source: TH