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Monday 27 February 2012

Inaccurate Information about Immunisation! Questioning the states' commitment to implementation of routine child immunisation programme, health minister Ghulam Nabi Azad today said 40% of the data provided by them was "wrong".

Inaccurate Information about Immunisation! Questioning the states' commitment to implementation of routine child immunisation programme, health minister Ghulam Nabi Azad today said 40% of the data provided by them was "wrong".

Azad said the lessons learnt from success of polio campaign could help eliminate measles-related child deaths and neonatal tetanus from the country. How should we consider this claim as Accurate Information?

Troubled Galaxy Destroyed Dreams, chapter 749

Palash Biswas

Inaccurate Information of Immunisation is the all time trend in Public Health sector! Now, the helth minister points at the default!Immunization is the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. Vaccines stimulate the body's own immune system to protect the person against subsequent infection or disease.Immunization is a proven tool for controlling and eliminating life-threatening infectious diseases and is estimated to avert over between 2 and 3 million deaths each year. It is one of the most cost-effective health investments, with proven strategies that make it accessible to even the most hard-to-reach and vulnerable populations. It has clearly defined target groups; it can be delivered effectively through outreach activities; and vaccination does not require any major lifestyle change.

India has a reason to smile on the poliofront, as it was taken off the list of polio endemic countries by the World Health Organisation (WHO), health minister Ghulam Nabi Azad announced at the Polio Summit 2012 held at Vigyan Bhawan on Saturday. The summit had Prime Minister Manmohan Singhalso in attendance. "WHO has taken India's name off the list of polio endemic countries in view of the remarkable progress that we have made during the past one year," Azad said. The heath minister also disclosed that from 2 lakh polio cases a year, the country has recorded not a single polio case in the past one year.

The Global Polio Eradication Initiative is a public-private partnership led by national governments and spearheaded by the World Health Organization (WHO)!

Amitabh Bachchan, who is a Unicef goodwill ambassador, is happy India is a polio-free nation now and says it is the result of hard work by some institutions. The Bollywood megastar posted that Rod Curtis, communication specialist, Polio Eradication Unit, UNICEF India, informed him that WHO and the Unicef wing for the eradication of polio had declared India a polio free nation. He even posted the letter on his blog.

"It is most satisfying to learn that there are some institutions, that genuinely acknowledge the hard work, voluntarily put in towards this campaign. Hours and hours of work, through the years has finally resulted in an outcome of which I feel so proud.

"I feel the pride on two counts. One of course and the most important, that the disease has been eradicated from our region and two, the fact that UNICEF chose to send their gracious thanks to me in writing - we had if you remember made this announcement many months ago at a formal ceremony. WHO giving it the final credit is definitive confirmation. There has been no acknowledgement from the government and one does not expect any either," Bachchan added.

The megastar is now recuperating at home from abdominal surgeries.

Questioning the states' commitment to implementation of routine child immunisation programme, health minister Ghulam Nabi Azad today said 40% of the data provided by them was "wrong".At the same time, laying emphasis on strengthening of routine immunisation, Health Minister Ghulam Nabi Azad said the lessons learnt from success of polio campaign could help eliminate measles-related child deaths and neonatal tetanus from the country. How should we consider this claim as Accurate Information?

Meanwhile, in a frontal attack on Uttar Pradesh's ruling Bahujan Samaj Party (BSP), Congress president Sonia Gandhi Sunday pointedly blamed the state government for swindling Rs.9,000 crore earmarked for the National Rural Health Mission(NRHM) in India's most populous state.

Charging the states with providing the Centre with inaccurate information about immunisation administered to children in their states, Azad said the centrally-run tracking system had verified this.

"Still many wrong names come from states. About 40% wrong names still come. Till the time, state governments ensure routine immunisation levels of 90% to 100% on the ground, only then will the stigma on our country that maximum number of children die in India would be removed," Azad told reporters at the conclusion of the Polio Summit.

Azad said the health and family welfare ministry had set up a BPO, whereby 26 million mothers and children have already been registered under the web enabled mother and child tracking system. The system generates weekly work plans for the Auxiliary Nurse Midwives through SMS and checks the data provided by states on immunisation administered on children.

"Since 1.5 years, under the new system we can track the children immunised. When states send the names and telephones, the central-operated BPO tracks them and verifies their antecedents," he said.

He added that "earlier too while states claimed 80% to 90% vaccination, they actually did 40% vaccination".

In some states, he said "only 40% vaccination takes place" and the country's average immunisation is "around only 60-61%".

"We learnt from polio. It used to happen with polio also, but in the past two years we ensured that vaccination should not be below 99 % and when we achieved the level of 99 %, the result is that within two years polio has been eradicated. Two years ago, half the polio cases in the world were in India," he told reporters.

In his valedictory address at the two-day Polio Summit in New Delhi today, Azad said there has to be continued vigil and effective emergency preparedness as India cannot afford to let its guards now on the polio virus.

"...Emboldened by our progress in polio, we are confident that we can achieve elimination of measles related child deaths. We also now wish to completely eliminate neonatal tetanus in India and are moving towards it. Some of our learnings and lessons from the Polio programme could prove to be extremely useful in accomplishing these tasks," Azad said.

The Minister laid stress on immunisation and said "strengthening routine immunisation is an imperative if we wish to sustain our gains in polio and guard ourselves against both distant and international importations."

He said, "We have declared 2012, the year of the intensification of Routine Immunisation. We intend to accelerate routine immunisation activities from 1st April itself through special immunisation drives, with a special focus on 207 districts recording low routine immunisation coverage."

The minister also reaffirmed India's commitment to funding the Polio programme and said it willing to lend all possible support for global eradication of polio.

Addressing an election rally in this western Uttar Pradesh city,Sharanpur, Gandhi said: "We had given UP a huge sum of Rs.9,000 crore for improvement of health services for the poor and under-privileged across the vast rural expanse of the state, but the funds were pilfered by the BSP government, that was now trying to shield the culprits."

While the Central Bureau of Investigation ( CBI) was currently investigating the NRHM scam, the Congress chief alleged that the "same story was repeated with MNREGA (rural jobs scheme) funds too and the culprits were allowed to get away with murder".

"I am aware that the people of UP are angry with this party as well with other parties like Samajwadi Party (SP) and Bhartiya Janata Party (BJP) and the time has come to treach them all a lesson," she said.

Stressing the Congress is not like other parties who believe in making all kinds of promises, Gandhi said the "believe in doing sincere work".

Highlighting how the state had suffered during the past 22 years of non-Congress rule, she said that very person wants development and upliftment of the weaker sections, who have been betrayed for the past 22 years.

"The state has suffered badly during the past two decades when it was ruled by SP, BSP and BJP," she said.

"What did you get here in the past 22 years? Did you get proper electricity and water? Do you have proper roads here? Are your children able to get proper education? Are fertilisers and seeds available for farmers? Has any new industry come up in UP? How many youth in the state are able to get a job here? Are you happy with the law and order situation in UP?" she asked the gathering, which responded with a loud "no".

Claiming that the Congress alone believed in fighting corruption, she accused the Mayawati regime of being "synonymous with corruption".

Focusing on the local issues of Saharanpur, widely known for its wood carving cottage industry, Gandhi said that apart from various other issues, the party also understood the problems being faced by them local artisans and manufacturers.

"Let me assure you that your problems will be solved once a Congress government is in place here," she said, adding she sought their support to accomplish the Congress' mission to change the state of affairs not only in and around this place but in entire Uttar Pradesh.

  3. [See: The Cancer Conspiracy]. [See: Medical doctors on vaccination quotes] [See: Interview of ex vaccine researcher whisteblower]. Also a very revealing 2001 ...

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  12. The anti-immunisation position is that it is an unreliable and extremely risky way of preventing childhood disease, a worldwide conspiracy, rife with side-effects.
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  33. 14 Jul 2011 – Recent reports suggest that the CIA set up a fake immunisationprogramme in Pakistan, in order to get the DNA of Bin Laden family members ...

The Global Eradication of Polio

- A World Without Polio -

The goal of the Global Polio Eradication Initiative is to ensure that no child will ever again know the crippling effects of polio. Polio is a highly infectious disease caused by a virus poliovirus. It invades the nervous system and can cause total paralysis in a matter of hours. It can strike at any age, but affects mainly children under three. Polio is mainly passed through person-to-person (i.e., fecal-oral) contact, and infects persons who do not have immunity against the disease. There is no cure for polio, but the disease can be prevented by immunization with polio vaccine. Oral polio vaccine (OPV) was developed in 1961 by Dr Albert Sabin; OPV is a highly effective, safe and inexpensive vaccine, and has been used in all countries of the world to achieve polio eradication

Along with all 192 member nations of the World Health Organization, the Government of India in 1988 committed the nation to the goal of global polio eradication. Since 1995, the Ministry of Health and Family Welfare, Government of India has been conducting intensive immunization and surveillance activities aimed at the complete elimination of poliovirus and paralytic polio. The National Polio Surveillance Project, which was launched in 1997, provides technical and logistic assistance to the GoI, and works closely with state governments and a broad array of partner agencies to achieve the goal of polio eradication in India.

25 FEB, 2012, 03.39AM IST, ET BUREAU

National Rural Health Mission Scam: CBI raids in 22 districts

LUCKNOW: CBI conducted raids in 22 district on Friday as part of its investigation into the NRHM scam, which has claimed five lives till now. It also lodged four fresh FIRs in the 10,000-crore scam that rocked the Mayawati government last year. Among those named in the FIR are doctors, health department officials and medicine suppliers. With this the total number of cases registered in regards to the NRHM scam is 12.

The raids were carried out in Lucknow, Basti, Bahraich, Varanasi, Gazipur among other places. CBI had on Wednesday questioned BSP MLA Ram Prasad Jaiswal, a key figure in the NRHM scam. It had already questioned and raided the residence of family welfare minister Babu Singh Kushwaha. It is likely to question him again in the coming weeks.

The NRHM scam came into the open after chief medical officer, family welfare, Vinod Kumar Arya, was killed in broad daylight on October 2010. This was soon followed by the killing of CMO BP Singh outside his home on April 2, 2011. In its bid to cover up the scam, the police under pressure from higher ups framed deputy CMO YS Sachan for getting the two doctors killed and he was sent to prison. But on June 22, 2011, Dr Sachan was also found dead inside the jail premises, with the police trying to dismiss it as a suicide first. Later it emerged that he too was killed to cover up the scam. These murders were related to the rampant corruption in the implementation of the NRHM scheme in UP.

The massive public outcry forced Mayawati to sack family welfare minister Babu Singh Kushwaha and health minister Anant Kumar Mishra. While Kushwaha was a close aide of Mayawati, the health minister is a close relative of BSP's Brahmin face Satish Chandra Mishra. Kushwaha was later expelled from BSP when he started accusing senior BSP leaders and bureaucrats of conspiring to kill him.

Later a project engineer with UP Jal Nigam committed suicide while NRHM clerk Mahendra Sharma was found killed earlier this month in mysterious circumstances in Lakhimpur Kheri. The scam was handed over to CBI, even before these incidents. CBI has since raided several places and questioned several contractors, bureaucrats, medical suppliers etc. Among those raided are senior IAS officer Pradeep Shukla.

Babu Singh Kushwaha after falling out with Mayawati tried to join BJP, but opposition by senior leaders saw party president Nitin Gadkari strategically putting off his induction while Kushwaha started campaigning for BJP in the assembly polls. Kushwaha has been seeking votes for BJP from an independent platform, trying to attract votes of Most Backward Communities for the party.

India polio-free for a year: 'First time in history we're able to put up such a map'


New Delhi, Feb. 25: The World Health Organisation has deleted India from its list of polio endemic countries, acknowledging the absence of any new instance of illness caused by the wild polio virus for more than a year since a child was diagnosed with the disease in Howrah in January 2011.
"This is the first time in history we're able to put up a map like this one," Bruce Aylward, an assistant director-general for polio in the WHO, told a conference here today. He presented a map displaying polio cases over the past year in Africa, Pakistan, Afghanistan and China but none in India.
Indian health authorities had recorded 741 patients paralysed by the wild polio virus in 2009 and 42 patients in 2010, but have detected no new patients since January 2011.
"But the big risk is to think we've finished," Aylward said. India will need to remain free of any paralysis caused by the wild polio virus for three years from the last case before it can seek WHO certification for having eradicated polio — in January 2014.
Aylward cautioned that India and countries that reported polio over the past year should continue to pursue aggressive immunisation to protect children from the polio virus which, history has shown, can reappear in areas from where it had vanished.
He said the world's polio eradication effort currently faces a funds shortfall of about $1.09 billion to cover immunisation-related activities over the next two years. "If we can't find funds to finish the job, the virus may return to India," he said.
The funds are needed for the immunisation of children across Afghanistan, Pakistan and Nigeria — the last three countries where polio is still endemic. "But India also has to reach all its children through routine immunisation," Aylward said.
Prime Minister Manmohan Singh told the conference that the completion of a year without polio being reported from anywhere in the country "gives us hope that we can finally eradicate polio not only from India but from the face of the Earth".
"Our ultimate objective is to achieve full immunisation of all our children. We must ensure that every Indian child, rich or poor, whether living in Ladakh or in Delhi, has equal access to the best immunisation," Singh told the conference, Polio Summit 2012, organised by the Union health ministry and Rotary International, a non-government organisation.
Public health experts say countries without polio face a risk of the disease re-entering them through the movement of people from countries where polio still persists. The number of polio cases in Pakistan and Nigeria has gone up in the past six months.
A virus from Pakistan, for example, had surfaced in China's western province of Xinjiang in mid-2011 after being carried across the Karakoram mountains, leading to China's first new polio in more than ten years. The virus paralysed 21 people — the youngest aged four months and the oldest, 53 years — but a quick immunisation response by Chinese authorities stamped out the infection.
Aylward said the WHO was looking for Indian vaccine-making companies that might be able to take up local manufacture of a new version of the injectible, inactivated polio vaccine (IPV), which might eventually replace the oral polio vaccine (OPV), which is now used in the programme.
If all goes according to plan, Aylward told The Telegraph, the WHO may tweak its polio eradication strategy and recommend the introduction of the IPV as a single additional dose with the OPV, but not before 2014.
The OPV, which is based on a live but weakened virus, has been used for decades and has helped other countries eradicate polio. But it carries a small risk of causing paralysis either through vaccine-derived poliovirus paralysis, or vaccine-associated polio paralysis.
Some paediatricians and infectious disease experts have long argued that the IPV will eventually need to be introduced for the true eradication of all polio paralysis, caused by the wild polio virus as well as the vaccine-linked polio.

PM's speech at Polio Summit

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Here is the full text of the speech delivered by Prime Minister Manmohan Singh at the Polio Summit, in New Delhi on February 25, 2012.
I would like to extend a very warm welcome to each one of our participants who have gathered here today from within India and from all over the world to join us for this unique event the Polio Summit. The Government of India has coordinated a massive effort to rid our country of the terrible scourge of Polio that has scarred the lives of thousands of thousand of children in India and elsewhere in the world. So it is a matter of satisfaction that we have completed one year without any single new case of polio being reported from anywhere in the country. This gives us hope that we can finally eradicate polio not only from India but from the face of the entire mother earth.
The success of our efforts shows that teamwork pays. The Central Government and the States Governments have worked in close partnership with many community base, national level and international organizations and groups including the Rotary International, the World Health Organization and UNICEF. But I venture to say that the real credit goes to the 23 lakh volunteers who repeatedly vaccinated children even in the most remote areas, often in very bad weather conditions. I commend each one of them for their dedication, for their commitment and for their selfless service.
Our ultimate objective is and as it must be to achieve full immunization for all our children. We must ensure that every Indian child, rich or poor, whether living in Ladakh or in Delhi has equal access to the best immunization. To this ambitious task I commit our government.
Universal access to safe vaccines, however, is only one of the many strategies for preventing and control of diseases and promoting good health among our children. We also need to provide them nutritious food, safe drinking water, proper sanitation and education. Nutrition especially for women and children is essential for community health. Sanitation and safe drinking water are pre-requisites for better absorption of food and prevention of infant and child mortality. But above all, we need to educate our children and our mothers on the importance of hygiene and nutrition to overall good health and longevity.
We are taking urgent measures to address these challenges. The National Council on India's Nutrition Challenges is spearheading our efforts to address the challenge of malnutrition. The Total Sanitation Campaign aims to eradicate the practice of open defecation by 2017. We are moving towards the creation of Public Health Cadres to work for the prevention and the control of disease. It will be our effort to ensure that every village has access to safe drinking water. The Right to Education Act is in place and we have made considerable progress in universalisation of elementary education. However, going forward we have to give proper attention to issues such as bridging social and gender gaps in school enrolment, adult literacy particularly of women and the need to improve learning outcomes.
Reduction of infant and maternal mortality rates and population stabilization are among the core health goals of our national programme, National Rural Health Mission. Some states in the Union have already reached the United Nations' Millennium Development Goals. This agenda however remains a challenge in many of the other states. We need to, in a mission mode, focus on these states and deploy more human, financial and managerial resources to improve their health status. This was what was done in the last three years under the polio campaign.
On a broader level, we need to accelerate our efforts to achieve our goal of providing universal access to health care at affordable cost for all our citizens. This needs first and foremost a determined effort to strengthen our public health systems. The National Rural Health Mission aims to develop the basic rural health infrastructure including through greater investments, community participation and optimisation of manpower and resources.
As the country enters a demographic and epidemiological transition, we need to focus more attention on non communicable diseases and a wider range of infectious diseases. The task of prevention of trauma through prompt and effective emergency care has also acquired great urgency. About 10% of our mortality is now due to trauma which is claiming many young lives.
The rising cost of health care is another key challenge. The impact of high medical costs places an unconscionable burden on the poor. We are, therefore focusing our attention towards social security of the poor with regard to their health care.
The Rashtriya Swasthya Bima Yojana provides insurance cover today to over 2.67 crore poor families. However, two thirds of private healthcare expenditure is on out-patient and diagnostic care and for purchase of medicines. Insurance schemes generally tend to focus on in-patient cares. We therefore need to work towards hassle free and cashless outpatient care in our public hospitals.
Thanks to our sustained high growth rates in recent years, we have been able to provide the higher levels of public investment needed in the health sector. Public expenditure on health has increased from less than 1% of our GDP in 2006-07 to an estimated 1.4% of GDP by the end of the Eleventh Five year Plan. But we will need to work harder and do more if we have to reach our goal of increasing public expenditure on health to at least 2.5% of the GDP. Education and health will be the key priorities of the Twelfth Five Year Plan.
More money for health must also result in more health for the money. Beyond investments, we, therefore need greater capacities for decentralized health care planning and management. This will require greater focus on human resource development as well as on technological innovation and information systems that can support such decentralization. These are the challenges for the future. Building capacities in our 600 odd districts and states of the union is one important area where the sustained support and partnership of all stakeholders will be vital in terms of health outcome.
Just as the polio campaign saw the Central and State Governments working closely with a common purpose, I am confident that the vision of universal health care will unite all of us in a concerted effort to preserve, to protect and promote the health of all our people.
Courtesy: PMO website
Keywords: Polio Summit, Manmohan Singh, public health, OPD in hospitals, cashless healthcare, polio campaign

PM for hassle-free, cashless outpatient care

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"Impact of high medical costs places an unconscionable burden on the poor"
Describing as a challenge the rising cost of health care, Prime Minister Manmohan Singh has advocated the need to work towards hassle-free and cashless outpatient care in public hospitals.
Speaking at the Polio Summit 2012 here on Saturday, Dr. Singh said the impact of high medical costs placed an unconscionable burden on the poor. "We are, therefore, focusing our attention on social security of the poor with regard to their health care," he said.
Key priorities
"Thanks to our sustained high growth rates in recent years, we have been able to provide the higher levels of public investment needed in the health sector. Public expenditure on health has increased from less than 1 per cent of our GDP in 2006-07 to an estimated 1.4 per cent of GDP by the end of the Eleventh Five-Year Plan. But we will need to work harder and do more if we have to reach our goal of increasing public expenditure on health to at least 2.5 per cent of the GDP. Education and health will be the key priorities of the Twelfth Five-Year Plan."
Universal access
On a broader level, the Prime Minister said: "We need to accelerate our efforts to achieve our goal of providing universal access to health care at affordable cost for all our citizens. We are moving towards the creation of public health cadres to work for the prevention and control of diseases," he said.
Cashless outpatient care and a specialised cadre for public health are major recommendations of the high-level expert group of the Planning Commission on universal health care which had also proposed cashless health package for all.
Joint effort
Strongly supporting the concept of universal health care, Dr. Singh said the vision would unite all in a concerted effort to promote everyone's health.
"Just as the polio campaign saw the State and Central governments working closely with a common purpose, I am confident that the vision of universal health care will unite all of us in a concerted effort to preserve, protect and promote the health of all our people," he said.
Pointing out that two-thirds of private health care expenditure was on outpatient and diagnostic care and on purchase of medicines, Dr. Singh said insurance schemes generally tend to focus on in-patient cases. He reiterated the government's commitment to provide health care to all.
"More money for health must also result in more health for money. Beyond investments, we, therefore, need greater capacities for decentralised health care planning and management. This will require greater focus on human resource development as well as on technological innovation and information systems that can support such decentralisation," he said.

Polio Eradication

A girl shows her finger mark after getting oral polio vaccine in  Pilibhit district of Uttar Pradesh. The child is part of a nomadic group attending religious congregation. Tracking and immunizing migrant and mobile population is crucial for the polio eradication programme in India. Constantly on the move, the nomads miss polio and routine immunization and are at risk of getting polio.
Credit: UNICEFIndia/Nizamuddin/2011

India achieves major milestone, no polio case for one year
On 13 January 2012, India has reached a major milestone in the history of polio eradication – a 12-month period without any case of polio. This date marks the unprecedented progress in India and an endorsement of the effectiveness of the polio eradication strategies and their implementation in India. Once all specimens from acute flaccid paralysis cases and sewage samples up to mid-January are tested in the laboratories and no wild poliovirus is detected, India will come off the WHO list of polio endemic countries.
In 2009 India had more polio cases than any other country in the world (741). In just two short years, India has taken a giant step towards ending polio globally forever.
India overcame huge challenges to stop transmission of polio, including its high birth rate, large population, hard-to-reach migrant communities and resistance to oral polio vaccine in high-risk populations, and its progress is proof-positive that polio eradication can be achieved anywhere in the world, even in the most challenging conditions.

The Polio Eradication Programme in India is a collaborative effort between the Ministry of Health and Family Welfare (MOHFW), WHO's National Polio Surveillance Project (NPSP), UNICEF, Rotary International, and the U.S. Centres for Disease Control.
The programme aims to eradicate polio from India by immunizing every child under five years of age with the oral polio vaccine. India, together with Afghanistan, Nigeria, and Pakistan, is one of the four polio-endemic countries left in the world.
Tremendous progress has been made in the last few years to interrupt polio transmission in India. The number of polio cases dropped to a record low of 42 in 2010 compared with 741 in 2009.
In 2011, India has had only one case of polio, in January in Howrah district of West Bengal. The traditional polio endemic states of Uttar Pradesh and Bihar have not reported any cases of polio this year.
Uttar Pradesh, the epicenter of almost all poliovirus outbreaks in the country, has not reported any case of polio since April 2010.  Bihar has not reported any case of polio since September 2010.
Closer to eradication, now every case of polio in the country will be treated as a public health emergency. In West Bengal an emergency response has been rolled out by the government and polio partners; efforts to mobilise the community for polio vaccination has been scaled-up and rapid and large-scale polio immunization rounds are being carried out to protect children against polio and prevent the virus from spreading to other parts of the state and the country.
The more efficacious monovalent oral polio vaccine and the bivalent oral polio vaccine, which protects against both circulating strains of polioviruses – type 1 and type 3, are being used in the ongoing polio immunization campaigns in West Bengal and the supplementary immunization campaigns in the polio endemic states of Uttar Pradesh and Bihar and other polio high-risk areas

Read More

Watch UNICEF Polio Ambassador Amitabh Bachchan Message

GOI Press Release: One Year of Polio Free India


Polio India Factsheet- 13 January 2012

Press Release

Amitabh Bachchan launches new Polio Communication Campaign

UNICEF Ambassador Fernando Alonso Promotes Polio Eradication


Photo Essays

The Bulawa Toli
Bulawa toli is a group of young volunteers who mobilise community for polio immunisation on the polio booth day. These these young advocates run house-to-house shouting slogans and blowing whistles to draw attention of the children and parents to the polio booth.

Eradicating Polio
UNICEF is working with the district health department and Dargah Committee in district Bahraich of Uttar Pradesh to ensure that every child coming to the Mela is immunized and large scale awareness about the polio prevention is raised..Polio: no place too far
This photo feature demonstrates the enormous challenge in reaching children in the high risk areas of Bihar. The trip to Sunita, a polio-affected child in Saharsa in the Kosi river area, was undertaken by SMNet Bihar team members.

Fighting Polio
In 2009, 66 per cent of polio cases nationally occurred in children under two years of age. About 230,000 children are born each month in Bihar, and in U.P., over 400,000 children are born each month
More Photo Essays


Amitabh Bachchan- Two drops of Polio PSA

Two Drops of Polio Saves your Child's Life

Two Drops for Protection- Every Child, Every Time

Tracking of Nomads for Polio Immunisation

Reaching the Unreached

Community Mobilisers For Polio: Social Mobilisation Network
Reaching the Unreached With Polio Vaccination
Developing advocates on TV and radio - towards polio eradication

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Real Lives
Polio eradication efforts strengthened during religious occasions
Polio Advocacy week was held in Patna, Bihar from February 27 – March 4, 2010 during hafta-e-rehmat (The Blessing Week) to overcome resistance towards repeated rounds of polio immunisation and other communication issues surrounding Polio Eradication.
Traditional healers become influencers in Bareilly
Traditional healers play an important role in influencing community health decisions and also provide invaluable access to primary health care in underserved areas
Reaching Out To Mobile Populations
With over 15% of polio cases in 2009 emerging from migrant communities, reaching these communities remains a crucial link to securing eradication in India
Two states and 100 blocks away from polio-free India
UNICEF India Representative, Ms. Karin Hulshof in conversation with Indian Association of Parliamentarians on Population and Development (IAPPD) (India) talks about the Polio Eradication Initiative in India
Mother- Baby get-togethers
Held in all the SMNet blocks of Meerut district, prior to each round of the polio immunization drive, these meetings educate pregnant women on early and exclusive breastfeeding and also encourage lactating mothers to have their babies weighed.
Cricket Champs Advocate to Bowl out Polio
Cricket aces championed the cause of polio eradication in Lucknow on the eve of the Ranji Trophy match between Uttar Pradesh and Delhi on November 23, 2009.
Imam calls for polio to be used as a platform to address other diseases
Qasmi has been at the forefront of the fight against polio for the past seventeen years, ever since he moved to Patna city from Madhubani district.
Profile of a Special Influencer
Over the past four years, Nadeem has been a permanent fixture at the polio booths during the polio rounds in Kandhla block of Muzzafarnagar
"May Allah bless us … and may polio be eradicated from the world…"
"May Allah bless us and our children with good health…...and may polio and other dreadful diseases be eradicated from the world. We will pray at Makkah Mukarramah for this", said Hazrat Syed Shah Shamim Munawi, Sazada-Nashin-Khan-Ka-Munamiya of Patna city
Winning against polio with Razda Begum
Razda Begum sits with her decorated white chart paper which has the Mohallah Sufi Khan in Farrukhabad mapped out with its masjids (mosques), public facilities, the "grids" within the area and the "influencers" who work for the polio eradication programme
Mecca-bound Pilgrims call for end of Polio
Javed Mian, 65, is a small-time businessman in the Sabzi Bagh locality of Patna, the capital city of the eastern Indian state of Bihar.
Moradabad celebrates win against Polio with Hockey
It was not only time for celebration but also time for re-dedication to the cause of polio eradication as former hockey Olympians Zafar Iqbal and Dhanraj Pillai, among others, signed a pledge for polio eradication
Babille Story
Irene Babille is a student at the American International School in New Delhi. Earlier this year, she participated in India's National Polio Eradication Programme, as part of her schools' community outreach effort...
Indian cricket team present "Bowl Out Polio" bat to UP Chief Minister
Post-match and victory, Indian cricket team player R.P. Singh was called out to receive a special award from Uttar Pradesh Chief Minister Ms. Mayawati in Kanpur.
Pilgrims visit Ghazi Baba's dargah as their children get polio drops
Ghazi Baba has as many ways of granting wishes as people have of asking. Those who have asked for children have got them; those looking for healing have been healed.


From Wikipedia, the free encyclopedia
For financial immunization, see Immunization (finance).
Dr. Schreiber of San Augustine giving a typhoid inoculation at a rural school, San Augustine County, Texas. Transfer from U.S. Office of War Information, 1944.
A child being immunized against polio.
Immunization, or immunisation, is the process by which an individual's immune systembecomes fortified against an agent (known as the immunogen).
When this system is exposed to molecules that are foreign to the body (non-self), it will orchestrate an immune response, and it will also develop the ability to quickly respond to a subsequent encounter (through immunological memory). This is a function of the adaptive immune system. Therefore, by exposing an animal to an immunogen in a controlled way, its body can learn to protect itself: this is called active immunization.
The most important elements of the immune system that are improved by immunization are the B cells (and the antibodies they produce) and T cells. Memory B cell and memory T cells are responsible for a swift response to a second encounter with a foreign molecule. Passive immunization is when these elements are introduced directly into the body, instead of when the body itself has to make these elements.
Immunization is done through various techniques, most commonly vaccination. Vaccines againstmicroorganisms that cause diseases can prepare the body's immune system, thus helping to fight or prevent an infection. The fact that mutations can cause cancer cells to produce proteins or other molecules that are unknown to the body forms the theoretical basis for therapeutic cancer vaccines. Other molecules can be used for immunization as well, for example in experimental vaccines against nicotine (NicVAX) or the hormone ghrelin (in experiments to create an obesity vaccine).
Active immunization/vaccination has been named one of the "Ten Great Public Health Achievements in the 20th Century".[1]

[edit]Passive and active immunization

Immunization can be achieved in an active or passive manner: vaccination is an active form of immunization.

[edit]Active immunization

Main article: Active immunity
Active immunization entails the introduction of a foreign molecule into the body, which causes the body itself to generate immunity against the target. This immunity comes from the T cells and the B cells with their antibodies.
Active immunization can occur naturally when a person comes in contact with, for example, a microbe. If the person has not yet come into contact with the microbe and has no pre-made antibodies for defense (like in passive immunization), the person becomes immunized. The immune system will eventually create antibodies and other defenses against the microbe. The next time, the immune response against this microbe can be very efficient; this is the case in many of the childhood infections that a person only contracts once, but then is immune.
Artificial active immunization is where the microbe, or parts of it, are injected into the person before they are able to take it in naturally. If whole microbes are used, they are pre-treated, Attenuated vaccine.
The importance of immunization is so great that the American Centers for Disease Control and Prevention has named it one of the "Ten Great Public Health Achievements in the 20th Century".[1]

[edit]Passive immunization

Main article: Passive immunity
Passive immunization is where pre-synthesized elements of the immune system are transferred to a person so that the body does not need to produce these elements itself. Currently, antibodies can be used for passive immunization. This method of immunization begins to work very quickly, but it is short lasting, because the antibodies are naturally broken down, and if there are no B cells to produce more antibodies, they will disappear.
Passive immunization occurs physiologically, when antibodies are transferred from mother to fetus during pregnancy, to protect the fetus before and shortly after birth.
Artificial passive immunization is normally administered by injection and is used if there has been a recent outbreak of a particular disease or as an emergency treatment for toxicity (for example, for tetanus). The antibodies can be produced in animals ("serum therapy") although there is a high chance of anaphylactic shock because of immunity against animal serum itself. Thus, humanized antibodies produced in vitroby cell culture are used instead if available.

[edit]See also


  1. ^ a b "Ten Great Public Health Achievements in the 20th Century". CDC

[edit]External links

[edit]Factors influencing eradication

Eradication of polio has been defined in various ways—as elimination of the occurrence of a poliomyelitis even in the absence of human intervention,[4] as extinction of poliovirus, such that the infectious agent no longer exists in nature or in the laboratory,[5] as control of an infection to the point at which transmission of the disease ceased within a specified area,[4] and as reduction of the worldwide incidence of poliomyelitis to zero as a result of deliberate efforts, and requiring no further control measures.[6]
In theory, if the right tools were available, it would be possible to eradicate all infectious diseases which only reside in a human host. In reality there are distinct biological features of the organisms and technical factors of dealing with them that make their potential eradicability more or less likely.[7] Three indicators however, are considered of primary importance in determining the likelihood of successful eradication: that effective interventional tools are available to interrupt transmission of the agent, such as a vaccine; that diagnostic tools, with sufficient sensitivity and specificity, be available to detect infections that can lead to transmission of the disease; and that humans are required for the life-cycle of the agent, which has no other vertebrate reservoir and cannot amplify in the environment.


The most important step in eradication of polio is interruption of endemic transmission of poliovirus. Stopping polio transmission has been pursued through a combination of routine immunization, supplementary immunization campaigns and surveillance of possible outbreaks. The four key strategies outlined by the World Health Organization for stopping polio transmission are:[8]
  1. High infant immunization coverage with four doses of oral polio vaccine (OPV) in the first year of life in developing and endemic countries, and routine immunization with OPV and/or IPV elsewhere.
  2. Organization of "National immunization days" to provide supplementary doses of oral polio vaccine to all children less than five years of age.
  3. Active surveillance for wild poliovirus through reporting and laboratory testing of all cases of acute flaccid paralysis[9] among children less than fifteen years of age.
  4. Targeted "mop-up" campaigns once wild poliovirus transmission is limited to a specific focal area.


Oral polio vaccine is highly effective and inexpensive (about US$0.10 per dose, or US$0.30 per child.[10]) and its availability has bolstered efforts to eradicate polio. A study carried out in an isolated Eskimo village showed that antibodies produced from subclinical wild virus infection persisted for at least 40 years.[11] Because the immune response to oral polio vaccine is very similar to natural polio infection, it is expected that oral polio vaccination provides similar lifelong immunity to the virus.[12][13]
Contact immunity to polio can occur when attenuated poliovirus derived from the oral polio vaccine is excreted, and infects and indirectly vaccinates unvaccinated individuals.[14]

[edit]Herd immunity

Polio vaccination is also important in the development of herd immunity.[15] For polio to occur in a population, there needs to be an infecting organism (poliovirus), a susceptible human population, and a cycle of transmission. Poliovirus is transmitted only through person-to-person contact and the transmission cycle of polio is from one infected person to another person susceptible to the disease, and so on.[14] If the vast majority of the population is immune to a particular agent, the ability of that pathogen to infect another host is reduced; the cycle of transmission is interrupted, and the pathogen cannot reproduce and dies out. This concept, called community immunity or herd immunity, is important to disease eradication because if the number of susceptible individuals can be reduced to a small number through vaccination, the pathogen itself can also be eliminated.
When many hosts are vaccinated, especially simultaneously, the transmission of wild virus is blocked, and the virus is unable to find another susceptible individual to infect. Because poliovirus can only survive for a short time in the environment (a few weeks at room temperature, and a few months between 0–8° Celsius (32–46° Fahrenheit)) without a human host the virus dies out.[16]
Herd immunity is an important supplement to vaccination. Among those individuals who receive oral polio vaccine, only 95 percent will develop immunity.[17] That means 5 of every 100 given the vaccine won't develop any immunity and will be susceptible to developing polio. According to the concepts of herd immunity this population whom the vaccine fails, are still protected by the immunity of those around them. Herd immunity can only be achieved when vaccination levels are high.[15] It is estimated that 80-86 percent of individuals in a population must be immune to polio for the susceptible individuals to be protected by herd immunity.[15] If routine immunization were stopped, the number of unvaccinated, susceptible individuals would soon exceed the capability of herd immunity to protect them.[18]


Among the greatest obstacles to global polio eradication are the lack of basic health infrastructure, which limits vaccine distribution and delivery, the crippling effects of civil war and internal strife, and the sometimes oppositional stance that marginalized communities take against what is perceived as a vertical (top down) intervention. Another challenge has been maintaining the potency of live (attenuated) vaccines in extremely hot or remote areas. The oral polio vaccine must be kept at 2-8°Celsius for vaccination to be successful.[12]
An independent evaluation of obstacles to polio eradication requested by the WHO and conducted in 2009 considered the major obstacles in detail by country. In Afghanistan and Pakistan, they concluded that the most significant barrier was insecurity; but that managing human resources, political pressures, the movement of large populations between and within both countries, inadequately resourced health facilities, also posed problems, as well as technical issues with the vaccine. In India, the major challenge appeared to be the high efficiency of transmission within the populations of Bihar district and Uttar Pradesh, set against the low (~80% after three doses against type 1) seroconversion response seen from the vaccine. In Nigeria, meanwhile, the most critical barriers identified were management issues, in particular the highly variable importance ascribed to polio by different authorities at the local government level, although funding issues, community perceptions of vaccine safety, inadequate mobilisation of community groups, and issues with the cold chain also played a role. Finally, in those countries where international spread from endemic countries had resulted in transmission becoming re-established - namelyAngola, Chad, and South Sudan, the key issues identified were underdeveloped health systems and low routine vaccine coverage, although low resources committed to Angola and South Sudan for the purpose of curtailing the spread of polio and climatic factors were also identified as playing a role.[19]
Two additional challenges are found in unobserved polio transmission and in vaccine-derived poliovirus. In 99% of infections, polio is a mild condition that causes very few symptoms [20] and most infected people are unaware that they carry the disease, allowing polio to spread widely before cases are seen.[21] And since 2000, there have been a number of outbreaks of circulating vaccine-derived poliovirus, following mutations or recombinations in the attenuated strain used for the oral polio vaccine, which have raised the necessity of eventually switching to the more expensive inactivated polio vaccine.[22]


International Polio Cases and Countries reporting Cases by Year

Following the widespread use of poliovirus vaccine in the mid-1950s, the incidence of poliomyelitis declined rapidly in many industrialized countries.[17] Czechoslovakia became the first country in the world to scientifically demonstrate nationwide eradication of poliomyelitis in 1960.[28] In 1962 — just one year after Sabin's oral polio vaccine (OPV) was licensed in most industrialized countries — Cuba began using the oral vaccine in a series of nationwide polio campaigns. The early success of these mass vaccination campaigns suggested that polioviruses could be globally eradicated.[29] The Pan American Health Organization (PAHO), under the leadership of Ciro de Quadros, launched an initiative to eradicate polio from the Americas in 1985.[30]
Much of the work towards eradication was documented by Brazilian photographer Sebastião Salgado, as a UNICEF Goodwill Ambassador, in the book The End of Polio: Global Effort to End a Disease.[31]


In 1988, the World Health Organization, together with Rotary International,UNICEF, and the U.S. Centers for Disease Control and Prevention passed the Global Polio Eradication Initiative, with the goal of eradicating polio by the year 2000. The Initiative was inspired by Rotary International's 1985 pledge to raise $120 million toward immunising all of the world's children against the disease.[30] The last case of wild poliovirus poliomyelitis in the Americas was reported in Peru, August 1991.[30]


On 20 August 1994 the Americas were certified as polio-free.[32] This achievement was a milestone in efforts to eradicate the disease.
In 1994 the Indian Government launched the Pulse Polio Campaign to eliminate polio. The current campaign involves annual vaccination of all children under age five.[33]
In 1995 Operation MECACAR (Mediterranean, Caucasus, Central Asian Republics and Russia) were launched; National Immunization Days were coordinated in 19 European and Mediterranean countries.[34] In 1998, Melik Minas of Turkey became the last case of polio reported inEurope.[35] In 1997 Mum Chanty of Cambodia became the last person to contract polio in the Indo-West Pacific region.[36] In 2000 the Western Pacific Region (including China) was certified Polio-free.[36]
In October 1999, the last isolation of type 2 poliovirus occurred in India. This type of poliovirus appears to have been eradicated.[17]
Also in October 1999, The CORE Group -- with funding from the United States Agency for International Development (USAID) -- launched its effort to support national eradication efforts at the grassroots level. The CORE Group initiated this initiative in Bangladesh, India and Nepal in South Asia, and in Angola, Ethiopia and Uganda in Africa.[37]


By 2001, 575 million children (almost one-tenth the world's population) had received some 2 billion doses of oral polio vaccine.[24] The World Health Organization announced that Europe was polio-free on June 21, 2002 in the Copenhagen Glyptotek.[38]
In 2002, an outbreak of polio in India occurred. The number of planned polio vaccination campaigns had recently been reduced, and populations in northern India, particularly from the Islamic background, engaged in mass resistance to immunization. At this time, the Indian state Uttar Pradesh accounted for nearly two-thirds of total worldwide cases reported.[39] (See the 2002 Global polio incidence map.) However, by 2004, India had adopted strategies to increase ownership of polio vaccinations in marginalized populations, and the immunity gap in vulnerable groups rapidly closed.
In August 2003, rumors spread in some states in Nigeria, especially Kano, that the vaccine caused sterility in girls. This resulted in the suspension of immunization efforts in the state, causing a dramatic rise in polio rates in the already endemic country. On June 30, 2004, the WHO announced that after a 10-month ban on polio vaccinations, Kano had pledged to restart the campaign in early July. During the ban the virus spread across Nigeria and into 12 neighboring countries that had previously been polio-free.[30] By 2006, this ban would be blamed for 1,500 children being paralyzed and had cost $450 million for emergency activities. In addition to the rumors of sterility and the ban by Nigeria's Kano state, civil war and internal strife in the Sudan and Ivory Coast have complicated WHO's polio eradication goal. In 2004, almost two-thirds all the polio cases in the world occurred in Nigeria (760 out of 1170 total).


Reported Polio Cases in 2005
1 ea.

There were 1,979 cases of wild poliovirus (excludes vaccine derived polio viruses) in 2005.[25]Most remaining polio infections were located in two areas: the Indian subcontinent and Nigeria.
Eradication efforts in the Indian sub-continent have met with a large measure of success. Using the Pulse Polio campaign to increase polio immunization rates, India recorded just 66 cases in 2005; down from 135 cases reported in 2004, 225 in 2003, and 1,600 in 2002.[26]
Yemen, Indonesia and Sudan, countries which had been declared polio-free since before 2000, each reported hundreds of cases - probably imported from Nigeria.[40] On May 5, 2005, news reports broke that a new case of polio was diagnosed in Java, Indonesia and the virus strain was suspected to be the same as the one that has caused outbreaks in Nigeria. New public fears over vaccine safety, which were unfounded, impeded vaccination efforts in Indonesia. In summer 2005 the WHO, UNICEF and the Indonesian government made new efforts to lay the fears to rest, recruiting celebrities and religious leaders in a publicity campaign to promote vaccination.[41]
The first case of the polio outbreak in Sudan was detected in May 2004. The reemergence of polio led to stepped up vaccination campaigns. In the city of Darfur; 78,654 children were immunized and 20,432 more in southern Sudan (Yirol and Chelkou).[42]
In the United States on September 29, 2005 the Minnesota Department of Health identified the first occurrence of vaccine derived polio virus (VDPV) transmission in the United States since OPV vaccinations were discontinued in 2000. The poliovirus type 1 infection occurred in an unvaccinated, immunocompromised infant girl aged 7 months (the index patient) in an Amishcommunity whose members predominantly were unvaccinated for polio.[43]


In 2006 only four countries in the world (Nigeria, India, Pakistan and Afghanistan) were reported to have endemic poliomyelitis. Cases in other countries are attributed to importation. A total of 1,997 cases worldwide were reported in 2006; of these the majority (1,869 cases) occurred in countries with endemic polio.[25] Nigeria accounted for the majority of cases (1,122 cases) but India reported more than ten times more cases this year than in 2005 (676 cases, or 30% of worldwide cases). Pakistan and Afghanistan reported 40 and 31 cases respectively in 2006. Polio re-surfaced in Bangladesh after nearly six years of absence with 18 new cases reported. "Our country is not safe, as neighbours India and Pakistan are not polio free", declared Health Minister ASM Matiur Rahman.[44] (See: Map of reported polio cases in 2006)
In 2007 there were 1,315 cases of poliomyelitis reported worldwide.[25] Over 60% of cases (874) occurred in India; while in Nigeria, the number of polio cases fell dramatically, from 1,122 cases reported in 2006 to 285 cases in 2007. Officials credit the drop in new infections to improved political control in the southern states and resumed immunisation in the north, where Muslim clerics led a boycott of vaccination in late 2003. Local governments and clerics allowed vaccinations to resume on the condition that the vaccines be manufactured in Indonesia, a majority Muslim country, and not in the United States.[40] Turai Yar'Adua, wife of recently-elected Nigerian president Umaru Yar'Adua, made the eradication of polio one of her priorities. Attending the launch of immunization campaigns in Birnin Kebbi in July 2007, Turai Yar'Adua urged parents to vaccinate their children and stressed the safety of oral polio vaccine.[45]
One factor in the failure of polio immunization programs has been opposition by Muslim fundamentalists. This opposition has varied and is linked mostly to local political will rather than any religious orthodoxy. In Pakistan and Afghanistan, the Taliban have issued fatwas against polio vaccination, while Saudi Arabia has supported the eradication effort by demanding that all pilgrims to the Haj that originate from polio endemic countries receive vaccination upon arrival. But even with the express support of political leaders, polio workers have been kidnapped, beaten, and assassinated.[46] In February 2007, physician Abdul Ghani, who was in charge of polio immunizations in a key area of disease occurrence in northern Pakistan, was killed in a terrorist bombing.[47] In July 2007, a student traveling from Pakistan imported the first polio case to Australia in over 20 years.[48] Other countries with significant numbers of wild polio virus cases include the Democratic Republic of the Congo which reported 41 cases, Chad with 22 cases, and Niger and Myanmar, each of which reported 11 cases.[25]
In 2008, 19 countries reported cases and the total number of cases was 1652. Of these, 1506 occurred in the four endemic countries (146 elsewhere). The largest number were in Nigeria (799 cases) and India (559 cases): these two countries contributed 82.2% of all cases. Outside endemic countries Chad reported the greatest number (37 cases).[25]
In 2009, a total of 1606 cases were reported in 23 countries. 1256 of these were in the four endemic countries, with the remaining 350 in 19 sub-Saharan countries with imported cases or re-established transmission. Once again, the largest number were in India (741) and Nigeria (388).[25] All other countries had less than one hundred cases: Pakistan had 89 cases, Afghanistan 38, Chad 65, Sudan 45, Guinea 42, Angola 29, Côte d'Ivoire 26, Benin 20, Kenya 19, Niger 15, Central African Republic 14, Mauritania 13 and Sierra Leone and Liberia both had 11. The following countries had single digit numbers of cases: Burundi 2, Cameroon 3, the Democratic Republic of the Congo 3, Mali 2, Togo6 and Uganda 8.


Accordi to figures updated in June 2011, the World Health Organization reports that there were 1,349 cases of wild polio in 20 countries in 2010. Reported cases of polio are down 95% in Nigeria (to a historic low of 21 cases) and 94% in India (to a historic low of 42 cases) compared to the previous year, with little change in Afghanistan (from 38 to 25 cases) and an increase in cases in Pakistan (from 89 to 144 cases). 457 cases (34% of the global total) were reported from an acute outbreak in Tajikistan, which was associated with a further 18 cases across Central Asia (Kazakhstan and Turkmenistan) and the Russian Federation, with the most recent case from this region being reported from Russia the 25th September. These were the first cases in the WHO European region since 2002. 441 cases (30% of the global total) were reported from an outbreak in the Republic of Congo (Brazzaville). At least 179 deaths have so far been associated with this outbreak, which is believed to have been an importation from the ongoing type 1 outbreak in Angola (33 cases in 2010) and the Democratic Republic of the Congo (100 cases).[25][49]


Up to the end of April 33 cases were reported in Pakistan, eight in Nigeria and only one in both India and Afghanistan.
To the end of June 2011 241 cases globally have been reported (216 wild poliovirus type 1 and 25 wild polio type 3). This compares with 456 cases reported to the end of May in 2010 (399 type 1 and 57 type 3). Cases have been reported in the four endemic countries -- Pakistan, Afghanistan, Nigeria and India -- as well as in the Democratic Republic of Congo, Chad, Angola, Mali, Cote d'Ivoire, Burkina Faso, theRepublic of Congo (Brazzaville), Niger and Gabon. Over 80% of all cases seen this year come from three countries: Chad, the Democratic Republic of the Congo and Pakistan. In India, only 1 case of wild poliovirus has been reported this year--a remarkable feat in a country that in many recent years has had a plurality or majority of the world's polio cases.[50]
Since the start of 2010 there have been 14 outbreaks of polio. Several are continuing into 2011. To June 2011 Chad has reported 80 cases; the Democratic Republic of the Congo has reported 59; and Pakistan has reported 54. Polio transmission has recurred in Angola, Chad and the Democratic Republic of the Congo. The number of cases reported in Pakistan is double the number reported over the same period in 2010. 16 cases have been reported in Nigeria. Although the situation in Northern Nigeria has improved, concerns exist about further outbreaks there because of its central location. On the basis of current trends it would appear that Pakistan will be the be last place of Earth where wild polio will survive.
Up to the end of August there have been 364 cases reported (308 type 1 and 56 type 3). Up to the same date in 2010 there were 641 cases (574 type 1 and 67 type 3). Kenya has reported its first case since 2009. China has reported four cases - the first cases since 1994. Côte d'Ivoire has reported 34 cases of type 3 polio as part of an ongoing outbreak. Afghanistan has reported 18 cases (all type 1). Chad has reported 109 cases. India has reported no case since January.
The situation in Pakistan is complex. The lowest number of cases reported in one year was 32 in 2007. In the first six months of 2011 there were 69 cases (compared with 37 in the same period in 2010). The remaining focuses lie in three parts of Pakistan: Balochistan Province,Karachi and the Federally Administered Tribal Areas.[51] About 25% of children in Karachi are unvaccinated against polio; in Balochistan ~50% are unvaccinated. In contrast in Afghanistan the unvaccinated rate is ~10%. The difficulty in Pakistan appears to be a lack of trust in the health workers trying to vaccinate the children, fueled partly by the CIA using fake vaccination campaigns as a cover to gather DNA samples from Osama Bin Laden's relatives[52].
Up to the end of September there have been 429 cases - 370 due to type 1 and 59 due to type 3. 36 have been reported in Afghanistan. Chad has reported 111 cases. 10 have been reported in China: all have occurred in the Xinjiang Uygur - 9 in Hotan prefecture
Afganistan reported a total of 76 cases in 2011 - all type 1. Cases were concentrated in the southern region of the country
Cases due to both type 1 and 3 were reported in Nigeria in 2011.


The WHO reported that in 2011 India had its first polio-free year and is therefore no longer considered polio-endemic.[53]
Nigeria remains the only polio-endemic country in Africa. The first case of wild poliovirus (WPV3)in 2012 in the country was reported on 14th January, 2012 from Sokoto State. [54][55]

[edit]See also


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  3. ^ McNeil, Donald (February 1, 2011). "In Battle Against Polio, a Call for a Final Salvo". New York Times. Retrieved 1 Feb 2011.; excerpt, "... getting rid of the last 1 percent has been like trying to squeeze Jell-O to death. As the vaccination fist closes in one country, the virus bursts out in another .... The [eradication] effort has now cost $9 billion, and each year consumes another $1 billion."
  4. ^ a b Barrett S (2004). "Eradication versus control: the economics of global infectious disease policies.". Bull World Health Organ. 82(9): 683–8. PMC 2622975. PMID 15628206. Retrieved 2007-04-13.
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  22. ^ John F Maudlin. "The Bumpy Road to Polio Eradication". NEJM(362): 2346–2349
  23. ^ Due to the large increase in the number of vaccinators and field workers since 1998, the number of estimated cases is thought to be reasonably close to the actual reported number of cases in recent years. Aylward, Bruce, Jennifer Linkins. "Polio Eradication: mobilizing and managing the human resources". World Health Organization. Retrieved 2007-02-01.
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