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.

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.

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.

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 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.

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.

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).

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

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