POLIO- A Re-emerging Global Health Priority

The global health systems and the communities worldwide were overwhelmed with over 300,000 wild polio cases around 3 decades back, bringing enormous focus on controlling and eliminating the spread of disease. The collaborated and rigorous efforts have resulted in the decline of polio cases by 99.99%, with multiple countries across the world obtaining “Polio free status”. Albeit in current scenario with globalization and inter country movements at an unprecedented rate, is anyone “safe” until everyone is safe, remains a point of contention.

The global spread of COVID-19 and now the emergence of monkey pox have given enough warning signs to establish the need of early interventions and strict surveillance, if we anyways are looking to prevent any other epidemic/pandemic.

Recently reported wild polio cases in the countries like Malawi and Mozambique, are sending alerts for POLIO outbreak concerns across the globe. Before these reported cases, Afghanistan and Pakistan were the only two countries in world, which are identified as an endemic country for POLIO cases and reporting wild POLIO cases.

POLIO program is currently being threatened by the circulation of this deadly virus via three presentations-

• Wild POLIO cases
• Circulating Vaccine Derived Polio Virus (cVDPV)
• Positive environmental samples for Polio virus/cVDPV

As per Global Polio Eradication Initiative, including 2 endemic countries, there are 28 outbreak countries and 7 at risk countries for POLIO disease this year. Recent positive environmental samples from London (UK) and Kolkata (India), prove that there is a circulation of cVDPV around. These two places are strategically significant as London is an International transit spot and Kolkata is in a State which is bordering to State of Bihar and country Bengal, a significant POLIO hot spot in the past. India reported its last case in West Bengal only. Around 20% of population is under Immunized for POLIO vaccine at both of the places.

The above scenario is one such example, although currently there are 28 countries in world, which have circulating polio virus, in one form or the other.

There are multiple healthcare priorities around the globe, though what we can’t afford right now is another outbreak, also a polio outbreak will not only contribute to the disease burden, but will be a huge multifaceted loss in terms of economic, human resource and years of hard work put in to eliminate this deadly disease. It’s the time when the focus and efforts should rather intensify to ensure the efforts from the past are not wasted, it is extremely crucial to bring utmost focus on POLIO spread across the world, before the damage is done. Loss to the polio eradication program will also have implications on the morale of thousands of public health professionals across the world, who have worked tirelessly on the policy, implementation, advocacy at all intersections and levels. The trust of community in public health programs and interventions is another dimension that has be considered before we loosen the grip on the polio eradication efforts.

Its once again the time to bring the focus back on the efforts towards

-?????????Improving Routine Immunization Coverage

-?????????Conducting campaigns in outbreak areas with nOPV2 or IPV

-?????????Increasing the sensitivity of surveillance

-?????????Managing POLIO vaccination for international travelers (where required)

-?????????Ensuring risk commu8nication

-?????????Conducting National Immunization Campaigns in endemic areas

-?????????Securing adequate vaccine stock pile

-?????????Conducting reviews at different level

-?????????Bringing researchers, policy makers, politicians and global public health thinkers on same platform

-?????????Acquiring integrated approach for prevention and control of all of the infectious disease of concern

To conclude it is indeed necessary to weigh the need of intensifying polio eradication efforts worldwide, with understanding the basic concept of “Global safety” being the only way to prevent any future disease outbreak/epidemic/pandemic. The biggest advantage with polio is that we have enormous knowledge, experience and expertise to curb its spread, the only need remain is to start working towards the escalated efforts, before we miss the bandwagon.