India leaps to first polio-free nation, but might a second attempt be needed?

Last September, India became the first country in the world to give an oral polio vaccine to every child under the age of five.

The World Health Organization and partner organizations, including Rotary International, have designated the move a major milestone in global polio eradication. India also launched a vaccination drive, joining Pakistan, Afghanistan and Nigeria in providing the oral polio vaccine in schools and places of worship.

According to the latest WHO figures, the number of children living in polio-endemic areas of Afghanistan, Nigeria and Pakistan have fallen from about 47 million in 2015 to 32 million this year, making the three countries polio-free for the first time in 15 years.

In India, though, the stock of polio-carrying wild virus is said to be high and there is still some talk of reintroducing the disease, though polio officials say that’s very unlikely. The major reasons behind the need for a new vaccine are both political and cultural. In Afghanistan, large numbers of nomadic groups still regard the vaccine as a Western threat and the northern tribal areas of Pakistan are rather tightly controlled by militant groups.

So far, a new oral polio vaccine — developed in collaboration with the U.S. government — has been developed and distributed to 5.4 million children in both Pakistan and India. In Pakistan, this vaccine, called Varilac, was deemed as the first truly effective oral polio vaccine in the developing world in the 1990s. But the move was met with some resistance and eventually, production of the vaccine was halted as militants pressured manufacturers to halt production and on some occasions blocked shipments from making their way to Pakistan.

Indian officials hope this new vaccine, called Omnilam, will address the culture of fear and resistance. But the research has not been entirely convincing, a recent report by Reuters on researchers of the Omnilam project, funded by Rotary, found.

India’s Omnilam oral polio vaccine was tested in 14 selected districts in 2010 and the analysts found that the vaccine was only effective in half of the cases.

The overall effectiveness of the treatment was also mixed. In children who were vaccinated with Omnilam, researchers saw more than an 80 percent chance of stopping the disease within three months, but this was not the case for many other vaccines. The report by Reuters suggests some poor planning and a potential mixed up interpretation of infection caused by other vaccinations in the past. And now, in order to stem the transmission of polio, researchers have also started testing a more effective oral vaccine, called CMV-VAX, with an eye to an approval for rollout in Pakistan and Afghanistan.

According to the Guardian, the Indian National Tuberculosis Control Programme recently tested this vaccine on 11,500 children in districts in the Punjab, the northern state that has recently seen an increase in tuberculosis cases. Initial results from the test found no indication of resistance among the children.

Whether or not India’s response to polio is successful will be determined by the pace of vaccine production and the ability of aid organizations to access areas of high polio transmission.

Read the full story at India Today.


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