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Polio Eradication Program in India: Actions in Post-Eradication Phase. By Prasanta K. Saha , M.Sc., FRSS(UK), CSTAT(UK) Sr. Consultant: National Council of Applied Economic Research, India
Prasanta K. Saha, M.Sc., FRSS(UK), CSTAT(UK)
Sr. Consultant: National Council of Applied Economic Research, India
[Former Chief Director: Ministry of Health & Family Welfare, & Additional Director General: Ministry of Statistics & Program Implementation, Govt. of India].
Under the Polio Eradication program of India, the most relevant issues-both technical and administrative, which will arise in post-eradication situation, are discussed in this lecture.
Polio Cases in India as on 5th June, 2006:
Serious Actions needed in Post- Eradication Phase
First to characterize the actual factors that country-level policy makers must weigh to manage polio risks during the first 5 years after certification by WHO.
Policy makers are to primarily formulate policies related to
Global certification will occur once all 6 Regions of World Health Organization (WHO) confirmno wild poliovirusunder high-quality surveillance for at least 3 years and the Global Certification Commission becomes satisfied that sufficient laboratory containment exists.
Determination of reasons for high incidence of vaccine failure
Answer to this query is derived from some of the reasons as revealed in various PPI rounds are as follows:
Portable cold storage containing the vaccines not providing desired cool temperature
Note: A few vials of Polio vaccines might have expired their effectiveness but that might have escaped notice of the health workers. It has been experienced that in rural areasContd.
the portable cold storage containing the vaccines does not provide desired cool temperature as the ice kept inside gets melted after sometime and there is no scope of filling it with fresh ice because the same is not available in the locality [NPSU, WHO regional office, New Delhi may supplement with further information].
(1) After eradication there was again outbreak of Polio in China [ after 5 years], Hispaniola [after 6 years], the Philippines [ after 4 years], Madagascar [ after 3 years] and in Egypt [ perhaps, after 25 years].
Such arrangement is yet to be initiated in India.
OPV Cessation Plan:
Policy Options for the First 5 Years Following Certification:
From the analysis of the implications of delays in outbreak response, experts recommended: (a) maintaining active surveillance for at least 5 years after ceasing all polio vaccination, (b) minimizing delays in diagnosis and confirmation of an outbreak,
(c) restricting poliovirus work to a few high-level containment laboratories, (d) maintaining OPV manufacturing capacity, and (e) establishing a stockpile and a response protocol for outbreaks.
(administered at 6, 10, and 14 weeks, with the fourth dose given either at birth or within the first year) in order to be fully protected against polio.
Management of Chronic Excretors of Polioviruses
Management of Chronic Excretors of Polioviruses: Current policies-continued
1. ‘Nature’,Vol.434,April,2005: ‘ A global call for new polio vaccines’
2. Dr. François Bompart, Aventis Pasteur, 2, avenue Pont Pasteur, 69367 Lyon Cedex 07, France.
3. Nalinee Sangrujee, PhD, MPH; Radboud J. Duintjer Tebbens, MS; and others: Medscape General Medicine:‘Policy Decision Options During the First 5 Years Following Certification of Polio Eradication’. www.medscape.com