Bill & Melinda Gates Foundation

Polio-Free South-East Asia Region: A Triumph That Transcends All Boundaries

March 26, 2014

In 2006, I was working for WHO’s National Polio Surveillance Project in India where I was responsible for surveillance and immunization activities to facilitate polio eradication. On my way back to my office one day after examining a child suspected to have polio, I took the above photo as we were driving past the international border between India and Bangladesh. 2006 was the year when Bangladesh reported 18 cases of polio after not having a case since 2000.  The outbreak came from across the border in India, which, had nearly 670 cases that year.  This image of the setting sun that evening reminded me of the reality of infectious diseases and vulnerabilities of us, the people, and the countries. The sun setting on the Bangladesh sky had its reflection across the man-made barbed wire border, onto the Indian waters. The parallel was too evident to be missed: as long as polio remained on one side of the border, it could cross over and infect children on the other side.  

Almost a decade later, today, 1.8 billion people across 11 countries in the South-East Asia Region of WHO (SEARO) are polio-free, and are expected to join the Region of the Americas (1994), the Western Pacific Region (2000) and the European Region (2002) as polio-free. India, the biggest country in SEARO, was long considered the most challenging place on earth to eliminate polio. In the past decade, importations of the virus in 3 of the 11 member states of SEARO were attributed to the on-going circulation in India. However, historic efforts from over two million volunteers coupled with local, national and global commitment to improve routine and mass immunization campaigns have resulted in India being wild polio-free ever since January 2011.

The regional polio-free certification of SEARO has been made possible due to the unprecedented trans-national efforts from governments and policy makers, exceptional improvements in quality of vaccination programs, and the dedication of millions of community health workers who delivered polio vaccines to each and every child, in the most challenging terrains and circumstances. Strong surveillance systems and laboratory network for rapid detection and response to any polio transmission, and meticulous documentation of the programmatic interventions were also critically important in ensuring success.  Ending polio in these 11 countries—most of which have been polio-free for more than 15 years—forged strong health care delivery and disease detection systems that are now being used to advance other health priorities.  In order to protect the historic progress in the battle against polio, we must remain committed to improving routine immunization and maintaining sensitive surveillance in these areas. Strengthening such initiatives in the currently endemic and re-infected countries in other parts of the world will be important to achieve the goal of global polio eradication.

I strongly believe that the day is not far, when the story will be that of a rising sun, showering light across all borders and geographies, in a world that is united in being polio-free.

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