Bill & Melinda Gates Foundation

Q&A with Ramesh Ferris: Polio-Free Certification of World Health Organization’s South-East Asia Region

March 27, 2014

Today the South-East Asia Region of the World Health Organization (WHO) was certified polio-free, the fourth of six WHO regions to receive the designation. This region of 11 countries is home to 1.8 billion people. With this milestone, 80% of the world’s population now lives in certified polio-free regions.

1. How important is this milestone?

Today is an incredible moment for the polio eradication effort: 11 countries in South-East Asia have been officially certified polio-free. India recorded the region’s last case on January 13, 2011, opening the door for the entire region to receive the polio-free certification. The accomplishment is the result of strategic partnerships (involving the Government of India, World Bank, Bill & Melinda Gates Foundation, WHO, UN, UNICEF, Rotary International, US CDC and Red Crescent), strong, dedicated leadership from both private and public sectors, and extraordinary commitment at all levels.

As a polio survivor from India, who only learned to walk after multiple surgeries, I can personally attest to the significance of wiping polio out of the region. In fact, I’d say it’s one of the most important global health achievements of all time.  

In December, I traveled to India and had the honour of meeting Dr. Matthew Varghese at St. Stephen’s Hospital in New Delhi and got a chance to visit the polio ward he’s been heading for over 30 years. The impact of India’s feat is clear there. For years, Dr. Varghese has been providing free-of-cost corrective surgeries to polio survivors. Now, India’s success in reaching children with the polio vaccine is reducing the number of young patients needing treatment. Dr. Varghese says that he looks forward to the day he’s out of a job and the ward is no longer needed – and we’re on our way there.

What’s more, the impact of this historic health achievement stretches far beyond polio itself. The infrastructure and innovations developed by the polio program in India are already helping tackle other health issues in the country. For example, India’s polio program rallied an impressive network of more than 7,000 social mobilizers who also help ensure newborns receive the range of other critical vaccines they need.

Finally, this accomplishment has demonstrated to the rest of the global community that when we work together we can achieve what once seemed impossible – a public health lesson that will hopefully resonate for years to come.

2. Experts have said India was the hardest place to get rid of polio. What are your thoughts on this? Do you agree?

India has a huge, densely packed population and poor sanitation in many areas, which, among other challenges, made tackling polio there extremely difficult.

But the last stretch is also a difficult one, and the three remaining endemic countries – the final polio reservoirs – all also come with their own unique set of challenges. That said, I’ve personally met with the presidents of these countries (Nigeria, Pakistan and Afghanistan), and am pleased to report that the political will and support to achieve a polio-free world is there. And India’s success offers inspiration that they too can tackle the disease.

These three countries are also benefiting technically from India’s experience. Experts from India have offered boots-on-the-ground support to help improve day-to-day operations in the endemics. Lessons learned include better mapping and planning systems to improve vaccine coverage, and innovative monitoring practices such as finger marking. India has revolutionized worldwide polio eradication efforts and created a successful blueprint for the last three remaining polio endemic countries to follow and make what may seem impossible possible in their own countries too. 

 3. What’s next now for India?                                                                                                                 

As I mentioned, India, and many of the other countries in the region, are now using the infrastructure developed to end polio to address other health issues – part of the polio program’s legacy.

But the region must still remain vigilant with respect to polio. Recent outbreaks in the Middle East and Horn of Africa show that a case of polio anywhere in our world is a threat to children everywhere in our world; no country is truly polio-free until the world is polio-free. India and the other countries in the South-East Asia Region continue to implement the successful blueprint developed to ensure that children receive the polio vaccines they need. They will need to continue these efforts until the disease is wiped out everywhere. If we don't continue the fight against polio, the WHO estimates that 10 million children will be paralyzed over the next 40 years.

Our job as a global community is not to turn our backs or decrease funding now that the end is closer with India polio-free, but rather our job is to move forward with the same vigour knowing that if India can be polio-free, the rest of the world can be polio-free!

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