Polio NID 2019Journey of the Polio Eradication Program in

India

1985 – After a successful pilot project of Polio immunization in the

Philippines in 1979, Rotary launches its most ambitious programme:

PolioPlus

1986 – Rotary International provides Euro € 2.3 (USD 2.62) million

grant to Tamil Nadu for Polio vaccine

1987: Rotarians around the world raise Euro € 216 (USD 245.87) million for

PolioPlus funds for the purchase of vaccine for a five year term (WHO

History – Carlos Canseco, Albert Sebin

1988 : World Health Assembly resolves to eradicate Polio from the world.

GPEI – Global Polio Eradication Initiative - spearheaded by Rotary, WHO,

the US CDC and UNICEF

1988 – 1994/95 The Challenges faced.

▪ Ministry

▪ Health State Subject

▪ Dr. Harshvardhan

▪ SSD (Shishu Suraksha Diwas) 2 Oct – 14 Nov

Surveillance,

Operation and

Monitoring

Vaccine

Procurement,

Communication

and Social

Mobilization

Advocacy,

Funding & Social

Mobilisation

Funding and

Surveillance

UNICEFWHO & GOVT.

CDC

(US, Federal Govt)ROTARY

Global Polio Eradication Initiative (a global partnership) is established after the World Health Assembly

resolution on Polio. The Polio eradication Partnership is spearheaded by….

Countries Year-to-date 2019

Year-to-date

2018

Total inOnset

paralysis of

case

WPV cVDPV WPV cVDPV cVDPV WPV cVDPV

Afghanistan 0 0 0 0 21 0 6-Nov-18 N/A

Democratic Republic of the

Congo

0 0 0 0 0 20N/A 7-Oct-18

Niger 0 0 0 0 0 9 N/A 30-Oct-18

Nigeria 0 0 0 0 0 33 N/A 21-Nov-18

Pakistan 0 0 0 12 0 7-Oct-18 N/A

Papua New Guinea

0 0 0 0 0 26 N/A 18-Oct-18

Somalia 0 0 0 0 0 13 N/A 7-Sep-18

Polio-compatible case is a case in which one

adequate stool specimen was not collected

from a probable case within 2 weeks of the

onset of paralysis, and there is either an acute

paralytic illness with polio-compatible residual

paralysis at 60 days, or death takes place within

60 days, or the case is lost to follow-up.

• Rotary’s contribution worldwide at present stands at

Euro € 1.5 (USD 1.8) billion towards the PolioPlus

Program

• Rotary apart from their own contribution helped raise more than

Euro € 7.5 (USD 8.5) billion from donor governments for the cause

• In India R.I. contributed Euro € 176 (USD 200) million for eradication of Polio

4 PILLARS

ROUTINE OPV

IMMUNISATION

MOPPING UP

OPERATIONS

IN HIGH RISK

AREAS

PPI

NID/SNID

REPORTING ALL

AFP CASES

(Surveillance)

# Each of these components is essential for the complete eradication of Polio.

1. Maintaining immunity

2. Maintaining surveillance

3. Readiness to respond

4. Reducing risk

5. Building on polio

6. Preparing for the endgame

Year 2005 = 66 wild Polio cases

Year 2006 = 676 wild Polio cases

Year 2007 = 874 wild Polio cases

Year 2008 = 559 wild Polio cases

Year 2009 = 741 wild Polio cases

Year 2010 = 42 wild Polio cases

Year 2011 = 01 wild Polio case

Year 2012 - 2018 = NO CASE

Last case reported in Uttar Pradesh = P-3 with onset on 21

` April 2010

Last case reported in Bihar = P-1 with onset on 1

September 2010

Last Case reported in India in West Bengal = P-1 with onset 13

January 2011

Last Wild Polio Virus case by

Country

Country Year

Bangladesh 2006

Bhutan 1986

DPR Korea 1996

India 2011

Indonesia 2006

Maldives 1994

Mynmar 2007

Nepal 2010

SriLanka 1993

Thailand 1997

Timor-Leste 1995

WPV Type 2

District: Aligarh

State: Uttar Pradesh (India)

Date of onset: 24-Oct-1999

WPV Type 3

District: Pakur

State: Jharkhand (India)

Date of onset: 22-Oct-2010

WPV Type 1

District: Howrah

State: West Bengal (India)

Date of onset: 13-Jan-2011

Nationwide

campaignsSub-national

campaigns

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

2016

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

2017

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

2018

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

2019

Helps sustain population immunity against polio –reduces risk of circulation of poliovirus

Important component of the polio endgame strategybefore & after withdrawal of OPV

Protects children against other vaccine preventablediseases

The Government of India as a strategic endeavour to boost Routine

Immunization coverage in the country launched Mission Indradhanush on 25

December 2014.

In line with Routine Immunization, this Mission provides vaccination against

seven life-threatening diseases and is aiming towards reaching the

unreachable. Three phases already implemented.

The Government has made funding available for IEC and Social Mobilization

for the Mission under the National Health Mission (NHM) funds.

528 District in India were targeted. (First Phase - 201 districts with weak RI

identified for focused attention, Second Phase – 297 districts to be covered)

• 709,000 vaccination booths

• 2,500,000 vaccinators

• 1,170,000 vaccination teams

• 155,000 supervisors, with 155,000 vehicles ( cars, motorcycles,

mopeds, bicycles, boats, elephants, camels or whatever it takes )

• 225 million doses of Polio Vaccine, carried around the country in 2

million vaccine carrier bags

• 6.3 million ice packs to keep al those doses of polio vaccine in the 2

million vaccine carries bags cold

• 209 million homes visited

• 170-172 million children immunized in one NID

Status of AFP Cases as on 18 January, 2019

Year AFP VDPVConfirmed

PolioCompatible Discarded Pending

2017 39128 0 0 37 39091 0

2018 36107 0 0 6 33426 2675

2019 428 0 0 0 2 426

"DECLARES polio eradication a

programmatic emergency for global

public health, requiring full strategy

implementation, strong national

oversight & accountability, and

vaccination recommendations for

travelers to & from infected areas "

25 May 2012

On 5 May 2014, the Director-General of the World Health Organization (WHO)

declared the international spread of wild poliovirus (WPV) a public health

emergency of international concern (PHEIC).

A surge of technical assistance and social

mobilization capacity...

If any child in the world is permanently

paralysed by Polio it is now a Global

Emergency

If any child in the world is not reached by

Oral Polio Vaccine it is now an emergency.

The Govt. of India has constituted a “Central Emergency Preparednessand Response Group” to ensure adequate preparedness for a rapidresponse and manage the actual response to the detection of a wildpoliovirus anywhere in India.

Rotary’s Role in Emergency Preparedness

and Response Plan

Advocacy at state and district levels for quality implementation ofpolio eradication activities.

Support IEC/Social mobilization activities & media management incoordination with Govt.. UNICEF and NPSP.

Any other essential emergency support activities.

Govt of India issued the notification:

A dose of oral polio vaccine (OPV) for all travellers to

and from India from polio endemic countries : In the

absence of which VISAS will not be issued.

Govt of India has set up immunisation booths across

borders.

PAKISTAN

INDIA

BANGLADESH

MYANMAR

NEPAL

Vaccination post

88 vaccination posts

along Indo-Nepal border since

Apr 2011

5 vaccination posts

along Indo-Pak border

since Sep 2011

2 vaccination posts along Indo-Bangladesh border since Mar 13

2 vaccination posts along Indo-Myanmar border since April 13

Measles and Rubella are

endemic across the

country

95% of the measles and

90% rubella cases

occurring under 15 years

of age

More than 50% of

measles cases

unvaccinated

Age distribution and

vaccination status of

Measles cases in

2016

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Rubella cases

in 2018

39 % cases found

unvaccinated

Measles Rubella (MR) to be given to the children of 9

months – 15 years, under SIA campaign.

MR elimination is targeted by 2020.

IEAG on MR seeking support from Rotary for MR

elimination.

Over 95% coverage from MR is required for elimination.

But MR coverage for several years is at 70%.

Rotary India’s new initiative to help Government to

eliminate MR by 2020

Withdrawal of oral polio vaccine to minimize risks

associated with use of OPV in the post eradication phase

Switched from tOPV to bOPV in April 2016

Withdraw all OPV from Routine Immunization

programme in 2018/2019

IPV introduced in November 2015. The introduction will

also protect the occurrence of vDPV cases.

The total funding requirement as on date is

USD 500 million/ Euro € 439 million.

In 2007, the Gates Foundation gave The Rotary Foundation a Euro

€ 88 (USD 100) million challenge grant for polio eradication, and in

2009, increased it to € 312(USD 350) million.

Rotary agreed to raise Euro € 176 (USD 200) million in matching

funds by 30 June 2012, but Rotarians in fact raised Euro € 200 (USD

230) million toward the challenge.

Gates Foundation will match two-to-one, up to Euro € 44 (USD 50)

million per year, every dollar Rotary commits to reduce the funding

shortfall for polio eradication through 2018.

Vaccine-derived polioviruses (VDPVs) are rare strains of poliovirus that

have genetically mutated from the strain contained in the Oral Polio

Vaccine

The oral polio vaccine contains a live, attenuated (weakened) vaccine-

virus.

When a child is vaccinated, the weakened vaccine-virus replicates in

the intestine and enters into the bloodstream, triggering a protective

immune response in the child.

Like wild poliovirus, the child excretes the vaccine-virus for a period of

six to eight weeks.

This is called a vaccine-derived poliovirus, which very rarely can lead

to Paralysis .

Inactivated polio vaccine (IPV) was developed in 1955 by Dr Jonas

Salk. Also called the “Salk vaccine”, IPV consists of inactivated (killed)

poliovirus strains of all three poliovirus types.

IPV is given by intramuscular injection and needs to be administered

by a trained health worker.

Advantages

As IPV is not a 'live' vaccine, it carries no risk of vaccine-associated

polio paralysis.

IPV triggers an excellent protective immune response in most people.

IPV is one of the safest vaccines in use. No serious systemic adverse

reactions have been shown to follow vaccination.

Rotary is working closely with Governments, WHO, UNICEF, BMGF and other

associated organizations to support the PolioPlus program in India.

WHO provides the technical support to the program

UNICEF looks after the communication aspect

Rotary provides support through Funding, Advocacy, Social Mobilization and

Operational Support

Visiting Rotarians from across the world create an environment of festivity and

increase booth coverage & helps motivate and enthuse local health workers,

medical staff and Host Rotarians

They create the awareness back in their countries leading to further support to

advocacy of the program in India and globally.

Its not over until its over everywhere

'The price of freedom is eternal

vigilance'

World Polio Day Celebration 2016 – Rotary reached more than 10 lakh (1

Million) students through a special film & other events in the month

leading to World Polio Day on October 24, 2016

India on World Polio Day illuminated iconic sites across the country including historic

monuments India Gate, Red Fort with End Polio Now message.

Red Fort

India Gate

India GateRed Fort

Rotary celebrates India’s Polio Free certification by hosting the historic

India Polio-Free Conclave 2014.

Our sincere thanks to PRID. Brad Howard and

PDG. Emma Groenan for leading the ‘Polio

Volunteers’ to India year after year and

organizing awareness events in their respective

District’s to support ‘End Polio Now’ campaign.

Rukhsar with her Mother in 2011 Rukhsar with INPPC Chair

Mike McGovern during his

visit to Kolkata

Thank You!

To the many Rotarians from overseas who are

here today and have volunteered time and

again for the program in INDIA .We salute your dedication.