|dc.description.abstract||Polio eradication continues to be a priority in the South-East Asia Region. In the first four months of 2009*, 40 polio cases were detected in India with 14 subtype 1 poliovirus (P1) and 26 subtype 3 poliovirus (P3) cases. This paper presents an update on the progress and challenges in polio eradication.
At the start of 2008 a reduction in the transmission of P1 cases, particularly in western Uttar Pradesh (UP) was seen which, however, was offset by re-importation from Bihar in the later half of the year, resulting in 62 subtype P1 cases. Rapid and large-scale mop-up immunizations prevented P1 importation into neighbouring states. The subtype P3 outbreak of 2007 was rapidly controlled with massive outbreak response and mop-up operations.
There are several challenges to the eradication of polio from the Region. The principal challenge in India is overcoming suboptimal vaccine efficacy in the districts of western UP which continues to be polio endemic. Another key challenge in the endemic areas is the low levels of sanitation and personal hygiene. While some efforts have been made by the government, these are at present not of sufficient scale to have an impact. More needs to be done in this area.
The main challenge for other countries in the Region, in particular the countries that share an open border with India, is to protect their polio-free status by preventing re-infection. A strong routine immunization programme that can deliver and maintain OPV3 coverage greater than 80% in all districts in all countries will help prevent re-infection. Additionally, all polio-free countries must conduct periodic risk assessment to determine the level of risk of re-infection and spread, and to decide whether or not polio immunization campaigns will be required to boost population immunity.
Finally, polio eradication requires substantial funding. A substantial proportion is being met through external funding. Member States can help the eradication effort by committing funds for surveillance, outbreak response, and strengthening routine immunization delivery.
The paper is submitted to HLP Meeting for its consideration and noting.||en