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Polio Immunization in India February 2015 Patricia Simone

Disclaimer:

I am not…

A nurse

A VPD expert

A Rotarian

An expert on India

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I am…

Passionate

Kind-hearted

A globally aware learner

Grateful!

India (2015)

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1.3 billion population

Independent from Britain 1947

10th largest GDP

3rd largest purchasing power

3rd largest army

9th in military spending,

including space program

74% illiterate

Crime rates tied to caste system

800,000 without latrines

Air pollution is #5 killer

4 main religions + 4

Traffic challenges

500,000 babies born every minute

(2 per second)

India & Polio

Perfect conditions for poliovirus

Population, sanitation, drinking water,

malnourishment in 40 million children

Vaccine resistant population

OPV – 2 strains

2009: Half of world cases of polio

2014: declared polio free by WHO

Global Polio Eradication Initiative:

Rotary International (RI), Bill Gates Foundation, UNICEF, CDC, WHO

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Polio 101

Gone from Americas, Western

Pacific, Europe

Still 125 countries under watch

globally

No cure, prevention only

Vaccine introduced in 1978 in India

Treated as an ongoing public

health emergency

All states are kept in readiness mode to

undertake mass immunization within

7 days

Twice annual tabletop exercises in the 12 riskiest states

Pakistan, Nigeria, Afghanistan plus

hotspots of Somalia, Syria, Iran

How? RI + WHO + India hold

National Immunization Days (NIDs)

in February

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What I did

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Challenges

Low levels of routine immunizations

Developing religious advocacy: 3 sects of Islam

Very low socio-economic status

Population movement

Polio knows no borders:

Densely populated areas (northern India)

High rates of malnutrition and unhygienic conditions

Switchover

Withdrawal of OPV to minimize risks in post eradication phases

Switch from tOPV to bOPV in 2017

Withdraw of OPV by 2019

Review of scope and frequency of polio campaigns

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February NID Logistics

709,000 vaccination booths + 2,500,00 vaccinators = 1,170,00 teams

155,000 supervisors each with transportation :

car, motorcycle, moped, bicycle, boat, elephant, camels

225 million doses of OPV in 2 million insulated vaccine carrier bags

6.3 million icepacks to keep cold chain

February NID Logistics

209 million homes visited

170-172 million children in NID campaign

Helicopter air drop of literature

Celebrity involvement: Professional Cricketers, Bollywood stars, Foreign ambassadors, Prime Minister Modi

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WHO

391 Medical Officers

964 Field Monitors

272 Locations Educate foreign

vaccinators

Education and support

of local teams

Intensive Monitoring

Capacity Building

Statistics & Research

Challenges

Program fatigue in workers

Minimal physician involvement

Many open positions in public health

Lack of intensive training

Rumours about OPV

Tendency to ‘hide’ male children

Religious advocacy

Negative propaganda

Low level of routine immunization

Children in the labour class: leave before 8 AM, return after 6 PM

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St.

Stephen’s

Polio

Hospital in

Delhi

Only one of its kind in India

Corrective surgeries to restore mobility

Treatment garners less attention vs. immunizing children

Given special shoes and orthotic aids free

Accepts all patients from everywhere

Patients also found in rural villages by health workers

Hold 83 corrective surgery and rehab camps around India

1.4 million prosthetics customized and distributed through Jaipur Limb Clinic

Supported by RI

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World Polio Day – October 28

Celebrates the work & achievements of

Dr. Jonas Salk (1961)

Approached RI for Global Awareness

campaigns

2 tiny drops with Vitamin A included

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Issues

Economics Health Divides

Funding

Politics World

Peace!