Reach the last person

Sunday 29 February 2004

Will that crippling scourge called polio be wiped out from the face of the earth by the end of this year? The World Health Organization (WHO) hopes so. But all its ambitions -- and that of the six governments it is working in tandem with -- will go to nought if the last person the disease could afflict isn't immunised. Reach the last person, Mahatma Gandhi used to say. How apt this pithy lesson on governance is in this effort to eradicate a disease that, otherwise, can only bounce back...

-- WILL that crippling scourge called polio be wiped out from the face of the earth by the end of this year? The World Health Organization (WHO) hopes so. But all its ambitions -- and that of the six governments it is working in tandem with -- will go to nought if the last person the disease could afflict isn't immunised. Reach the last person, Mahatma Gandhi used to say. How apt this pithy lesson on governance is in this effort to eradicate a disease that, otherwise, can only bounce back.

But how well are governments immured to this lesson? Despite the much-hyped nation-wide polio immunisation drive, commenced in 1995, India recorded a six-fold increase in polio cases in 2002. In 2003, the number of cases dropped drastically, but polio had spread to three regions other than the usual hotspots UP and Bihar, sporadically but surely. The reasons were obvious: a drastic cut in budget for the polio vaccine coverage and the lackadaisical attitude of the public health machinery.

India, with a high intensity transmission rate, is central to the world health body's polio eradication plans. WHO has every reason to decide to go for the kill. Its well-chalked-out 15-year-old initiative has pushed the poliomyelitis virus back to a few reservoirs in six endemic countries -- from 125 countries in 1988. But it is also fighting against time: if the disease is not controlled by 2004-end, the yawning gap between the demand for funds and its supply may get the better of the programme. The six endemic countries, apart from India, are Pakistan, Afghanistan, Egypt, Nigeria and Niger. Recently, other African countries which share borders with Nigeria -- Benin and Cameroon -- reported polio cases.

Polio has no cure. It can spread in no time. It targets the most vulnerable section of society: kids under age 5. It invades the nervous system, and can cause total paralysis in a matter of hours. One in 200 infections leads to irreversible paralysis, usually in the legs. Come December 2004, if the bug is still in no mood to relent, what would be abetting it would not be natural factors, but inefficient health management practices. Its containment demands much more than ambition, or preaching: it demands no less than an absolute commitment to reach the last person. Before the virus does.

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