A committee including experts from home and abroad has asked for direct intervention by the Prime Minister and President in the fight against polio, saying the next six months are ‘‘a critical period’’ for the eradication programme in the country, with a deadline of end 2004.The committee comprises eminent personalities like Director General of the Indian Council for Medical Research (ICMR) Dr N.K. Ganguly, representative of the Centre for Disease Control, Atlanta, Dr Steve Cochi, and the WHO in-charge of the Global Polio Eradication programme, Dr Bruce Aylward.In a report submitted to the Health Ministry after a meeting of the India Expert Advisory Group for polio eradication on November 18 and 19, the committee has recommended that A.P.J. Abdul Kalam Azad and Atal Behari Vajpayee be requested to make public appeals through the media to get national support for polio eradication.While the good news is that high-risk areas like UP (which is still leading, with 70 cases of the 190 reported in the country this year) and Bihar (13) were found to be ‘promising’ this year, Karnataka (31 cases) and Andhra Pradesh (18) have been listed as the new hot zones. The two states had maintained zero status in the past few years, including the epidemic outbreak of 1,600 cases in the country in 2002.‘‘.Coming after the major outbreak in West Bengal in 2002 and early 2003, the outbreak in the southern states demonstrates the significant risk faced by states, that have previously been polio-free, when gaps in immunity in young children develop. These risks will remain as long as the wild polio virus continues to circulate anywhere in India,’’ the reports points out.‘‘While the problem in Uttar Pradesh is due to the misconceptions in the minority community, the southern states have become a problem just because of poor routine immunisation policy of the state government. While there are just two cases among Muslims in Karnataka, there is only one case among the minority community in Andhra Pradesh,’’ said an official in the ministry who did not want to be named.Suggesting a revamp of immunisation strategies like supplementary immunisation activities, strategic communication, surviellance and routine immunisation services, the committee has called the next six months ‘‘the most critical period for polio eradication and also a period when strong government leadership at all levels is most crucial.’’ Insisting that ‘‘there can be no better oppurtunity than now to interrupt the wild virus transmission in India as only 190 to 200 cases had been reported’’, the key recommendations of the committee are:•The Government should implement the national policy of giving polio vaccine together with BCG at the time of birth.•Re-activating the national parliamentarians’ Polio Consultative Committee as early as the Parliament session.•Monthly briefings of the status of polio programme to be sent to the PMO every month.•The Prime Minister should hold a meeting with chief ministers of different states. Briefings for chief minister/chief secretaries should be held every two weeks.•Four rounds of supplementary immunisation activities; three rounds of National Immunisation Days (NIDs) and one intensified round of Sub NIDs between January and May 2004 are needed.•A district task force should closely monitor the SNID state and a report to identify high-risk areas should be specified.•There is a need for mop-up exercises, which means giving additional doses of polio vaccine to children where a case is detected.•A communications strategy for oveall communication, particularly in Muslim populations, should be worked out.•A weekly surveillance programme should be continued and data on the genetic lineages of wild polio viruses should be updated and made available monthly in a standard format.
