India is polio-free: Cheer with caution

31 January 2014

Rana Mehta, Leader, Healthcare, PwC India

After being among the handful of polio endemic nations all these years, India has finally been declared a polio-free country by the WHO. India has historically followed a strategy of focussing on specific infectious diseases. For a country that lacks a functional all-encompassing public healthcare system, ‘polio-free status’ provides an opportunity for celebration. In 2009, India reported 741 polio infections which accounted for nearly half of the world’s total. Cut to 13 January 2011, when the last polio case was recorded in West Bengal. Yet, a closer look at our polio-free status reveals certain systemic problems and caveats that need to be addressed.

Such a victory overshadows risks posed by vector-borne diseases that are set to rise because of soaring temperatures globally. India, with high population density is especially vulnerable to epidemics. Recent World Bank estimates state that the country’s sanitation deficit, leads to losses worth roughly 6% of India’s gross domestic product (GDP) by raising the disease burden in the country. The trade-off between building a strong public healthcare system with 100% accessibility as against targetting particular diseases has been consistently misjudged causing a collapse of the healthcare infrastructure.

Due to increase in dosage of the polio vaccination, AFP cases have been steadily on the rise. In the last 13 months, India has reported at least 53,000 cases of NPAFP which mean rising paralytic conditions. The estimates for India, according to the WHO, stand at 12 in every 1,00,000 children as against the global benchmark of 2.

Resurgence is another risk India needs to be extremely cautious of. Syria, Egypt, Tajikistan and Israel, for instance, discovered cases of polio, after they had been declared polio-free, suggesting that the chance of resurgence remains very real. The Indian subcontinent also presents before us a huge risk of importation.

Success in spurts resulting from disease-specific campaigns is not sustainable in the long run. We need to renew our focus on alternatives that will provide the country with a strong healthcare system.


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