Polio eradication programme: some ethical issues.

In 2000 and 2001 there were 265 and 268 virologicallyconfirmed polio cases respectively, in India. In 2002 the number increased to 1,600. In response to some questions raised by the author (1), Dr Jay Wenger, project manager of the National Polio Surveillance Project of the WHO (NPSP-WHO), stated: “...the outbreak of 2002 and the problems of polio eradication were not caused by the failure of OPV or occurrence of VAPP, but the failure to vaccinate children adequately. This is shown most clearly when we consider that in states like Tamil Nadu and Kerala, where immunisation coverage is high, no polio cases occurred in 2002, whereas in states like UP and Bihar, where coverage has been low, the outbreak took full advantage causing hundreds of cases of clinical disease.... Encouragingly, in the last 12 months, both the number of immunisation rounds, and the quality of the supplementary immunisation activities had increased, the latter especially in UP and Bihar. The number of polio cases between March and July 2003 in these states is at its lowest ever. Successes like these clearly demonstrate that the polio eradication programme will succeed in India.”(2)