Celebrating 10 years of polio-free India

As the Rotary Club of Madras, RID 3232, celebrated the 10^th anniversary of a polio-free India through a power-packed virtual meeting presided over by IPPC chair Mike McGovern, there was palpable presence of its late veteran past president Kris Chitale. Along with a core group of dedicated Rotarians from RC Madras and some other clubs from Tamil Nadu, Chitale had spearheaded the vaccination drive to eradicate first red measles and then polio from the region, even before a full-fledged polio eradication drive was announced by Rotary International.

Giving an overview of the polio eradication project of Rotary, the ground it has covered, the money it has raised, and the children of the world it has helped, as also the challenges that Rotary is facing during the Covid pandemic, McGovern said: “Isn’t it amazing that today 19 million people are walking on this earth who otherwise would have been paralysed by polio? We don’t know who they are but it could be one of us.”

We have been patient, persistent and given so much for this cause… thanks for all that you have done towards the 10th anniversary of ensuring that Rukhsar was the last child from India to get polio.
— IPPC chair Mike McGovern

Analysing the data from the two endemic countries left, Pakistan and Afghanistan, he said the news was “good” from Pakistan where the infections from the wild poliovirus had come down to 84 in 2020 from 147 in 2019. Even though in Afghanistan, the cases had gone up from 29 in 2019 to 56 in 2020, worldwide the cases of wild poliovirus had come down from 176 to 140 in these two countries. “This is a 20 per cent decline. And if you consider the challenges this year of the corona pandemic, to me it is almost miracle.”

But unfortunately, the vaccine derived cases of paralysis reported from 28 countries were 1,000.

He said we had reason for cheer if we made a comparative analysis of polio cases in 2009 in India, from where no case has been reported now for 10 years and compared the figures with Pakistan. In 2009, India had reported about 700 polio cases, but in 2010 there were only 40 and in Jan 2011, Rukhsar Khatoon, from ­Howrah in West Bengal, was the very last case in India. “In 2017, the scenario in Pakistan is similar to what happened in India in 2004–05, when the polio cases came down substantially, before spiking up again.”

The same thing had happened in Pakistan in 2019. “But under TRF Trustee Aziz Memon’s leadership, Pakistan continues to fight, and follow the path we saw in India. While during the whole year there were 80 cases in that country, in the last six months the number had declined to 24 cases, and in the last three months, the cases fell from 4 to 2 to 0 and thus far, no cases have been reported in 2021. This is really a good sign that Pakistan is working very hard to eradicate polio.”

Coming to Afghanistan, the IPPC chair said “our challenge is the areas that are controlled by the anti-government elements. For two years those areas have not been open for house-to-house vaccination.” Both WHO and UNICEF have been talking to Taliban regarding this and “we hope for some progress soon. We do have some good news but it’s not official yet. The fact remains that as long as those areas remain inaccessible, we are not going to be able to get rid of polio. Covid did pose challenge but also gave opportunities and our polio network, already in place, helped with surveillance, labs, etc for Covid-19.”

My most memorable achievement as RI president was leading India to become polio-free in 2011. Rotarians went to remotest parts of UP and Bihar; I remember crossing unbridged rivers by boat, climbing mountains, risking alligators and tigers, and a miracle happened!
— PRIP Kalyan Banerjee

But once other organisations picked up responsibility for Covid, house-to-house polio vaccination in Pakistan and Afghanistan was resumed. Attention was also given to vaccine derived cases in the African region and elsewhere. “The almost 1,000 vaccine-derived cases do cause concern because they can also cause similar paralysis as the wild poliovirus cases.” One response was trying out the new vaccine called the Novel Oral Polio Vaccine 2 (nOPV2), “which is genetically more stable. Clinical trials have shown great results and we hope it will be successful,” McGovern said.

Underlining the importance of getting “this job done along with our partners, and do advocacy with the governments of the world”, he shared a screenshot of President of India Ram Nath Kovind giving polio drops to a child at the Rashtrapati Bhavan last month, and said just before the pandemic began, RI President Holger Knaack and TRF trustee chair K R Ravindran, along with TRF trustee Aziz Memon, had called upon the Pakistan Prime Minister Imran Khan and discussed the progress made in polio eradication work in Pakistan.

Advocacy with governments helps a lot, and thanks to ­Rotary’s advocacy, the governments of UK, US, Japan, Monaco, Canada and ­Australia have contributed a significant amount for this programme.

Urging Rotarians to stop the vaccine derived cases and encourage “the shot in the arm, as I call it”, McGovern said Rotarians would also have to keep convincing parents to vaccinate their children. “We have the obligation to get this done for the children of the world. We have been patient, persistent and given so much for this cause… thanks for all that you have done towards the 10^th anniversary of ensuring that Rukhsar was the last child from India to get polio.”

Addressing the meet, PRIP Kalyan Banerjee said a decade of India being polio-free really called for a celebration. “I have always admired RC Madras for being engaged in controlling and eradicating diseases like measles and polio in the 1960s and 1970s when Kris Chitale was the main person leading the efforts.” He was on the IPPC with both Bob Scott and McGovern and “we all were happy to get the opportunity to do whatever we could to get our job done.”

By ending polio in India, the annual gains to the national economy, by the most conservative estimate, is $400 million. Nobody recognises Rotary as a wealth creator but it has done just that!
— Virologist Jacob John

Referring to PDG and Nigeria PolioPlus Committee chair Tunji Funsho, who made it to the Time 2020 list of the world’s 100 most influential people, Banerjee said: “He is one of the heroes of immunising Nigeria and helping to make it polio-free. I have known him from the early 2000, when I was in his district as an RI president’s representative for the district conference.”

He recalled that during his tenure as TRF trustee, “when Nigeria needed a new national PolioPlus chair, I got in touch with PRIPs Raja Saboo and Jonathan Majiyagbe and talked about Tunji’s many abilities and then persuaded TRF chair Wilf Wilkinson to have him as the Nigeria chair. And he has been a gamechanger, handling admirably well an extremely difficult situation in a difficult country with several problems ranging from the Boko Haram problem to the Ebola disease. But he got the job done.”

Banerjee said that “perhaps the most memorable achievement during my year as RI president in 2011–12 was leading India to become polio-free that year. With our enthusiastic and young Rotarians joining hands with the government and going to the remotest parts of UP and Bihar, which were the most difficult states, we got the job done. I remember crossing unbridged rivers by boat, climbing mountains and risking both ­alligators and tigers… yes, tigers, really…and a miracle that none had expected possible, happened!”

Apart from the tremendous work put in by the India National PolioPlus Committee chair PDG Deepak Kapur, “we had the guidance of Dr Jacob John, an amazing man, who all the time advised us on how to get on with the job.” The Indian government was so happy, that not only did it acknowledge Rotary’s help and role “but the health minister of India personally came to Evanston to thank us. It is wonderful to relive those terrific moments in the presence of people who led us in that effort,” Banerjee added.

Bob Scott recalled how he and his wife had first visited RC Madras in Jan 1988. During a later visit to India, he had visited Howrah and “met Rukhsar as a toddler, who was screaming her head off as she didn’t like being lifted by this tall white man!”

He told past president S N ­Srikanth, “when you first approached me, when I was the IPPC chair, to take the End Polio flame around the world, being a cautious Scott, I was a bit hesitant, but you were persistent and convinced me. That flame has been around the world, including my club in Canada where we had a special dinner and raised some funds.”

Eminent virologist Dr Jacob John said it was nothing short of miraculous that by ending polio in India “the annual gains to the national economy, by the most conservative estimate, is $400 million. Nobody recognises Rotary as a wealth creator but it has done just that!”

Dr Funsho thanked both Saboo and Banerjee “who have been friends of Africa well before I became the chair of the Nigeria PolioPlus committee” for all their help in ridding Africa of the wild poliovirus. India Rotarians, he added, “have played a huge role in mentoring us to ensure we meet the goal of making Nigeria polio-free in 2016. Both Saboo and Banerjee were at our beck and call, and came with teams of Indian surgeons for polio corrective surgery.”

RC Madras president Kapil Chitale proudly announced that their club has been chosen as the nodal club to partner with and assist the health department of Tamil Nadu in Covid vaccination.

Past president Srikanth moderated the Q&A session with McGovern, and played a video of the End Polio flame programme started by the club during his presidentship, and thanked past president Gopinath for his immense help and support in this venture. It was taken to the Sao Paolo convention of RI and has already visited 35 countries and helped collect over $10 million for ending polio. Recalling the efforts of the pioneers from RC Madras who had led the red measles and polio eradication drive, braving cold chain challenges, he added that thanks to Rotarians from the state, Tamil Nadu was the first state in India to become polio-free.

The cynosure of all eyes at the zoom event was Rukhsar. Club president Chitale announced that to mark the 10^th anniversary of a polio-free India, the club is gifting her a tablet, which will be sent to her. RIDE A S Venkatesh, TRF trustees Aziz Memon and Geeta Manek and PRID P T ­Prabhakar attended the meeting.