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What (and Who) Took Down Polio in India?

January 24, 2012

Flash back two years or so, to 2009. Polio had largely been eradicated globally, with only a few countries still experiencing the debilitating disease. Unfortunately, India was one of those unlucky countries. With 741 reported cases of polio in 2009 alone, India had the regrettable distinction of having the most cases of any country and,  overall, more than half of the world’s polio infections. The nation struggled to find more effective and reliable ways to combat polio and prevent it from taking a further hold.

Source: wisdomblow.com

Now fast forward to the present. A few days ago, India happily announced that it has had no new cases of polio for the 2011 year, an incredible improvement from the high levels that existed just two years before. These results were almost entirely due to a vast and ambitious effort that sent 2.3 million vaccinators around the country to give 900 million doses of the polio vaccine that prevents the disease. An obvious question comes to mind: how was such a large and complex mission possible, and ultimately successful?

The Global Alliance for Vaccinations and Immunizations (or GAVI) is largely responsible. GAVI is a public-private partnership that has brought together a vast assortment of world leaders, experts, philanthropists, and pharmaceutical companies to eradicate polio once and for all. In the case of India, companies and organizations such as UNICEF, the United Nations, the World Bank, the Bill and Melinda Gates Foundation, and JP Morgan teamed up with the Indian government to fight the disease head on.

Largely the brainchild of technology mogul and noted philanthropist Bill Gates, GAVI implements innovative practices that channel its partners’ specific skill sets, while also setting up infrastructure to maintain success in the future. As GAVI partner David Cameron, prime minister of the United Kingdom, states:

It was set up by people who wanted to do aid in a different way. It doesn’t just save lives for the here and now but gives those countries and economies the ability to grow and succeed

GAVI has two main features that have been crucial in the partnership’s success. First, GAVI requires some kind of financial buy-in from the recipient country, even if it is only a small amount. This practice keeps the recipient nation invested in the project and creates a healthy peer-to-peer relationship between the country and the partnership. Secondly, GAVI stresses accountability; it requires extensive record-keeping to make sure that vaccines get to where they need to be and are generally used in the correct way.

Source: measlesintitiative.org

GAVI is far from perfect. For example, Publish What You Fund, a global campaign to improve aid transparency, rated the alliance as having “poor” transparency, and criticisms have arisen about Gate’s tendency to allow personal connections to influence grant-making decisions. Their overall strategy, however, has been undeniably successful, even in areas other than India. GAVI’s Hib Initiative paved the way for the spread of the Hib vaccine (which prevents meningitis, pneumonia, epiglottis, and other serious infections) in sub-Saharan Africa; instances of illnesses caused by Hib have declined by 85% in the area. The partnership’s rotavirus vaccine project in Kenya has also been highly effective, as the rate of rotavirus, which is a major cause of child mortality, has fallen sharply.

Though India is rightfully celebrating the success of conquering its polio problem, many challenges in other health areas still exist. For example, India still has high rates of malaria, tuberculosis, and various NTDs. Luckily, almost all of these can be prevented with the use of vaccines, and GAVI has put forward a successful, public-private blueprint for combating these sicknesses. If India and GAVI keep up the good work, then who knows: India could be announcing a year free from another disease sooner than we might think.

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