Polio eradication in India: pulse polio immunization.

The magnitude of the public health program for the eradication of poliomyelitis launched by the Government of India and the State Governments has few parallels. Over 87.77 million children, including 79.29 million children less than three years of age, were given a dose of oral polio on one day throughout the country on 9 December 1995. In the second round on 20 January 1996 over 93.118 million children including 85 million children less than three years were immunized. The program reached out to children in more than 5,57,000 villages and nearly 4000 towns. More than 500,000 immunization posts were set up to avoid over-crowding and to ensure easy accessibility, even to children from the remote villages and difficult terrain. More than 2 million persons manned the posts, many of them volunteers from the community and other government departments (Table I). It is estimated that half the families in the country have a small child and thus directly benefited from the program. Others participated as neighbors, teachers, social workers and responsible citizens. The major achievement of the programme was to bring together all sections of the society, various government departments, voluntary organizations, medical and nursing professional bodies, religious leaders, children and youth for an activity perceived to be in the interest of the children of the country. The central and state health ministries provided the logistics support, trained manpower for administration of oral polio vaccine and demand generation for pulse polio immunization. Several high level meetings were held in New Delhi and the state capitals to generate support for polio eradication efforts, assign responsibilities and to make sure that the programme did not fail due to a 'weak' link anywhere. A National Steering Committee under the chairpersonship of the Cabinet Secretary, with the secretaries of the concerned central ministries as members,