How A region Gets Certified 'Polio-free'

Wild poliovirus has not been found in India since 13 January 2011 meaning that, from that date, India is no longer a country where polio is endemic. Three years of being polio free is a notable milestone for the country as a whole, but the success of the immunization and awareness campaign has had a wider impact – with this achievement, it is hoped that soon the entire South-East Asia Region can be considered certifiably free from polio. A commission of experts will meet at the World Health Organization offices at the end of March to analyze the data and determine the polio status for the Region.

Historically, India has been the largest endemic reservoir of polio in the world with between 50 000 to 100 000 paralytic polio cases occurring each year between 1978 and 1995. It has also been one of the main sources of polio importation for other countries. This achievement has been driven by the partnership between the Government of India, international organizations, local NGOs and other institutions. An extraordinary mobilization of health workers was necessary to reach this point, particularly in the Uttar Pradesh and Bihar states. The outcome of this has been an improved vaccine delivery system, better trained health staff and high quality surveillance, monitoring and research mechanisms.

This does not mean that the virus cannot reemerge within any of the countries or the Region. There is no room for complacency with ongoing polio vaccination work. High immunity levels must continue in order to protect those in the Region and as newer, more comprehensive interventions are developed, these too need to be rolled out. Furthermore, whilst no new cases of wild polio have been recorded recently, the disease in different forms can be brought in to the Region via those who have contracted it in other parts of the world and then travel to South-East Asia.

Facts about Polio Certification

In 1988, the forty-first World Health Assembly adopted a resolution for the worldwide eradication of polio. Here are some polio certification facts:

• No single country can be certified as polio free. Regions as a whole are certified as polio free
• For certification, all countries in the Region need to not register a case of wild polio for 3 years in the presence of high quality surveillance
• The formal process for certification of polio eradication was established in 1995 at the first meeting of the Global Certification Commission (GCC)
• There are National Certification Committees (NCCs) who focus on analysis at the country level. In SEARO, each of the 11 member states has a NCC
• All Regions have a certification commission. For SEARO there is the South-East Asia Regional Certification Commission which comprises eleven global and regional experts. It is this commission that can certify the South-East Asia Region as polio free
• Three Regions (Americas, 1994; Western Pacific, 2000; Europe, 2002) have already been certified as polio free

About poliomyelitis (polio)
Poliovirus is transmitted mainly from person-to-person through the fecal-oral route and on average, depending on the serotype (poliovirus type 1, 2 or 3), a single case of paralytic polio represents 200 to 1000 silent infections surrounding the case.

WHO fact sheet on polio
10 facts on polio eradication
About Vaccine derived polio

The work to date on the eradication of polio from the South-East Asia Region is the culmination of a long standing partnership between WHO and donors such as Rotary International, Centers for Disease Control and Prevention (CDC), UNICEF, the Bill and Melinda Gates Foundation and USAID.

For more information on WHO South-East Asia Regional Office’s work on Polio, visit the immunization section.