NEW DELHI // India yesterday marked the first year in its history with no new case of polio after a decades-long vaccination campaign to eradicate the crippling virus.
The country once had the world's worst infection rates because of its dense population, poor sanitation, high levels of migration and weak public health system.
An aggressive programme to vaccinate children below the age of five, costing the government 120 billion rupees (Dh8bn), means India will be removed from the polio endemic list compliled by the World Health Organisation (WHO).
"India's success is arguably its greatest public health achievement and has provided a global opportunity to push for the end of polio," said Margaret Chan, the director-general of WHO.
Polio mostly affects children under the age of 5. It can cause irreversible paralysis, crippled limbs and death.
India had 150,000 polio cases in 1985. By the time the WHO launched a global campaign in 1988, the virus was paralysing 1,000 children in the world every day, with most cases in India.
There were 6,000 cases in 1991 and even until 2009, when 741 cases were reported from India, it still accounted for nearly half the global cases.
Known as the Pulse Polio programme, the immunisation effort that began in 1995 included 2.3 million vaccinators who delivered 900 million doses to homes and special medical camps across the country.
By 2010, there were only 42 new cases reported in India and last year, of the 604 cases of polio reported worldwide, India was finally down to one.
The last new case in India was detected on January 13 last year when an 18-month-old girl child was diagnosed in Howrah, 15 kilometres west of Kolkata.
The Indian health minister, Gulam Nabi Azad, remained cautiously optimistic about India's future fight with polio. It will take two more years to declare the country completely free of the virus.
"We are excited and hopeful, at the same time vigilant and alert," Mr Azad said in a statement.
He said that "there was still no room for complacency" and that India "needed to ensure no case of polio infection is registered in the next three years".
India has been a frequent exporter of the disease to other countries but has also been reinfected from abroad. It now faces the challenge of trying to prevent the migration of the virus from the countries it borders, including Pakistan and Afghanistan, where, along with Nigeria, are the countries still considered endemic by health organisations.
The success in India has raised hopes that polio could become the second infectious disease after smallpox to be eradicated from the world.
Vaccination and immunisation against the virus are widely available but in India, it took decades of government action, efforts by UN agencies and donations from private charities that allowed the poor better access to the antidote.
Lieven Desomer, the head of the polio unit at Unicef India, acknowledged that organisations such as Rotary International and the Bill and Melinda Gates Foundation helped efforts to eradicate polio.
"If we can achieve that, it will be of great benefit to the children of the world," said Mr Desomer, head of the polio unit at UN children's agency Unicef in India, told AFP. "But the last bit is the toughest. What India has achieved is reaching a first milestone in a very important process. It's not the end of the road, but it's something to be very proud of.
"Achieving this milestone is going to instil confidence in polio eradication efforts globally. If it can be done here, it can be done everywhere."
The Bill and Melinda Gates Foundation last year made polio eradication in India its top priority. "We must ensure that India's polio programme continues to move full-steam ahead until eradication is achieved," Mr Gates said yesterday.
The foundation spends $150 million (Dh550m) annually for polio eradication worldwide.
Meanwhile, as part of celebrations in India yesterday, the former Indian president, APJ Abdul Kalam, made a personal donation of 200,000 rupees to the Polio Foundation in the state of Gujarat.
The organisation helps provide callipers, or metal splints that support the limbs of students afflicted with polio.
* With Agence France-Presse, Associated Press and Bloomberg News