On the day India was feted by the World Health Organisation (WHO) for clocking three polio-free years, reports coming out of Iraq spoke of a suspected case of polio re-infection — its first in 14 years.

A grim reminder that being polio-free was just part of the battle — the challenge was in staying that way, especially since neighbouring Pakistan, besides Nigeria and Afghanistan are still reporting cases of polio.

Countries are vulnerable until polio is eradicated everywhere, says WHO’s Poonam Khetrapal Singh, adding that India will have to continue its routine immunisation programme, with surveillance and emergency response playing a significant part in picking up and tackling possible incidents of re-infection.

Being polio-free is a huge milestone, but it is not the end of the story, says Singh, who heads the 11-country South East Asian region that has also become polio-free, following India’s achievement.

Instability, re-infection

The re-infection reported in Iraq seems to be similar to that in Syria seen months ago, and possibly of Pakistani-origin, says Sona Bari, WHO spokesperson on global polio eradication. Besides, Iraq and Syria, Jordan is of great concern, she says, adding that conflict and instability prevents children from being immunised, leading to “heart-breaking” incidents of infection.

“The virus is very good at finding children and our task is to find these children and get them vaccinated,” she says, adding that the WHO was involved in a vaccination campaign covering 22 million children in regions including Iraq, Jordan, Syria, Egypt and Gaza.

The WHO polio endgame plan expects to eradicate polio from the world by 2018.

It has now come down to eradicating cases in Pakistan and Nigeria, as Afghanistan’s cases are a fall-out of proximity to Pakistan, says Bari.

Besides, conflict-hit regions and the resulting displacement of people make it hard to run immunisation programmes.

Polio vaccination drives are sometimes also viewed with suspicion with fears that it is a tool to sterilise people .

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