Context: Polio, a near-eradicated disease, has resurfaced in various regions, with detections of both wild poliovirus (WPV) and vaccine-derived poliovirus (VDPV). This resurgence calls for a reassessment of eradication strategies and vaccine choices to sustain global progress.
Relevance : GS 2(Health )
Resurgence in Developed and Developing Nations:
- Detection of poliovirus in wastewater in developed nations like Finland, Germany, Spain, Poland, and the UK underscores the global nature of the threat.
- Pockets of under-vaccination, even in nations with high immunization rates (85-95%), create vulnerabilities.
Polio Vaccination Dilemma:
- The oral polio vaccine (OPV) is effective and easy to administer but risks circulating vaccine-derived polioviruses (cVDPVs).
- The inactivated polio vaccine (IPV), being non-transmissible, is seen as a safer alternative but is costlier and requires trained personnel for administration.
Transmission Dynamics – Faecal-Oral vs. Respiratory:
- Traditional understanding emphasizes faecal-oral transmission.
- Emerging research suggests a significant role for respiratory transmission, challenging long-held assumptions and necessitating nuanced interventions.
Global Polio Eradication Initiative (GPEI):
- Reliance on OPV for eradication has been questioned.
- A phased global shift to IPV is recommended for sustainable eradication, addressing both WPV and cVDPVs.
Challenges in Polio Eradication:
Surveillance Gaps:
- Routine surveillance must identify subnational immunity gaps, especially in underserved regions and conflict zones.
Vaccine Controversy:
- Transitioning from OPV to IPV involves logistical, financial, and policy hurdles, particularly in low-income countries.
Public Health Preparedness:
- Stronger health systems and consistent vaccination campaigns are crucial to counter resurgence and prevent vaccine hesitancy.
Environmental Factors:
- Wastewater surveillance highlights the role of environmental reservoirs, necessitating multi-sectoral interventions, including sanitation improvements.
Recommendations:
Phased Transition to IPV:
- Immediate planning for an OPV–to–IPVswitch in phased manner across countries.
- Encourage funding and partnerships to mitigate the cost implications of IPV.
Enhanced Surveillance and Data Integration:
- Expandwastewatertesting and genomic analysis for real-time tracking of virus circulation.
- Focus on underserved areas with low vaccination coverage.
Public Awareness and Advocacy:
- Disseminateaccurateinformation about IPV’s safety and effectiveness.
- Engage communities to address vaccine hesitancy.
Global Coordination and Equity:
- Strengthen international cooperation for vaccine availability and equitable distribution.
- Reinforce the GPEI with targeted funding and country-specific strategies.
