Dr. Anil Bilimale the chief Master of Public Health Program Coordinator at JSS Medical College was a guest speaker on May 24th. He has public health experience with the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) of India. I chose to do my critique on this speaker because of his public health background and how he centered his presentation on the elimination of Polio in India. As someone who is interested in immunology, I found his lecture interesting when he spoke about the history of polio vaccinations and the steps taken to eradicate it in India. Dr. Bilimale focused on Immunization Programs in India: from Resistance to Eradication- The Journey of the Healthcare System. During his presentation, I recognized the importance of vaccinations and programs and approaches needed to sustain at-risk populations.

 

Polio is a viral disease that causes paralysis in children by affecting the nerves in the spinal cord or brain stem. It directly affects children under the age of five years old. Transmission occurs person-to-person through the contamination of water, food, and fecal-oral (WHO). This highly infectious disease is easily spread in areas of deficient sanitation systems. The only way to treat polio is through immunization since there’s no cure for it.

 

Dr. Bilimale opened his lecture with the question “Is polio eliminated or eradicated?” This led to an open discussion on the difference between elimination, eradication, and extinction. We determined that elimination means that a particular disease or illness is removed from a particular geographical area. While eradication means that there are no species present of the disease. Extinction is when the disease or species is completely gone. In order to achieve eradication, there should be an effective vaccine, no non-human reservoir, and the disease should be acute with a short incubation period. It is known that certain diseases are hard to eradicate due to the civil unrest in areas and not being able to reach certain populations. A statistic that stood out to me during his lecture was “if one child is affected with polio then approximately 10,000 people are affected.”

 

There was a big importance and emphasis on making sure underserved populations received vaccinations. Identified high-risk areas in India were migratory slums, construction sites, brick kilns, nomads, sugarcane cutters, and settled slums. These areas are considered high risk due to poor sanitation, low immunization coverage, isolation, and being heavily populated. There was heavy importance on immunizing populations at border crossing points. Doctors actively went to vulnerable communities, religious congregations, and mobile and underserved populations to vaccinate newborns, children, and adults. In doing this, 8 million children whom road public transportation was immunized for each round. There was a slight issue with certain communities that did not accept the poliovirus vaccine. To combat this, female Muslim vaccinators were on a team, there were mosque announcements and advocacy, and village-level representatives showed support for immunization.

 

Since 2012, India has been removed from the WHO list of polio-endemic countries. To reach this point, India implemented strategies such as routine immunizations that allowed babies and children to get oral vaccinations, immunization days that reached a coverage of 90-98% and partook in acute flaccid paralysis surveillance which is a broad agenda of finding people with the polio virus. Some success factors I found important were financial resources guaranteed by various organizations such as (UNICEF, WHO, and Rotary), different innovations and programs to increase polio vaccinations, and the surveillance system that monitored the activities of the rates of immunization.

 

Overall, my reaction to Dr. Bilimale’s lecture left me very intrigued. It has given me hope and insight for my future as a research scientist to think critically I never realized the amount of background work and dedication it takes to achieve the eradication of the polio virus in India. It left me wondering what efforts and plans the United States of America has made to eradicate the polio virus since I’ve never looked at the polio virus from a public health provider standpoint. I have learned that there is no one-step approach to immunization and that with the right governmental support, change can happen. A few main takeaways I would implement in my future career are surveillance and communication. It is integral to monitor viruses and diseases to detect changes in their incidence. Obtaining information about cases allows doctors and researchers to gain insight into patients and the trajectory of the virus.