In the early 90s, I was a pediatrician working in a small town in my home state of Gujarat, India when a wave of polio cases hit the state. This outbreak was on a scale that I had never experienced before. I personally treated more than 50 cases in less than two months.
As the outbreak spread, I realized the urgent need to increase awareness about the disease and the vaccine. For many rural and migrant families, I knew that the polio vaccine would be their first brush with organized health care. So, I started creating informational booklets and postcards to be distributed through my network of pediatricians – one of the first ways I became involved in the movement to end polio in India.
Back then, many thought eliminating polio from India would be nearly impossible. Poor sanitation, difficult terrain and high population density made the country an especially challenging setting to stop the spread of the virus and reach children with vaccines. So, when India and the entire South-East Asia region were certified polio-free in March 2014 five years ago this week it was, and continues to be, an unparalleled achievement in human health.
India’s victory over polio stands in contrast to the recent and alarming outbreaks of vaccine-preventable diseases we are now seeing around the world. From the United States to the Philippines, mistrust – fueled by rumors and misinformation about vaccines – has often been a driver of these deadly and avoidable outbreaks.
While challenges around vaccines look different everywhere, how can the world learn from India’s experience? As I reflect five years on from the region being certified polio-free, there is one lesson that stands out far and above the others: the importance of prioritizing building trust within communities.
India’s polio program began with understanding the concerns of each community or region. Then, the program employed local people known, and trusted in the community, as health workers who could go door to door to address those concerns. The program also engaged local medical practitioners, religious leaders, and even Bollywood celebrities, to help educate parents about the need to immunize their children. Once the community got involved, ensuring that every child received the vaccine was much easier.
The benefits of this community-focused approach have rippled beyond the country’s fight against polio. After success against polio, public confidence in immunization led to a demand for other kinds of vaccines. Since 2014, India has introduced four new vaccines, and is now working hard to scale up protection against diseases like diarrhea, pneumonia, meningitis and sepsis.
The government’s flagship immunization program Mission Indradhanush, also introduced in 2014, has reached nearly 34 million children across the country, aiming to raise immunization coverage to 90 percent, with special focus on underserved and hard-to-reach communities.
Of course, trust is just one part of what it takes to protect a child from preventable disease. Stopping polio in India, for example, took unprecedented political commitment and resources; support from partners like UNICEF, the World Health Organization and Rotary International; and two million health workers across the country, who overcame some of the most remote and challenging settings on Earth. It took perseverance; close monitoring through a complex surveillance system that tracked 33,000 reporting sites across the country; and campaign management on a scale that the country and the world had rarely seen.
But, at the end of the day, none of these incredible efforts could achieve the goal unless parents understood and believed that the vaccination was important for their child’s health.
Today, the world is poised to deliver game-changing reductions in deaths caused by vaccine-preventable diseases. To realize this potential, we, as doctors, scientists, public health professionals and parents need to come together to build trust in vaccines. We need to remind our leaders and neighbors alike that immunization remains not only the best way to protect our children against deadly diseases, but also generate long-term impact on the health and well-being of our society.
Each one of us needs to step up and proactively engage with and mobilize our communities to immunize. Because if there is one thing that India’s polio campaign has taught us, it is that when we work together, even the most unsurmountable challenges can be overcome, and the most debilitating of diseases fought, and defeated.