In 2024, India achieved a notable 43 percent reduction in the number of zero-dose children, those who have never received vaccination. However, over nine lakh children are still unvaccinated, leading to vulnerable populations at risk of vaccine-preventable diseases, including polio. Addressing these gaps is crucial for preserving India’s polio-free status.
Polio continues to remain unresolved in neighboring Pakistan and Afghanistan, presenting ongoing risks of virus importation. The resilience against polio and other vaccine-preventable diseases relies on effective surveillance, response measures, and outreach efforts.
India’s success in combating polio was recognized in 2014 when the World Health Organization (WHO) declared the country part of its Southeast Asia region free from the virus. This milestone was significantly influenced by the Pulse Polio Programme, launched in 1995, which aimed to overcome vaccine hesitancy, reach mobile populations, and maintain high immunization rates through consistent campaigns. National Immunisation Days have mobilized millions of health workers, volunteers, and community leaders to ensure the oral polio vaccine reaches every child.
As National Immunisation Days continue to play a vital role in maintaining immunization coverage and reaching underserved populations, innovative strategies have emerged. For instance, in Rajasthan, mobile vaccination units follow nomadic groups to provide vaccinations on the move. In the crowded slums of Mumbai, polio immunization campaigns aligned with local events have successfully increased participation and fostered trust within communities. As World Polio Day 2025 approaches, the dedication of these health workers serves as a reminder of the ongoing need to secure progress.
Despite high routine immunization rates in several states preventing the paralysis caused by polio, averages can obscure areas with insufficient coverage. In these regions, unvaccinated children remain at risk, leaving communities exposed to potential outbreaks.
India’s achievement in eliminating polio is attributed to one of the world’s most sophisticated disease surveillance systems. The Acute Flaccid Paralysis (AFP) network, created under the National Polio Surveillance Project, monitors poliovirus transmission across diverse environments, from densely populated cities to remote rural areas.
Such vigilance has enabled targeted immunization responses. For instance, in 2009, the detection of polio cases in high-risk districts along the border with Pakistan prompted immediate vaccination campaigns to prevent further transmission. This proactive approach has ensured early intervention and timely immunization for families in remote areas, protecting them from a disease that can lead to lifelong disability.
Looking ahead, with over 27 million births each year and plans for scaling back the National Polio Surveillance Project, comprehensive monitoring of polio cases is becoming increasingly difficult. Any reduction in resources must be approached carefully, as diminishing this capability without an alternative strategy risks compromising the defenses against the virus. A sustainable solution involves integrating this network into broader public health systems to maintain its efficacy while enhancing operational efficiency.
Effective surveillance is just one part of the equation; a robust response system is vital for translating data into targeted actions. The path forward is unequivocal: strengthen surveillance and response mechanisms, adapt them to evolving challenges, and ensure that no child is left unvaccinated. Committing to proactive measures is essential to safeguarding decades of progress against polio.
(The writer is Chair of Rotary International’s India PolioPlus Committee. The views expressed are personal.)
Published on November 3, 2025
