Zaracostas identifies the importance of ensuring a successful campaign against polio eradication and the possible catastrophes of a failed one.1 We disagree on the four key factors for polio eradication, in that both community acceptance and political will are major issues in India.
In India, the highest numbers of cases occur in the districts of western Uttar Pradesh followed by Bihar.2 A similar problem to the one encountered in Nigeria in late 2003 is also being seen in these parts of India. Misleading and untrue information of a potential association between oral polio drops and sterility is being spread among many Muslim communities by various community leaders and several related and unrelated agencies. This is leading to a widespread non-acceptance of the programme in this particular community and consequently has resulted in the increase in the number of cases of polio, notably in western Uttar Pradesh. This year too most cases are from the same region.2 The stakeholders are doing their best to manage the situation and the shift to the use of monovalent oral polio vaccine from the conventional trivalent oral polio vaccine is a reflection of this.
However, without engaging the communities and without a great deal of political will very little success will be seen in these provinces.
Competing interests: None declared.
References
- 1.Zaracostas J. Failed vaccine campaigns may lead to polio resurgence, experts warn. BMJ 2006;333:823. (21 October.) [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.AFP Surveillance Bulletin—India. GoI/NPSP: report for week 40, ending 7 October 2006. www.npspindia.org/bulletin.pdf (accessed 23 Oct 2006).