Epidemic year

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IF only paucity of funds was the only problem. But it is not. Amar Singh, Moradabad’s immunisation officer, has a simple explanation for the recent spurt: “This is the epidemic year.” He might be right; the disease has been seen to follow a cyclic pattern. Every fourth year sees a rise in the number of cases. Down To Earth asked Singh why the district did not take special steps when it was known that 2006 was going to be an epidemic year. He declined to comment, stating merely that the disease is now under control.

This assertion notwithstanding, the failure in up"s polio eradication programme is apparent. The administration has decided to change the strategy this year. Instead of using the trivalent vaccine, which targeted all the three strains of the poliovirus, the programme has been administering the monovalent oral polio vaccine (mopv1), which is effective only against the p1 virus. After finding incidence of the p3 viral strain, December 2006 saw a special round of m opv3.

It is now believed that that three strains of the poliovirus in the trivalent vaccine compete with each other, reducing the vaccine’s overall efficacy. Children under five in Moradabad, Badaun, Bareilly, Ramnagar and JP Nagar were slated to receive movp3 on December 10.

Earlier this year, mopv1 targeted the most common of the three poliovirus strains. But many areas in Moradabad continue to be ravaged by polio virus’s two common strains. For example, in village Naherther in the Sambhal block, two-year old Mohammad Kaif is afflicted by the p3 virus, while three-year old Akansha is struck by the p 1 variety. This year, 52 cases of p1 and 12 cases of p3 have been reported from Moradabad.

Viral preferences
The poor have borne the brunt of the failure to eradicate polio. Bikash and Nikhil’s father, Subhash, for example, is a daily-wage labourer, who has not been able to work since his children contracted the disease. His wife and he have been camping since November in Meerut, where the children are being treated by a local vaidya. They have spent Rs 25,000 on treatment. Subhash’s mother Rajo says that they have heard that treatment can cost as much as Rs 1 lakh per child, but the family does not have any long-term plans.

Monis’s parents are also getting him treated by a private doctor. The government doctors at the Kotwali block dispensary have told them there is no treatment for the disease. One of the teams that came after the child fell sick promised them Rs 10,000 for treatment. But they heard nothing further about it.

Besides being a cause of personal tragedy for families of victims like Mehreen and Nikhil, the disease also affects the country’s productivity. According to the Union ministry of health and family welfare’s multiyear strategic plan, annual losses to India’s gdp due to polio-related disability is around Rs 2,700 crore. This is a conservative estimate. It excludes the cost incurred on treatment of polio cases. The document also points out that, at the current rate, operational costs are around Rs 4 per round per child. The cost of oral polio vaccine per round per child is around Rs 5.

Polio in monetary terms
A lot of money has been spent to eradicate polio in India. In 1996, Rs 400 crore came from international agencies including the Rotary International. But the government also had to take loans from agencies like the World Bank. The Union government spent Rs 1,000 crore of its own money on the programme in 2006 so far