[e-drug] Is the Pulse Polio failing? Confession of Indian Health Minister

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E-DRUG: Is the Pulse Polio failing? Confession of Indian Health Minister
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[Copied as fair use. Thanks to Gopal Dabade for spotting this. HH]

Is the Pulse Polio failing? Confession of Indian Health Minister
NDTV.com, Wednesday, April 9, 2008 (New Delhi)
By Mohuya Chaudhuri
   
www.ndtv.com/convergence/ndtv/story.aspx?id=NEWEN20080046361

It is one of the most high profile public health campaign the country has seen, but 20 years after it was launched, the Pulse Polio campaign is now raising more questions than answers.

There has been a sharp increase in P3 type polio cases and P1 too is not quite wiped out. Now, Dr Anbumani Ramadoss, the Union Health Minister, said he wants a review. 

One case of P1 polio has been detected in Bhubaneswar and the person is not from Uttar Pradesh or Bihar but West Bengal.

The challenge has just got bigger. 

It's about two drops of life but is the polio vaccine effective? Four years ago, the government introduced a vaccine carrying P1, the deadliest strain of the virus. 

But experts said, though most children have been repeatedly vaccinated, polio-related paralysis has been on the rise. 

''Children are getting more than 25 doses. There are studies to show that in malnourished children, the vaccine can be fatal. It actually causes paralysis, so it is contraindicated in undernourished population,'' said Sathyamala, Epidemiologist.

The government's own data shows that in Uttar Pradesh, the cases of polio related paralysis rose from 3789 cases in 2004 to 10,055 after the P1 vaccine was introduced and six doses were given the next year.

The number had risen to 11,538 after children received nine doses.

The potency of the vaccine seems to be a possible reason. Unlike the older one that had all three strains, the P1 vaccine is five times more powerful and it was not tested before being used. 

''The article published by National Polio Surveillance Project in Lancet clearly says that they have got a new vaccine that is five times more potent than the old vaccine. When you give a new vaccine, you are expected to do some amount of surveillance to see what the adverse effects are. This is unethical and disturbing. The rates of flaccid paralysis has gone up,'' said Dr Jacob Puliyel, Department of Paediatrics, St Stephen's Hospital.

Epidemiologists said the government has changed the parameters of identifying polio. Doctors rely on stool tests instead of physical signs of paralysis. 

But if the virus is not kept in a cold chain, it dies. It means that even though the child is paralysed, he cannot be declared polio-affected.

''I have asked for a review of the polio programme. All these cases of children getting polio after vaccination is a cause for concern,'' said Dr Anbumani Ramadoss, Union Health Minister.

Faced with enormous pressure from WHO, the government spends over Rs 1000 crore every year on Pulse Polio. But with the vaccine coming under scrutiny, the programme is facing its biggest challenge ever.