|Gates: Help at hand |
New Delhi, Nov. 7: The health ministry has for the first time signalled its concerns about the efficacy of a vaccine it has been using against polio, saying it is ready to examine new strategies to accelerate eradication efforts.
A group of experts will meet next week to discuss new strategies, including the possibility of introducing an injectible polio vaccine (IPV) that has never been used in India's public immunisation programme, officials said.
The government has been relying on an oral polio vaccine (OPV) to combat polio, but several studies, the earliest conducted more than 30 years ago, have questioned its efficacy.
The ministry said yesterday that at least 315 children (64 per cent) among 499 paralysed by the wild polio virus from January through October this year had already received 10 or more doses of OPV.
Health officials say that while OPV has succeeded in ejecting the wild polio virus from most Indian states, the persistence of polio in Uttar Pradesh and Bihar has proved frustrating.
"A fatigue has set in," said an official who was part of a round-table meeting called by the health ministry earlier this week. "The numbers (polio cases) continue. There is a feeling that we need to look at new tools," another official said.
Some paediatricians and infectious diseases experts have long been arguing for the introduction of IPV which, they believe, is more effective in protecting a child than OPV. "A combination of IPV and OPV will provide better protection," said Nitin Shah, the co-chairperson of the polio eradication committee of the Indian Academy of Pediatrics.
The earliest studies questioning the efficacy of OPV in parts of India were conducted by T. Jacob John, an infectious diseases expert in Vellore, during the 1970s. John is head of the expert group that meets next week.
The health ministry has so far consistently turned down such recommendations, saying IPV is expensive and not enough of it is produced in the world to immunise the 25 million children born in India each year.
Concerned at the persistence of polio in India, the Indian Academy of Pediatrics committee has asked doctors in the private sector to offer IPV to parents of children who can afford to pay for it..
The government approved IPV for the Indian market more than two years ago. It has since been available through the private sector, each dose costing about Rs 300, said Subhash Arya, a senior consultant paediatrician at Delhi's Sir Ganga Ram Hospital. It is given in three doses at six, 10 and 14 weeks after birth. "We're now routinely offering it to children," said Arya.
A source said the participation of top officials from the Bill and Melinda Gates Foundation at the round-table meeting earlier this week had raised hopes that the cost barrier to introducing IPV could be overcome.
"Adding an injectible polio vaccine to (immunisation with) the oral vaccine may be a key tactic to accelerate eradication," said Microsoft chairman Bill Gates, co-chair of the Foundation, who had attended the round-table.
Gates and health ministry officials said it was up to the expert group to decide next week the specific new tools to be added to combat polio.
In addition to IPV, other options include two different versions of OPV.
The Foundation has already committed more than $400 million to support polio eradication worldwide. A part of this funding supports the immunisation programme in India.