Nepal observed the World Polio Day on October 24, 2018, amid various programs organized across the country.
The Himalayan Nation proudly celebrated this day as a society that completely fought out the epidemic Polio.
World Health Organization (WHO) declared Nepal as a completely Polio-free nation in 2014.
The Success Story: Beginning!
Nepal got its first polio eradication program in 1998 under the funding of the Global Polio Eradication Initiative and affiliated to WHO’s Nepal country office.
The program was formed with an aim to conduct active surveillance for possible polio cases and ensure technical and other assistance on polio vaccination to the country’s national immunization program, the Expanded Programme on Immunization (EPI).
Further, the program grew in strength with nearly 14 field-offices-based surveillance medical officers engaged in the search for people with Acute Flaccid Paralysis (AFP), i.e. suspected polio cases.
The program thus succeeded in utilizing the surveillance data to guide polio immunization activities through mass campaigns with oral poliovirus vaccine.
By 2000, the country could successfully eliminate indigenous polio!
The Success Story: Period of Change!
2000 was a successful beginning for the country in its fight against polio. The country further succeeded in controlling the disease outbreak between 2005 and 2010.
Dealing with indigenous polio gave the country abilities to use resources from the polio eradication program to also control other vaccine-preventable diseases.
Since 2002, the program staff began to implement their experience to bring in improvement in multiple aspects of EPI.
They performed a series of activities such as continuous training to EPI staff on issues such as data management, vaccine cold chain management and assessment of adverse events. Besides, they also took ahead the development and implementation of policy guidelines.
They also assisted the public officials in supervision and monitoring regular immunization activities, microplanning to increase reach-out to every district, enhancing research capabilities and piloting innovations such as electronic immunization records and immunization training centers.
Finally, Nepal participated in a certification program on wild poliovirus elimination in the World Health Organization (WHO) South-East Asia Region in 2014, before finally getting declared as the ‘polio-free nation’.
The Success Story: Way Forward
In 2014, the number of surveillance system activities expanded to 299 sites, with focus on measles, rubella, and neonatal tetanus.
And, the information from the expanded surveillance helped in taking further the development and implementation of the country’s immunization policies.
Backed by surveillance data and the polio eradication program, EPI launched a measles vaccination campaign during 2004–2005 and could successfully identify 45 confirmed measles cases in 2006.
Further, a reported rise in measles cases led to a follow-up vaccination campaign in 2008, targeting children aged 9 months to 4 years.
Problems intensified in 2011 with additional measles cases reported along with years of data showing rubella on the other side. This led to the combined measles–vaccination campaign in 2012–2013.
Following this, EPI added rubella vaccination to the country’s routine immunization schedule, which further curtailed measles and rubella cases during 2013-2014.
Overall, the polio eradication program helped EPI introduce hepatitis B vaccine in 2003, Haemophilus influenzae type b vaccine in 2009, inactivated polio vaccine in 2014 and pneumococcal conjugate vaccine in 2015.
And, the eradication program’s research contributed to rise in vaccination coverage in the country among children aged 12–23 months during 2001-2015.
In a Nut Shell
The polio eradication program in Nepal not only addressed polio concerns but also became successful in preventing other vaccine-preventable diseases, thus also strengthening immunization system and reducing disease incidence across the nation.