WHO declares end of Indonesia’s poliovirus outbreak

• The World Health Organisation (WHO) has declared Indonesia’s polio outbreak officially over, following nearly three years of intensive response efforts.

• Indonesia officially ended its outbreak of poliovirus type 2, which arose from years of low polio immunisation coverage.

• The outbreak began in October 2022, when the first confirmed case was reported in Aceh province.

• Over the next two years, cases appeared in the provinces of Banten, West Java, Central Java, East Java, North Maluku, Central Papua, Highland Papua and South Papua. 

• The last confirmed Circulating Vaccine-Derived Poliovirus type 2 (cVDPV2) case was in South Papua on 27 June 2024.

• Indonesia’s response included two rounds of nationwide polio campaigns using novel OPV-2 (nOPV2) vaccine between the end of 2022 and the third trimester of 2024. 

• In parallel, routine immunisation coverage also improved, with the percentage of children receiving their second dose of inactivated polio vaccine (IPV) rising from 63 per cent (1.9 million children) in 2023 to 73 per cent (3.2 million children) in 2024.

• Nearly 60 million additional doses of polio vaccine were administered to children during the response.

• This achievement is made possible with the collaboration of the Government of Indonesia with WHO, UNICEF, the United Nations Development Programme (UNDP), the Clinton Health Access Initiative (CHAI), and the Rotary International, underpinned by the dedication of health workers and communities across Indonesia.

• With the end of the polio outbreak, the Ministry of Health reaffirms its commitment to keeping Indonesia polio-free through strengthening routine immunisation, enhancing surveillance, cross-sectoral collaboration, and community support.

Key points on polio:

• Poliomyelitis (polio) is a highly infectious viral disease that largely affects children under five years of age. The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common vehicle (for example, contaminated water or food) and multiplies in the intestine.

• It can infect a person’s spinal cord, causing paralysis and possibly permanent disability and death.

• Of the three strains of wild poliovirus (type 1, type 2 and type 3), wild poliovirus type 2 was eradicated in 1999 and no case of wild poliovirus type 3 has been found since the last reported case in Nigeria in November 2012. Both strains have officially been certified as globally eradicated. At present, wild poliovirus type 1 affects two countries —  Pakistan and Afghanistan.

• Economic modelling has found that the eradication of polio would save at least $40-50 billion, mostly in low-income countries.

• There are two vaccines available: oral polio vaccine and inactivated polio vaccine. 

• Both are effective and safe, and both are used in different combinations worldwide, depending on local epidemiological and programmatic circumstances, to ensure the best possible protection to populations can be provided.

Eradication of polio in India

• India was certified polio-free by the Regional Polio Certification Commission in 2014. 

• The last case of wild poliovirus in the country was reported in 2011 from Howrah, West Bengal and no wild poliovirus cases have been reported thereafter from any state/UT.

(The author is a trainer for Civil Services aspirants.)