India marked a year since its last case of polio on Friday, a major milestone in a country once considered the epicentre of the disease and one that gives hope of eradicating the scourge world-wide. The country had 150,000 polio cases in 1985, but a huge government campaign backed by donor money has led the number of infections to plummet - into double figures in 2010 and finally zero in the last 12 months.
India, which until recently accounted for half of all the polio cases in the world, is one of four countries where the highly contagious virus is still officially endemic alongside Afghanistan, Pakistan and Nigeria.
If all laboratory tests return negative in January, India will follow recent success stories Niger and Egypt and be removed from the endemic list by the World Health Organisation (WHO) by mid-February. There was cautious optimism in New Delhi as health workers and the government celebrated while at the same time stressing that sustained efforts were required to prevent another outbreak.
"We are excited and hopeful, at the same time, vigilant and alert," Health Minister Ghulam Nabi Azad said in a statement to mark the occasion. Polio - which afflicts mainly the under-fives causing death, paralysis and crippled limbs - travels easily across borders and is transmitted via the fecal matter of victims.
India has been a frequent exporter to other developing countries, but has also been re-infected from abroad. The ancient disease was wiped out from the 1970s in developed countries through successful vaccination campaigns. The last new case in India was detected on January 13 last year when an 18-month-old girl, from an impoverished Muslim family, fell sick in a slum near Kolkata, the capital of the state of West Bengal. "Her condition is improving. She can walk now," chief medical officer from the district, Swati Dutta, told AFP by telephone.
Since this case, there has been another vast effort to immunise the nation's children, with 2.3 million vaccinators fanning out to deliver 900 million doses in home visits and special camps. They have visited slums and railway stations, construction sites and bus stops, using all means of transport to reach even the most far-flung corners of one of the world's most crowded, diverse and impoverished countries.
It represents a rare public health success story in a nation where four in 10 children under five are underweight due to malnutrition and only a third of people have access to toilets. "India's success is arguably its greatest public health achievement and has provided a global opportunity to push for the end of polio," said WHO Director-General Margaret Chan in a statement. The decline in polio world-wide, through a concerted effort by governments, UN agencies and private donors, has raised hopes polio might go the way of smallpox, the only disease successfully eradicated globally.
There were 604 cases of polio world-wide in 2011 and India will only be judged to have eradicated the disease if it stays infection-free for another two years. UNICEF figures show India, where the crowded and impoverished northern states of Uttar Pradesh and Bihar have historically been the hotspots, had 150,000 cases of the disease in 1985. This had fallen to about 6,000 in 1991, to 741 in 2009 and to just 42 in 2010.