The Last Mile Against Polio

On October 24 the world observes World Polio Day, a date chosen to honour the birth of Dr Jonas Salk, whose inactivated vaccine first offered a reliable shield against a virus that once paralysed hundreds of thousands of children each year. What began as a medical breakthrough has grown into one of the most ambitious public-health campaigns ever undertaken. Since the Global Polio Eradication Initiative was launched in 1988, the number of wild-poliovirus cases has fallen by more than 99.9 per cent, from an estimated 350,000 cases across 125 countries to a handful concentrated in just two remaining endemic nations—Afghanistan and Pakistan. More than twenty million people are walking today who would otherwise have been paralysed, and the economic savings in treatment and rehabilitation have been measured in tens of billions of dollars. Yet the final stretch has proved stubbornly difficult.
India’s own journey supplies both inspiration and a cautionary lesson. In 2009 the country accounted for the largest share of the world’s polio cases. Two years later, on 13 January 2011, the last wild-poliovirus case was recorded in West Bengal. By March 2014 the World Health Organization certified India, together with the rest of the South-East Asia region, as free of wild poliovirus. The achievement rested on the Pulse Polio programme, relentless National Immunisation Days, house-to-house teams that reached remote hamlets and migrant populations, and a public-awareness campaign whose simple slogan—“Do Boond Zindagi Ke”—entered popular memory through the voice of Amitabh Bachchan. Surveillance systems stayed vigilant, and every suspected case of acute flaccid paralysis was investigated. The result demonstrated that even a vast, diverse and densely populated country could interrupt transmission when political will, community trust and operational precision converged.
That success, however, is not self-sustaining. Afghanistan has already recorded roughly forty-two wild-poliovirus type-1 cases in 2026, double the total for the previous year, while Pakistan continues to report sporadic cases. Circulating vaccine-derived polioviruses have appeared in several other countries where immunisation coverage has slipped. Conflict, population movement, restricted access for vaccinators, and funding shortfalls have slowed progress in the remaining endemic zones. Because poliovirus crosses borders with ease, a single importation into an under-immunised pocket can restart transmission even in a country long declared free. India therefore continues to conduct nationwide and sub-national immunisation rounds, maintains high-quality surveillance, and keeps emergency response plans ready. The same discipline that secured certification must now protect it.
World Polio Day 2026 arrives at a moment when the end is genuinely in sight yet still requires sustained investment. Health workers in Afghanistan and Pakistan continue to deliver drops under difficult conditions; laboratory networks track every environmental sample; and partners—from Rotary International to national governments—renew their financial and political commitments. The theme that has guided recent campaigns, emphasising collective action to reach every child, underscores a simple truth: eradication is possible only when the last reservoirs are extinguished. Until that happens, every country, including those that have already succeeded, must treat routine immunisation, supplementary campaigns and rapid outbreak response as non-negotiable.
The story of polio is ultimately a story of what sustained public effort can achieve. It is also a reminder that the final cases are always the hardest. On this day the world is invited to honour the scientists, frontline workers, parents and volunteers who have brought humanity this close, and to finish the work so that no future generation will need to fear a disease that two drops of vaccine can prevent.