Role of genetic factors in polio eradication: new challenge for policy makers

In 1988 the World Health Assembly passed resolution WHA 41.28, for global eradication of poliomyelitis by the year 2000 by providing immunization exclusively with oral polio vaccine (OPV). India happens to be the largest country in the world, where polio cases are occurring in large numbers. Despite increase in number of pulse polio immunization (PPI) rounds and introduction of monovalent oral polio vaccines mOPV1 and mOPV3, polio has not been eradicated from India. Global polio eradication cannot be achieved unless polio is eradicated from India because of the risk of exportation of wild poliovirus to other countries. India cannot become polio free unless Uttar Pradesh and Bihar become polio free. Because of genetic and some other factors, OPV cannot eradicate polio from Bihar and Uttar Pradesh. The present scenario strongly suggests that due to some host factors in recipients OPV cannot eradicate polio. Rather than extending the deadline for polio eradication again and again, it is time to prepare strategy for final push to polio.