Fifteen Years Polio‑Free: Harnessing Eradication Success to Drive Broader Public Health Progress in WHO South‑East Asia

Breaking: Southeast Asia Reaches 15-year Polio-Free Milestone While Strengthening Health systems

The WHO South-East Asia Region has marked 15 consecutive years without a wild poliovirus case, preserving a polio-free status for a quarter of the world’s population.The milestone underscores a sustained commitment to vaccination, surveillance, and health system resilience across 11 countries.

Officials credited unwavering leadership, a dedicated health workforce, and robust partnerships with communities for keeping polio at bay. “This achievement reflects what can be accomplished and sustained through strong governance, committed professionals, and deep community engagement,” said Dr. Catharina Boehme,the Officer-in-Charge of the WHO South-East Asia Region.

Ancient context anchors the milestone: in 2011, an 18-month-old girl in Howrah, West Bengal, India, developed paralysis from wild poliovirus. The comprehensive, rapid response that followed resulted in the region’s last wild poliovirus case. By 2014, the region was certified polio-free on March 27, a status it has vigilantly maintained as.

Today, vigilance remains high to prevent importation. Health authorities continue to protect children through vaccination and rigorous surveillance, recognizing that eradication requires constant monitoring even after a region’s polio-free status is achieved.

Surveillance and testing have grown more robust. In 2025, more than 50,000 stool samples where collected and analyzed across 13 WHO-accredited laboratories, spanning national, regional, and global reference facilities. Environmental surveillance further enhances detection,with 93 sites across five countries monitoring potential transmission in high-risk populations.

Immunization coverage has remained strong. According to WHO/UNICEF estimates, regional immunity levels against poliovirus—through a combination of bivalent oral polio vaccine and at least one dose of inactivated polio vaccine—have stayed above 90% for many years, even during emergencies and crises.

Independent oversight from the South-East Asia regional Certification commission for Poliomyelitis Eradication (SEA-RCCPE) meets annually to review progress, assess risks, and confirm the region’s continued polio-free status.

The polio program’s impact extends beyond a single disease. Countries have translated innovations and operational lessons into broader health gains, strengthening routine immunization, advancing measles and rubella elimination, and boosting public health laboratory capacity and emergency preparedness. These advances have helped widen immunization coverage, reach previously underserved communities, and close immunity gaps.

Beyond poliovirus, the region has achieved notable progress against other vaccine-preventable diseases. Efforts include sustaining the elimination of maternal and neonatal tetanus and introducing vaccines against pneumococcal disease, rotavirus, hepatitis B, Japanese encephalitis, typhoid, and human papillomavirus, contributing to lower mortality and long-term disease burden.

Yet the risk of poliovirus importation persists while the virus exists anywhere in the world. Authorities stress the need to maintain high immunization coverage, sensitive surveillance, and rapid response capacity for poliomyelitis and other preventable diseases.

“The transition from polio endemicity to sustained polio-free status demonstrates that ambitious public health goals are attainable,” Dr. Boehme said, reiterating WHO’s commitment to supporting countries in protecting every child through resilient routine immunization systems and broader disease elimination efforts across the Region.

Key Facts at a Glance

Key Fact	Details
last wild poliovirus case	2011, Howrah, West Bengal, India
Polio-free certification	27 March 2014 (Region-wide)
Surveillance activity (2025)	Over 50,000 stool samples tested
Laboratories	13 WHO-accredited national, regional, and global reference labs
Environmental surveillance	93 sites across five countries
Immunization coverage	Above 90% for bOPV and at least one IPV dose (many years)
Oversight body	SEA-RCCPE, meets annually
Broader health impact	Advances in routine immunization, measles/rubella elimination, lab capacity, emergency preparedness

Readers, what lessons from the polio elimination program can strengthen routine immunization in your country? How can communities contribute to maintaining a polio-free region?

Share your thoughts in the comments and spread this milestone with peers championing public health.

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Fifteen Years Polio‑Free: Leveraging Eradication Success for Broader Public‑Health Gains in WHO South‑East Asia

1. Milestones of Polio Eradication in the Region

• 2001–2021: The WHO South‑East Asia Region (SEAR) achieved the world’s first regional polio‑free certification in 2014, followed by a continuous 15‑year period without wild‑type poliovirus (WHO, 2025).
• Key interventions:

1. Mass Immunization campaigns – Pulse‑polio and national immunization days delivered > 400 million OPV doses.
2. Robust Surveillance – Acute Flaccid Paralysis (AFP) network with > 90 % reporting completeness.
3. Cross‑border Coordination – Joint task forces with neighboring countries ensured no virus re‑introduction.

2. Core Lessons that Translate to Wider Health‑System Strengthening

Lesson	How It Informs Othre Programs
Integrated Surveillance	AFP framework repurposed for measles, rubella, and emerging infections, reducing detection lag by 40 % (CDC, 2024).
Community‑driven Outreach	Mobilisation of local volunteers during polio drives now supports maternal‑child health campaigns, boosting antenatal care uptake by 22 % in rural Bangladesh.
Data‑driven Decision‑making	Real‑time GIS mapping of vaccination sites informs micro‑planning for COVID‑19 boosters and seasonal influenza drives.
Flexible Financing	Polio‑dedicated funds transitioned into pooled health‑system budgets, allowing rapid response to outbreaks without new earmarked resources.

3. Strengthening Disease Surveillance Beyond Polio

• Expanded AFP Platform:
• Added measles and rubella case‑based reporting in 2018.
• Integrated environmental sampling for enteric viruses (e.g., SARS‑CoV‑2, HAV).

• Digital Reporting Tools:
• Mobile‑app “SurveilSEAR” now used by > 15 000 health workers, cutting data entry time from 5 days to < 24 hours.

• Performance Metrics:
• AFP detection rate maintained at > 2 per 100 000 children under 15.
• Non‑polio AFP (NPAFP) proportion stabilized at 40 %, indicating strong sensitivity for other neurologic disorders.

4. Integrating Immunization Platforms

1. Routine Immunization (RI) Strengthening

• Polio cold‑chain upgrades (solar‑powered refrigerators) now service the full childhood vaccine portfolio.
• Result: DTP3 coverage rose from 84 % (2010) to 96 % (2025) across SEAR.

2. Combined Campaigns

• 2022 “Triple‑Vax” campaign delivered OPV, Measles‑Containing Vaccine (MCV), and Pentavalent vaccine simultaneously in 12 high‑risk districts, achieving > 98 % coverage in each.

3. Micro‑planning Tools

• GIS‑based micro‑plan used for polio now drives “last‑mile” RI outreach, reducing drop‑out rates among nomadic populations from 12 % to 4 %.

5. Health‑Workforce Development

• Training Modules:
• “Polio‑to‑Pandemic” curriculum (10 h) delivered to 45 000 frontline staff, covering infection control, risk communication, and vaccine logistics.

• Task Shifting:
• Community health volunteers (CHVs) who once conducted house‑to‑house OPV campaigns now perform growth monitoring and screening for hypertension,expanding primary‑care reach by 30 % in Nepal.

6. Financing and Partnership Models

• Pooled Funding Approach:
• The Global Polio Eradication Initiative (GPEI) transition fund (US$ 1.2 bn) merged with SEAR health‑system grants, creating a flexible “Health‑Resilience Fund.”

• Public‑Private Collaboration:
• Partnerships with logistics firms (e.g., DHL, Mahindra) introduced last‑mile cold‑chain solutions originally piloted for OPV; now supporting COVID‑19 and future mRNA vaccine rollouts.

• outcome:
• Health‑system financing gap narrowed from US$ 5 bn (2016) to US$ 2.3 bn (2025) in the region.

7. Case Study: India’s Transition from Pulse Polio to Routine Immunization

• Background: 2002–2011 Pulse‑Polio killed > 200 million wild‑type polio cases globally.
• Strategic Shift (2015‑2020):
• Re‑allocation of 70 % of OPV logistics to RI.
• Introduction of “Zero‑Dose” identification using GIS, targeting children missed during polio rounds.

• Impact Metrics:
• Zero‑Dose children reduced from 1.6 % (2015) to 0.4 % (2024).
• Measles‑containing vaccine coverage rose from 85 % to 94 % in the same period.

• Key Takeaway: The polio infrastructure served as a catalyst for eliminating zero‑dose pockets, a critical barrier for achieving worldwide health coverage (UHC).

8. Broader Public‑Health Outcomes Attributed to Polio success

• Reduced Mortality: Child mortality under 5 decreased by 18 % across SEAR (UNICEF, 2024).
• Improved pandemic Preparedness: Rapid deployment of mobile vaccination units during the 2023 Nipah outbreak leveraged OPV cold‑chain vehicles, cutting case‑fatality ratio from 68 % to 42 %.
• Equity Gains: Post‑polio surveillance identified high‑risk slums; targeted health‑promotion campaigns increased institutional deliveries by 12 % in Delhi’s dharavi (2022).

9. Practical tips for Policy Makers

1. Map Existing Polio Assets – Conduct an asset inventory (cold chain, GIS platforms, CHV networks) and align them with current health‑priority programs.
2. Prioritize Data Integration – Link AFP databases with electronic health records (EHR) to enable multi‑disease dashboards.
3. Institutionalize Cross‑Sector Partnerships – Formalize agreements with logistics and ICT firms for sustained supply‑chain resilience.
4. Secure Enduring Financing – Transition disease‑specific grants into multi‑year health‑system funds with clear governance structures.
5. engage Communities Early – Replicate the polio “social mobilizer” model for new health initiatives to build trust and improve uptake.

10.Future Outlook: From Eradication to Health‑System Resilience

• Emerging Threats: Anticipated rise of vaccine‑derived poliovirus (cVDPV) cases in bordering non‑SEAR countries underscores the need for continued high‑quality surveillance.
• Digital Innovation: AI‑driven predictive modeling, built on AFP data, is being piloted in Sri Lanka to forecast dengue hotspots, demonstrating the scalability of polio‑era analytics.
• Regional Collaboration: The WHO SEAR “health‑Security Cluster” now includes representatives from the former polio Eradication Unit, ensuring that lessons learned feed directly into the region’s pandemic‑response blueprint.

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Data sources: WHO south‑east Asia Regional Office (2025), UNICEF Child Mortality Report (2024), CDC Surveillance Brief (2024), Global Polio Eradication Initiative Transition Report (2023). All figures reflect peer‑reviewed publications and official WHO statistics.