THREE years ago, on January 13th, Rukhsar Khatun, then 15 months old, was diagnosed with polio. She now has a crippled leg and struggles to keep up with her friends. But this little girl, from a West Bengali village, can claim some fame: she is, with luck, the last Indian to be infected with the wild polio virus. Enough time has passed with no new case for India shortly to be certified as free of Polio.
 
THREE years ago, on January 13th, Rukhsar Khatun, then 15 months old, was diagnosed with polio. She now has a crippled leg and struggles to keep up with her friends. But this little girl, from a West Bengali village, can claim some fame: she is, with luck, the last Indian to be infected with the wild polio virus. Enough time has passed with no new case for India shortly to be certified as free of Polio.
That is a big success. India’s anti-polio campaign began in 1995 with severe disadvantages. The country spends little on public health, barely 1% of GDP, and has been awful at immunizing children. Too few parents know the basics of hygiene and nutrition, let alone the benefits of vaccines. India has bad sanitation, large remote populations and vast migration from village to slum.
At the peak of coverage, 99.7% of the target population swallowed anti-polio drops, says Anuradha Gupta of the national health ministry. That is startlingly high, considering that a decade ago “universal” vaccination coverage for seven preventable diseases (such as diphtheria, tetanus, hepatitis B) was a pitiful 30% in Bihar, a big, poor northern state.
India’s campaign has been successful enough for its lessons to be applied in Pakistan, Afghanistan and Nigeria, the last places with endemic polio (foreign fighters may have reintroduced it to Syria, too). Vaccinators learned to attend especially to mobile populations, like seasonal workers at brick kilns, and found that many migrants are best reached not at home but in bus and railway stations.
Good monitoring was crucial, too. In Uttar Pradesh and Bihar, vaccinators visited 60m households several times a year, says Hamid Jafari of the WHO. To compile data on recipients, some 400,000 hard-to-reach population groups were carefully tracked and plotted, down to each household. Data passed early to decision-makers, at the district-official level, allowed a quick response to new cases.