IAS Officer’s Brilliant Ideas Took India from World’s Highest Cases To Becoming Polio-Free

Anuradha Gupta, deputy CEO of Gavi was at the forefront of the fight against polio. And her efforts were effective, and India was declared polio-free in 2014.

Anuradha Gupta always wanted to be a doctor. But she ended up becoming an IAS officer instead. She always wanted to work for the people. She worked in many sectors like the education sector, welfare for women and child welfare, and poverty alleviation. But she found her true calling when she was appointed to the health sector.

She joined the 1981-batch of the Haryana cadre and began her career as a sub-divisional magistrate in Mahendragarh. Shortly after Anuradha began working as the health secretary in Haryana, there was a polio case in Mewat. “That’s the time I began to understand just what polio is, and how poor the immunization rates in Mewat were,” Recalls Anuradha. She went by the book and worked relentlessly. But then that case became the last reported polio case in Haryana.

It was then that Anuradha received a call from Sujatha Rao, former secretary at the Ministry of Health, Government of India, who invited her to join the ministry as the secretary. “When I joined the GOI in early 2010, I was put in charge of women and child health, including polio. It was here that I truly realized how much India was contributing to the global polio burden,” Anuradha says.

Anuradha realized that the way to tackle the nation’s polio crisis was not by looking at how many children were being covered in every round of immunization. Instead, it was to factor in how many children the government was missing. She and her team focused on the children who were missing out on the polio vaccine. They completely repositioned the programme.

She was the one who solved the issue regarding the funding from the World Bank for the vaccines. World Bank funded vaccines only from WHO approved organizations. But WHO approved only the organization which produced the monovalent vaccine. And with India’s condition, India needed a bivalent vaccine (which stimulates an immune response against two different antigens, such as two different viruses or other microorganisms). But Anuradha found that Bharat Biotech which was producing bivalent vaccines could be considered WHO-approved because Bharat Biotech had received approval from the National Regulatory Agency, which was WHO-prequalified.

Anuradha went to Dr Naved Masood, then financial advisor in the Ministry of Health. He heard her appeal and scrutinized the overall budget of the ministry, and realized there was an unspent balance from another project that year. He gave her a ‘go ahead’. Like this, despite losing the World Bank funding, India strengthened its immunization programme. The bivalent vaccine, combined with an increased focus on “missed children”, got India over the hump.

A rapid emergency mop-up was conducted and was completed within a record six days, although these sorts of procedures can take weeks due to the sheer number of population that needs to be vaccinated. And on 27 March 2014, the WHO declared India polio-free.

In 2015, Anuradha joined Gavi. Since then, she says, “India is the world’s largest and most precious lab. It’s a combination of the best and the worst and the most challenging. When I joined Gavi, I brought my learnings of how to use data to identify marginalized populations that need to be prioritized, and how to bring in equity in immunization.”

Under Anuradha’s leadership, Gavi had developed a programme to identify ‘Zero Dose Children’, wherein they analyzed data to find that one-in-ten children in Gavi-supported countries have not received even a single dose of routine immunization.

As far as vaccination programmes in India are concerned, Anuradha opines, “India has many gaps in terms of vaccination. We’ve made progress in coverage, but inequity is a huge challenge. The country has the largest number of zero dose children at 3 million, a number that increased last year. The pandemic has hit routine immunization services, especially for marginalized communities. That means that India needs to focus more on these children, lest they begin seeing outbreaks of diseases like measles, or the return of polio — a vaccine-derived virus, not wild polio. Gavi is working to introduce new vaccination and immunization programmes in India. There are a lot of gaps to be covered.”

Credit: The Better India