The World Health Organization (WHO) fears that the spread of polio now poses a global public health emergency. In the three countries where it is endemic—Pakistan, Afghanistan and Nigeria—and in 7 others which had not reported incidence in years, 74 cases have been reported so far this year. The WHO notes that Pakistan, Syria and Cameroon contributed the most to the spread, with adult travellers from these countries serving as carriers.
India, recently declared polio-free, faces grave risks given its proximity to Pakistan, where cases rose from 58 in 2012 to 93 in 2013, accounting for nearly a fifth of the global caseload that year. While the WHO recommends that travellers from Pakistan, Syria and Cameroon be required to get vaccinated a mimimum of 4 weeks before going abroad, India has said that nothing less than 6 weeks will do. However, this is easier said than met because there is no real way to enforce it, except for invoking the International Health Regulations. Besides, the oral-faecal route of transmission for polio virus makes us especially vulnerable given north India shares portions of its water bodies with Pakistan. Apart from continued vaccination, the other major step that the world at large cab take is mount serious efforts to improve access to sanitation and clean drinking water. This will especially be true for India—according to the 2013 baseline survey for the Nirmal Bharat Abhiyan, 54.7% of all households in the country don’t have a toilet, despite the large public spending on that overhead.