New Delhi, Aug. 3: A nationwide surveillance and laboratory network that analyses every case of childhood paralysis to rule out or diagnose polio is now facing a $34-million (Rs 153 crore) funding shortfall at a critical juncture in the war on polio.

The National Polio Surveillance Project (NPSP), also engaged in measles surveillance, will need about $43 million (Rs 193.5 crore) for its activities during 2012 but faces a funding gap of $34 million (Rs 153 crore), an NPSP official said.

The shortfall that may jeopardise surveillance activities comes at a time India appears on the verge of eradicating polio. The health ministry’s polio immunisation campaigns have helped dramatically reduce the number of cases of wild polio paralysis from 741 in 2009, to 42 in 2010, to a single case — in Bengal — so far this year.

There is no shortage of funds for either procurement of polio vaccines or their delivery, for which the Union health ministry spends around $250 million each year. But NPSP is entirely funded by external donors such as Rotary International, the US Centers for Disease Control, and the Bill and Melinda Gates Foundation.

“A funding gap now would mean we’d be (operating) blind when we need to be most alert,” said Hamid Jafari, project manager of the NPSP, a 14-year-old joint initiative of the health ministry and the World Health Organisation (WHO).

A network of 270 medical officers with the NPSP across the country help in the surveillance, screening children with acute paralysis to determine the cause. The NPSP also provides equipment and chemical reagents to eight laboratories in India that screen stool samples of children to look for polio virus and examine sewage water, a potential reservoir of the polio virus excreted by infected children.

“These labs have the world’s highest (diagnostic) workload,” Jafari told The Telegraph yesterday on the sidelines of a South East Asian regional conference on strategies to intensify routine immunisation called by the WHO. Last year, these laboratories screened stool samples from more than 55,000 children and have processed 22,000 samples this year.

Taking into account available and pledged funds from the donors, the NPSP faces shortfalls of $19 million (Rs 85.5 crore) needed for staff costs, $9million (Rs 40.5 crore) for polio surveillance, and $2.4 million (Rs 10.8 crore) for equipment and reagents for the eight laboratories. Other NPSP activities account for the rest of the shortfall.

A document circulated by the WHO at the conference indicates that the funding gaps could also affect surveillance for measles and technical assistance provided by the NPSP staff during special immunisation campaigns for measles.The NPSP also earmarks part of its funds for a rapid response should polio cases surface in places that had been free of the disease. “When a new theatre of operation opens up, we quickly move staff to strengthen immunisation there,” Jafari said.

The medical officers help local health authorities determine how and where the immunisation may have faltered — leading polio to re-emerge — as well as design micro-level immunisation strategies to bolster protection for children.