In 2014, one-and-a-half-year-old Rukhsar Khatoon became a symbol of India’s fight against — and eventual victory over — polio.

The little girl, a resident of Howrah district in West Bengal, was the last-ever reported case of the deadly virus.

Three years after her diagnosis, India was declared polio-free after an 18-year-long rollercoaster with many ups and downs.

The face behind the long war against the deadly virus, Anuradha Gupta, was the then additional secretary in the Ministry of Health and Family Welfare, and director of India’s National Health Mission.

“Within the country, there was immense fatigue. The programme [to tackle polio] had been going on for years, but we were still unable to get rid of the virus. People were getting tired,” recalls the IAS officer.

When the opportunity to rid India of polio came knocking at her door, she made it her life’s mission. Anuradha soon began working as the health secretary in Haryana.

“That’s the time I began to understand just what polio is, and how poor the immunisation rates in Mewat were…In the end, that was the very last case in Haryana,” she shares.

She then 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.

After joining the ministry in 2010, she soon realised the way to tackle the nation’s polio crisis was not by looking at how many children were being covered but by how many children the government was missing.

“Otherwise, the programme was repetitively going back to the children we had covered, but constantly excluding the kids we had missed,” she says. “We completely repositioned the programme.”

At the time, India was receiving funding from the World Bank for procuring vaccines, with the condition that the manufacturer should be WHO-qualified.

A significant hurdle emerged when India’s global tender for it didn’t succeed. According to the agreement with the World Bank, if India partnered with manufacturers not approved by WHO, they would risk losing their funding.

At this time, Bharat Biotech had also bid for the global tender and was manufacturing the bivalent vaccine in India.

“I realised that this Indian company had received approval from the National Regulatory Agency, which was WHO-prequalified. So if the company was prequalified by our own agency, it meant that they were meeting the required standards of WHO as well,” she explains.

She approached Dr Naved Masood, then financial advisor in the Ministry of Health and the duo got the go-ahead to use Bharat Biotech as a manufacturer.

Despite losing the World Bank funding, India strengthened its immunisation programme. The bivalent vaccine, combined with an increased focus on “missed children”, got India over the hump.

In 2011, Anuradha asked the Union Health Minister to declare polio as a Public Health Emergency, which put all states and union territories on high alert.

Rukhsar’s case became the last polio case reported, and on 27 March 2014, the WHO declared India polio-free.

.