Global-Local Dialectic in Medico-Administrative Practice

This paper is an analysis of the discursive formation of poliomyelitis in India. The period under consideration is from 1970, prior to the adoption of World Health Organisation's Expanded Programme on Immunisation (EPI) by the government of India, to the first National Pulse Polio Immunisation Campaign held during 1995-96. The change in state policy from management and control of the disease to its eradication is an outcome of the interaction between local and global factors in international health. The interface between the Indian state and the medical profession foregrounds the discussion in the present paper. Indian researchers have questioned the OPV immunisation regime promoted by the global EPI. A survey of Indian paediatric literature reveals that concerns with vaccination efficacy and the immunisation schedule are accorded prime importance in the medical research on poliomyelitis. The review of the medical literature shows how studies on country-specific pathogenesis of vaccine preventable diseases result in recommendations for alternative vaccine regimes that contest the universal norms put forward by the global EPI.