India, once the epicentre of polio, marked its first full year without a new case of the crippling disease on Friday, but the US taxpayer, who has been generously supporting India's polio fight, may be pulling the plug on funding.

India's success leaves just three countries where polio is still endemic. When India was polio ravaged, it was one of the four countries along with Pakistan, Afghanistan and Nigeria to be known by the acronym PAIN.
India's success in fighting polio, which has cost almost $2 billion and several nationwide immunisation programs, has been credited to decades of work by the Indian government, Rotary International, along with the US government-funded Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and UNICEF. According to the Washington Post, the US has spent more than $2 billion around the world since the WHO launched the global eradication campaign in 1988.

"Federal funding for global health programs now faces sharp cuts from Tea Party lawmakers and others worried about the deficit," warned The Hill.

"House Republicans last year voted to cut funding for global health by more than $1 billion from 2010 levels. A House and Senate conference committee last month ended up agreeing to slash President Obama's request for $9.1 billion by 9.2 percent, or $840 million."

Lawmakers have had to resort to sharp cuts in global health programs as America is running a $15 trillion debt and its own entitlement programs are on the brink of insolvency.

Officials with the CDC say US funding and experience were key to beating back polio in India.

"Since 1999, CDC has provided more than $113 million to India for technical, programmatic and laboratory support and purchase of oral polio vaccine," Kevin De Cock, the CDC's director for global health, told The Hill.

In India, De Cock said, the CDC "worked side-by-side with the government of India in designing and maintaining WHO's highly effective national polio surveillance system" while "CDC disease detectives and laboratory experts [were] on the ground working with global and local partners to investigate outbreaks and rapidly stop their spread."

Back at CDC headquarters in Atlanta, De Cock said, health experts "collect and analyze the latest information on eradication progress and share with those on the ground so strategies are adjusted based on the science."

The US government has shown huge commitment to eradicating polio in India, but if state funding dries up India will have to rely more heavily on Bill Gates who has made eliminating polio a centerpiece of his efforts to use his Microsoft fortune to change the world.

"We must build on this historic moment and ensure that India's polio program continues to move full-steam ahead," Gates said in a statement released by the Bill & Melinda Gates Foundation.

Gates said India had demonstrated that polio can be halted "when countries combine the right elements political will, quality immunisation campaigns, and an entire nation's determination."