Insecurity threatens Nigeria’s $200m polio intervention

Insecurity of lives of health workers, including polio immunisation workers has brought fresh challenges to global polio eradication efforts despite millions of dollars spent by the Federal Government, Rotary International, Bill & Melinda Gates Foundation, United Nations Children Fund (UNICEF) and the World Health Organisation (WHO), to fund polio vaccines in the country.

Only recently, gunmen attacked two polio clinics in Kano, killing some individuals before fleeing even as insecurity in Borno state prevented health officials from performing Immunisation Plus Days (IPDs) held across the country.

With the World Bank’s lending commitments to Nigeria for polio from 2003 to 2012 totalling $195 million, Dangote Foundation and Bill & Melinda Gates Foundation, provided funding, equipment and technical support to the Kano State government to strengthen polio immunisation, the Federal Government in March 2012 pledged to spend $60million in two years to eradicate the disease. This is coming on the heels of Bill Gates’ $10billion pledge to develop and distribute vaccines.

Reacting to this development, Osahon Enabulele, president, Nigeria Medical Association (NMA) said that the insecurity challenge is coming at a time when Nigeria is struggling very hard to drop her gold medal in polio, being one of three remaining countries where polio is endemic.

“We call on government at Federal, State and Local levels to urgently provide effective police/security post in all public health facilities in the country. We call for intensification of health enlightenment and reach out campaigns to demystify the myths surrounding Polio vaccination. The slain polio vaccinators are heroes in the war against polio and symbols of implementation of the Child Survival Strategies in Nigeria,” Osahon advised.

Until now, cultural beliefs and free movement among border countries in the north has continued to pose serious challenges to tracking millions of missed children for vaccination against the dreaded polio virus. The intermingling of nationals of Nigeria, Niger and Chad, on the northern borders poses another shade of challenge in statistics.

Currently, one new WPV case was reported in the past week (WPV1 from Yobe), bringing in the total number of WPV cases for 2013 to 3. The total number of WPV cases for 2012 remains 122. The most recent WPV case had onset of paralysis on 31 January 2013 from Yobe, according to Global Polio Eradication Initiative (GPEI), a public-private partnership spearheaded by national governments, WHO, Rotary International, UNICEF, and supported by key partners including the Bill and Melinda Gates Foundation.

Nationwide Immunisation Plus Days (IPDs) were conducted using trivalent OPV on 2-5 March in 30 states, coordinated with activities in neighbouring Republic of Niger. However, IPDs were postponed by one week in four southern states and the Federal Capital Territory due to the need for more time to adequately prepare for the round of immunisation. IPDs have been postponed in Kano and Borno states due to security concerns.

The security situation in the north remains fluid even as the Expert Review Committee on Polio Eradication and Routine Immunisation (ERC) meets from 19-20 March to review ways of nipping polio in the bud.

While Nigeria remains the only country in the globe with the three strains of polio virus, the risk of an explosive return of polio within the West African sub-region remains a major concern and raises the chilling spectre of many deaths resulting from the upsurge of polio even as the deadline of eradicating the disease gets close.

Public health experts believe that interrupting the remaining poliovirus transmission in the country requires institutionalising the raised supplementary immunisation coverage. Other strategies that should be deployed in eradicating the virus include scaling-up international technical support to intensify eradication activities, expanding social mobilisation and communications capacity, implementing nationwide ‘IPDs’ to maintain high levels of population immunity needed to reduce the risk of outbreaks following importations into polio-free areas of the country.

ALEXANDER CHIEJINA