Nigeria is the only African country to have never stopped transmission of the wild polio virus. Can this change this year? Adetola reports…
Nigeria, Pakistan and Afghanistan, what does these 3 countries have in common? Poliomyelitis, the debilitating paralytic illness that affects non-immunised children.
Nigeria is the only African representative to have never stopped transmission of the wild polio virus (WPV) and has in addition, the vaccine-derived polio virus (VDPV) in circulation. According to the National Primary Health Care Development Agency (NPHCDA), there were 4 cases in 2016 with the most recent case reported in Monguno Local Government Area, Borno, in August 2016 and no cases reported in 2017.
A country is regarded as polio free or non-endemic if no cases have been detected for a year and in September 2015, the World Health Organization (WHO) removed Nigeria from the list of polio endemic countries after a year of zero polio cases, however, polio made a return to the country in 2016. But for that setback, the nation would have, after 2 decades of work, marked 3 years of zero polio cases in 2017 and have been certified by WHO as a polio-free country.
Stopping polio transmission is pursued globally, and in Nigeria as well, with a four-pronged strategy- routine immunization, regular supplementary immunization campaigns, surveillance of possible outbreaks, and targeted “mop-up” campaigns once wild poliovirus transmission is detected in a specific focal area. Considering that polio vaccine has been available and in use since the 1960s, and an amazing victory has been won over polio in various countries of the world with this same approach, more easily in some countries like the USA than in others, India, winning the polio war in Nigeria is highly feasible.
The greatest obstacle to polio eradication may well be the lack of basic health infrastructure in the most vulnerable areas of the nation, which limits vaccine distribution and delivery for routine immunization as well as for supplementary immunization days and disease surveillance system. In addition to a colored perception of polio vaccination by communities in these areas, poor security has exacerbated all the other pre-existing factors. During periods of highest unrest, Boko Haram had barred and even murdered vaccination teams.
This 2018, in addition to the aid being received from the international community which effectively addresses funding gaps and further improve technical capacity across board, an increased and concerted efforts by all levels of government, civil society organizations and religious leaders may well be the mortar holding all the other bricks together. Often, religious institutions and community based organizations wield an underestimated but important influence to achieve success.
Strengthening Nigeria’s polio surveillance systems to detect the virus early must be prioritized as a critical component in polio eradication efforts, in fact, regions cannot be certified polio-free without standard surveillance systems in place. There is a great need to intensify and institutionalize this in such hard-to-reach problem areas as the Lake Chad region, which spans several countries and is often affected by conflict and large population movements.
As the country moves on from the 2016 setback and seeks to sustain the 2017 zero-polio-case trend in this new year and being certified as having eradicated polio successfully in 2019, the path will be defined by continuing and unrelenting efforts made by all players in this new year.