It took Nigeria longer than other African countries to have its documents accepted by the Africa Regional Certification Committee — a step towards wild polio-free certification for the entire African region. But it is not a total victory, yet, as the battle against polio has only taken a new dimension which would require doing more to maintain a wild polio-free status. Adeola Oladipupo, The West African Pilot News Assistant Editor, writes from Lagos.
LAGOS –— In May 1988, the World Health Assembly of the World Health Organization (WHO), launched a global effort to end polio by the year 2000. At the time, about 300,000 cases of paralytic poliomyelitis were recorded each year and 125 countries were endemic. It was an ambitious plan that included ensuring a robust surveillance system and an effectual immunisation system – to prevent outbreaks.
Polio is a highly infectious disease by a virus that invades the nervous system and can cause total paralysis in a matter of hours. The virus is transmitted from person-to-person spread mainly through the faecal-oral route and less frequently through contaminated water or food.
By 2006, globally, about 10 million volunteers had administered ten billion doses of polio vaccine. Their efforts had reduced the number of children affected by polio from 1000 per day in 1988 to five per day, six years after the WHO established target date. In 2020, WPV is endemic in two countries – Pakistan and Afghanistan, down from 125 countries in 1988.
WPV was last reported in Nigeria in 2016. Before it achieved the feat going 36-months without WPV cases in August 2019 and had its documents accepted by the African Regional Certification Committee (ARCC) in June 2020, it put all other African countries’ at risk of WPV imported cases and outbreak. It also delayed the WPV free status for the continent as the ARCC does not certify individual countries WPV free.
The acceptance of Nigeria’s documents by the ARCC was an historic achievement for the nation and its development partners who had invested financial, material and human resources to make it happen.
“We can only be happy with the news that this effort has paid off,” Dr Fiona Braka, Acting WHO Representative in Nigeria, told The West African Pilot News.
Nigeria’s WPV free status is coming 20-years after the WHO fixed year of 2000. Experts told The West African Pilot News that the country’s journey towards a polio-free status was challenged by misleading information, religious and cultural factors
In 2003, five ardent muslim states in northern Nigeria, boycotted a global and national campaign to carry out polio immunisation in a bid to end WPV by 2004. The states, at the time, said that they suspected the vaccine had been contaminated with anti-fertility hormones. Some people alleged that it was an American plot to spread HIV.
While Zamfara, Bauchi, Kaduna and Niger States later rejoined the programme, in Kano state, the boycott remained for almost a year. Reported cases jumped from 202 in 2002 to 1,143 in 2006 and the Nigerian strain of the virus spread to other African countries. By 2012, Nigeria was said to account for over half of global cases of wild polio.
Some people said the suspicion of polio vaccine by some people in Kano, could be traced to the 1996 test of Trovan and Chloramphenicol on 200 children by pharmaceutical giant, Pfizer, for a meningitis outbreak. While eleven children reportedly died due to Trovan and low dosages of Chloramphenicol, others suffered injuries including deafness, paralysis and blindness.
The revelation of the test’s outcome in 2000, reportedly led to demonstrations on the streets of Kano. Thirty families and the Kano government sued Pfizer in 2001 and 2007 respectively. An out-of-court settlement was later agreed in 2009.
“Nigeria’s battle with polio has been a long and torturous one, but we have gone pass all those and it is better late than never,” Dr Saheed Gidado, a Medical Epidemiologist, told The West African Pilot News. “There were several issues that had to do with rumour and misleading information that originated from some Islamic scholars.”
Nonetheless, the drivers of the campaign to end polio in Nigeria had to draw in religious and traditional leaders for an effective end of the scourge.
Dr Faisal Shuaib, the Executive Director of the National Primary Health Care Development Agency, wrote in a tweet that the turning point in eradicating polio “would have to be when the program ceded the leadership and management of the polio program to the traditional and religious leaders.”
But some are worried that the duo of COVID-19 induced movement restrictions and worsening insecurity – leading to more displaced persons – hindering access to health services including vaccination, may negatively affect immunisation programmes, including the end polio campaign.
The WHO agreed that there had been a reduction in the number of children vaccinated for different antigens during the COVID-19 outbreak. Dr Braka partly linked it to COVID-19 movement restrictions and fear by parents to take their children to health facilities for routine immunisation services.
Dr Emmanuel Balogun, a Biochemist at the Ahmadu Bello University affirmed that insecurity, as it affects access to health services at the grassroots, is a big concern. He noted that with humanitarian organisations’ staff, risking their lives to get health services to displaced persons in conflict zones, sustained vigilance to detect and address suspected cases, an outbreak which could roll back the success of eradicating wild polio was not likely.
As Nigeria continues to celebrate the end of wild poliovirus, experts warn of another threat – importation of the wild poliovirus from countries where it is currently endemic and the circulating Vaccine-Derived Poliovirus (cVDPV). Experts say although the likelihood of an oral polio vaccine (OPV) mutating to a virulent form to cause cVDPV is low, it is possible in settings where population immunity is very low.
“We have issues with cVDPV. So what the government is doing is to ensure that we build immunity of all eligible children. There are also plans to withdraw from circulation the type of vaccine that has the potency of mutating into a virulent form,” said Dr Gidado. “There are efforts to massively build the immunity of children with the inactivated polio vaccine. It is currently part of the immunisation schedule for children alongside the OPV.”
Experts who are involved in the end polio campaign all believe that the battle does not end with the certification, it has only taken a new dimension which would require consistency in policies even when a government changes and adaptation of strategies to address challenges which may arise post wild polio-free certification.
“There is need to be consistent in the message we disseminate and maintain the same strategies that have contributed to stopping the circulation of the wild poliovirus.
“Surveillance needs to remain very strong to rapidly detect the virus from the children or the environment, and polio vaccination needs to continue through routine immunization and periodic catch-up campaigns,” Dr. Braka affirmed.
- PHOTOS: After 48 Days in Hospital, Boy Labelled Witch and Abandoned is Discharged - August 8, 2021
- Travellers Complain Over Fly Infested Aminu Kano Airport - August 6, 2021
- Ondo 2020: Mimiko Criticises Akeredolu’s Performance - September 28, 2020
