Guardian

Unlike India, which in January became the latest country to be declared polio-free by the World Health Organisation (WHO), after going a full year without registering a new case, Nigeria, Pakistan and Afghanistan remain endemic due to insecurity, heavy rains, controversies and shortfall in global funding mechanism.

NIGERIA will not be able to meet the Presidential target of stopping the transmission of the Wild Polio Virus (WPV) by December 2012, and eventually eradication by December 2013, following the sustained transmission of the virus.

Reasons: Insecurity has forced the federal government to postpone the Immunisation Plus Days (IPDs) campaign especially in northern states. A recent polio campaign was postponed in Kaduna, Yobe and Borno due to insecurity. The three states were part of the 11 northern states scheduled for IPDs between July 7 and 10, 2012.

It is feared that the number of new polio cases in Nigeria will continue to rise following the beginning of the rainy season, a “high season” for polio transmission. In many countries, the high transmission season for poliovirus begins with the rainy season.

Some Nigerians especially in the northern region have continued to reject the vaccine due to controversy on whether the administration of polio vaccines on children causes infertility among women and Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS).

This is despite efforts by the Presidential Taskforce on Polio Eradication and the National Primary Health Care Development Agency (NPHCDA) to educate the Nigerian public on the causes of WPV spread and the need for them to allow their children to be administered with the Oral Polio Vaccine (OPV) to prevent the disease and the imminent paralysis.

The Independent Monitoring Board (IMB) of the Global Polio Eradication Initiative (GPEI), in a recent report, said the global financial crisis coupled with growing needs for polio funding had led to a shortfall of $945 million (N153 billion) out of a total 2012-13 eradication programme budget of $2 billion (N324 billion).

The IMB chairman, Liam Donaldson, told reporters: “The shortfall would have a ‘real and immediate’ impact. Vaccination campaigns for 2012 would have to be cancelled in 33 countries, leaving 94million children “exposed to the horrors of this disease.”

Indeed, these challenges have led to an upsurge in new cases of WPV in Nigeria. According to the Weekly Polio Update published by the GPEI, “three new wild polio virus cases were reported in the past week, all from Nigeria. This brings the total number of cases globally for 2012 to 103, from four countries (Nigeria, Pakistan, Afghanistan and Chad). This compares to 303 cases reported from 13 countries for the same period in 2011.

“Poliovirus transmission is largely contained within the three polio-endemic countries. The only non-endemic country with cases this year is Chad, with five cases.”

According to the GPEI, three new cases were reported in the past week, two type one WPV (WPV1s) from Kano and a type three WPV (WPV3) from Bauchi, bringing the total number of cases for 2012 to 60. The most recent case was one of the newly-reported WPV1 from Kano, with onset of paralysis on July 1.

The next sub-national Immunization Plus Days (IPDs), according to GPEI, are planned for September15-18, in 11 states across the north, using bivalent OPV.”

The GPEI said despite the low number of cases and infected countries in 2012, vigilance is now critical, as in many countries, with the beginning of the rainy season the high transmission season for poliovirus transmission is also beginning. “High quality immunization campaigns and sensitive disease surveillance are more important than ever!”

According to the World Health Organisation (WHO), polio is caused by a virus that attacks the nervous system and can cause irreversible paralysis within hours of infection. It remains endemic in three countries-Pakistan, Afghanistan and Nigeria-after India in January became the latest country to become polio-free, after going a full year without registering a new case.

Polio often spreads in areas with poor sanitation-a factor that has helped it keep a grip on those endemic countries for many decades-and children under five are the most vulnerable.

WHO said the disease can be halted, as it was in Europe, with comprehensive, population-wide vaccination programmes.

The IMB report titled Every Missed Child focused on the need to reach children who repeatedly slip through the net during polio vaccination campaigns.  It said that in six countries where polio persists-the three endemic countries plus Angola, Chad and the Democratic Republic of Congo-there are 2.7million children who have never received even a single dose of polio vaccine.

“These are the children that the world forgot, growing up with no protection from polio at a time when most of the world’s parents have long forgotten what polio even is,” Donaldson said.

The report said the polio virus is hiding out in a number of “sanctuaries”-specific areas in the worst hit countries where too many children have been missed in vaccination campaigns and where the virus can multiply and prepare for a fresh attack.

Minister of State for Health and Chairman Presidential Taskforce on Polio Eradication, Dr. Muhammad Ali Pate, told The Guardian that the Task Force meets regularly to evaluate progress towards fully implementing the national polio emergency action plan.

The task force was set up by President Goodluck Jonathan in March 2012, to oversee implementation of the emergency plan. This follows the 300 per cent increase in staff to support polio eradication in the worst-performing areas in the north of the country.

Reacting to the controversy over the polio vaccine, a consultant in the Department of Public Health of Federal Ministry of Health, Dr. Nasir Sani-Gwarzo said the polio vaccines neither cause “infertility nor HIV/AIDS” among residents and communities in the North.

The WPV1-3, he however, said are transmitted and eventually spread through two sources; namely contaminated water and refuse dump sites that dot most of the cities and towns.

Speaking at the flagging off of the July 2012 polio immunizations and sensitization of traditional rulers in Maiduguri at the Government House, he said: “Once a child contracts the viruses through contaminated water and refuse dump sites, they spread in a second; and multiplies in millions in children’s stomach and intestines.”

He said the WPV1-3 finally ends up in the spinal cords to become polio that cripples many children for life, while their hands and other limbs are chopped off.

Meanwhile, despite its security challenges, the Plateau State Government said that it is polio-free, as no single case of polio has been recorded in the recent past. Deputy Director in the Plateau State Ministry of Health, Maidawa Musa, confirmed this to The Guardian in Jos.

According to him, what the ministry is now doing is just that of surveillance around the state to make sure that polio does not come to the state. He said they are sensitizing members of the communities to report immediately anybody with paralysis to the ministry for the quick immunization.

Musa said it is the local government staff who normally go round to sensitize the community on how to ensure that this epidemic is permanently kept at bay. “But with them being on strike now, everything is at a standstill. We pray that nothing happens.”

However, the Jigawa State Director of Primary Health Care, Gunduma Health System, Alhaji Aminu Danmallam, has described the recent polio immunization as one of the most successful exercises witnessed in the State as it recorded over 110 per cent success.

He indicated that though the state targeted to immunize 1, 150, 000 children at the end of the exercise, about 1, 400, 000 children were successfully immunized.

The director who spoke through the State immunization Officer Alhaji Hassan Kwallam said the immunization took place in all the 27 Local Governments covering 288 political wards.

According to him: “2064 house-to-house teams were deployed, 339 special teams to work in the schools, motor parks, remotest areas and so on. 576 fixed post teams for health facilities catchment areas mainly for children under the age of one.”

“1, 150, 000 children were targeted for immunization but, at the end of the exercise, we immunized about 1, 400, 000 children so it was a huge success, more than 110 per cent success. Soap tablets of about 1400 pieces were purchased and distributed as incentive for each of the children immunized.”

He said there was an emirate flag off conducted by the Emir of Hadejia in Auyo local government and a community dialogue flag off in Buji and in Miga local governments by the Emir of Dutse.

He explained that the community dialogue is an interaction with the childcare givers on the need for the polio immunization, which is normally done in places where non-compliance is high.

He said they tried to contain the high risk local council by special intervention, monitoring and supervision and community dialogue.

He listed the high-risk areas to include Ringim, Taura, Babura, Dutse, Birninkudu, Miga, Buji, Auyo Gumel and Hadejia.

He said with the additional teams, the teams have tripled from 77 to 2069

“We are using trackers, wherever you go, we have some electronic device that monitor where the teams go so at the end of the day it can be connected to the computer and it will indicate wherever you went.”