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Wednesday, February 11, 2015

Nigeria’s Final Push against Polio

With several accolades that Nigeria has received globally on the fight against polio virus, stakeholders believed that there is need to avoid complacency for complete eradication of the virus, Paul Obi and Martins Ifijeh writes
To herald one of his greatest surprises and wonders that occurred in 2014, Co-Chair of Bill and Melinda Gates Foundation, Bill Gates said "one of my favourite stories in 2014: in just one year, Nigeria went from 50 cases of polio to 6."
And in a more elaborate analysis of the need to stay focus on the fight to keep children save and from diseases, Gates writing in The Economist (The World in 2015) said: "2015 can be the moment when the fight to save the lives of children around the world turns into a popular movement, because the world has built a record of progress that proves dramatic change is possible in our lifetimes."
In many respects, Gates' push for a new movement that will put to end diseases like polio resonates in Nigeria.
Yet, it is not that rosy as it seems on the surface.
Notwithstanding, the government’s resolve to go further in 2015 to halt polio, current challenges appear to be an obstacle, indeed.
Chief among the challenges standing on the way in combating polio is the 2015 general elections, observers believed.
Immunization has very often been slow in elections year, they argued. The other and most critical is funding. With less than three years to certifying Nigeria polio free, stakeholders are of the view that any form of complacency will stagnate the progress made already.
It is in that light that the 29th Expert Review Committee on Polio Eradication Routine Immunization in Nigeria met recently in Abuja.
The meeting centred on how to ensure that Nigeria continue to focus on its target goal of complete eradication of polio virus in the country.
The Executive Director, National Primary Health Care Development Agency (NPHCDA), Dr Ado Muhammed said the event was geared towards carefully reviewing the progress Nigeria as a country has made in terms of polio eradication.
"We are speaking with all partners, all stakeholders on polio eradication globally; Rotary International, Bill and Melinda Gates Foundation, UNICEF and other partners to review the progress we’ve made," Muhammed told journalists in Abuja.He added: "In 2014, Nigeria made an unprecedented progress which was widely commended globally by all stakeholders by reducing the cases of polio virus to just few cases in 2014. When we compare that with 2013, it is about 89 percent reduction in cases of our polio virus in Nigeria. So far, the last case of wild polio virus in Nigeria was reported on 24 July 2014, making it six months without any case of wild polio virus in Nigeria."
The essence of the meeting according to NPHCDA boss is to galvanise support to end the pandemic.
He said: "What it means is that no child has been paralysed by wild polio virus in Nigeria for six months. And, we are already counting days to interrupt wild polio virus in Nigeria by July 24, 2015, which will be one year, if a case of wild polio virus is not reported in Nigeria. What it means is that Nigeria would have interrupted wild polio virus transmission.
“Then, two years later, we would achieve certification. So, we’ve made a lot of progress. This meeting is to carefully review the progress we’ve made; to identify other areas we can further fine-tune and to improve on the gains we’ve made.
"Let’s also not forget of all polio-endemic countries, Nigeria has made much more progress than any of these countries. As at the last count, Afghanistan recorded 32 cases of wild polio virus, Pakistan recorded 237 cases of wild polio virus, with Nigeria reported only few cases of wild polio virus. So, the world is looking up to Nigeria as the next country to exit as polio-endemic country. This is not just by chance; this is the result of hard work put in by the programme, because of the guidance provided by the Minister of Health, Dr Khaliru Alhassan and the former Minister (Prof Onyebuchi Chukwu). This is also not unconnected with the Transformation Agenda of Mr. President Goodluck Jonathan."
Muhammed reiterated the commitment of the agency to continuously pursue efficient immunisation policy that will address all the gaps that impede the eradication of the disease.
"As we talk of polio, let’s not forget that polio and immunization must go together," he said. "If you make gain in polio without maintaining routine immunisation, you cannot sustain that gain. This is the first time in this country that routine immunisation is working and working very well. We have been able to move routine immunisation coverage from 52 per cent two years ago to remarkable and commendable level of 91 per cent national average administrative coverage by the end of 2014. What it means is that 31 percent of children that are eligible are being reached by safe vaccines."
Regarding the fears that the forth coming general elections will obstruct and even slow immunisation programme, he concluded by stating that “election must not become a distraction to polio programme. Election should be a campaign.”Also, the Chairman, Expert Review Committee on Polio Eradication Routine Immunisation, Prof. Oyewale Tomori listed four critical areas the committee and other stakeholders are focusing on to end the virus. Tomori said, these areas include "the issues of circulating the wild polio, together with the wild polio which we recorded last year are issues we need to pay attention to make sure that this country is totally free of either of the two types of virus; that is number one." The other issue, he said dwells on "compatible polio cases, which means that our surveillance has not gone very well, we missed what could have been polio. We need to improve on our surveillance to ensure that such compatible cases do not occur.
"The recent information which has been misinterpreted by the generality of Nigerians that Nigeria will be declared free of polio is not correct. The issue is that, according to WHO regulation, we need to be totally free of polio for three years before we are declared polio free. I think that is what is what we want to achieved. Polio transmission is just a step in the way. Polio eradication is what we are looking for. That will require us to sustain no polio for the next three years." He called for sustenance and improvement of funding for the target.
UNICEF Country Representative, Jean Gough, on her part harped on the need for Nigeria to show more commitment and dedication as the country tips towards the final stage in eradicating the virus. Gough observed
"This is the first time in the history of Nigeria that for six months, we have not had cases of polio. We are on a good step; we are on a good track. Today, we really want to celebrate all the frontline workers in the states, the people that are in the far communities, not here at this meeting. It is because of them and their tireless efforts in the different communities, reach each house, reaching all the children. The leadership provided by government of Nigeria, the leadership provided by the independent monitoring team, the technical team that is reviewing today, the ERC, all the donors and partners who believe that this target is possible, we are here today celebrating. But, we are not there yet.
"We still have three more years to go to ensure certification, if these years, we don’t have more cases of polio.  So, we are on a good track. But, we are not there yet. I think we need to continue motivating all the community workers, the traditional leaders, the politicians to continue their efforts because the goal is possible." Gough added that vaccination should not be only against polio, but against all forms of communicable diseases to help reduce mortality. She also urged all politicians in the country to support the efforts.
Chairman, Rotary International Polio Plus Committee in Nigeria, Dr Tunji Funso highlighted the existing gaps to be closed on polio in Nigeria. He stressed that notwithstanding the success recorded, Nigeria must persistently push for complete eradication of polio. Funso explained that "one of the important things is to avoid complacence. We know we’ve done very well; we patted ourselves on the back. But, usually, things can go wrong. We had got almost this close before in 2010 when we had reduced all cases phenomenally by almost eighty percent. "But, now, we have gone further than that, we have reduced by 90 percent. So, one of the things we are going to do is that we are not complacent. We want to build on the strength of what we have done, we also want to ensure that those things that still need to be done, particularly the challenge of having to reach children in the security-challenged areas, either because of access or because they are now IDPs, (Internally Displaced Persons), where we can reach them. These are strategies that we never had before. We are developing strategies to ensure that all children in IDPs are reached."

For his part, the Research Director, Action Against Diseases, a non -governmental organisation based in Kaduna, Dr. Rufus Kazeem has said that Nigeria is in the winding face of eradicating the virus from the country, but the government should intensify campaigns for routine immunisation so that other cases will not be recorded.
According to him, “this is even the time government should declare holidays more often for the purpose of national immunization exercise, so that every child in the country will not be left out of polio immunization and vaccination.
He called on the government to restore peace to the troubled northern states as the crippling effects of the Boko Haram crisis may affect the monitoring exercise that should follow within the three years window.
“The crisis has made a lot of families uncomfortable sending their wards for immunisation or receiving health workers in their homes to immunise their children. Religious bodies should continuously educate their followers on the need for their children to undergo polio immunisation. The battle is not yet over until it’s over. Immunisation should be given even greater priority at this stage,” he said.
Thus, the current challenges Nigeria is facing in the northern part of the country are not only severed but legion as well. The displacement of persons as a result of Boko Haram insurgency has worsened the situation for vaccinators. Then again, IDPs would not be that committed to turn up for immunisation as they struggle against survival. Even those at home would be more concerned with the general elections in the coming months. Pray, post - elections violence is avoided, otherwise, Nigeria would have to shift the goal post in its drive to end polio virus.
Instructively, many are optimistic that Nigeria will scale through. Stakeholders opined that Nigeria can no longer continue with the tagging of a polio country. The task therefore is to increase the pace of immunization coverage and ensure that there are no loopholes. There is no other better time for Nigeria to stop polio than now. Both policymakers and stakeholders alike have critical roles to play. Nothing should be left to chance as Nigeria is set to become a success story in the fight against polio virus. Therefore, 2015 presents Nigeria with another clinical opportunity to tame and extinct polio virus from its shore. The Supervising Minister of Health, Alhassan and the NPHCDA boss would definitely need to embrace the golden opportunity to put Nigeria in good record globally. That is just three months away for Nigeria to be polio-free.

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