Nigeria will on Tuesday receive its Wild Polio Virus (WPV) free certificate from the World Health Organisation (WHO), following approval from Independent Africa Regional Certification Commission (ARCC).
The implication of the certificate from WHO is that Nigeria is now without poliomyelitis, or polio, for short, after many years of battling it.
Nigeria is the last country in Africa to achieve this milestone. This means the continent is now polio-free.
This is a remarkable breakthrough considering the fact that seven years ago, the country had accounted for more than half of all polio cases worldwide, according to the World Health Organization(WHO).
According to experts, polio is a highly contagious viral infection that causes serious health defects including infantile paralysis, breathing problems, or even death.
It has no cure but can be prevented by polio vaccine which has helped in reducing the incidence of polio by over 99 per cent from 1988, when more than 350, 000 children have paralyzed annually in 125 endemic countries, to 33 reported cases in 2018.
With no new cases for three consecutive years, Nigeria became eligible to be certified free of polio in August 2019. This is the requisite period for any country to be certified polio-free.
The virus will now remain in only two countries — Afghanistan and Pakistan – and the entire African continent would be free, with the world inching closer to ending yet another viral disease just as Smallpox in1980.
The last four cases of wild poliovirus occurred in Borno State, Nigeria in 2016, an area where the terrorist group Boko Haram’s presence has hampered health workers’ ability to immunise children. The country also saw a spike in cases in 2006 fueled by strong community resistance to vaccination.
In response, the Nigerian government and its partners used innovative ways to reach children in these hard-t- access areas, said Dr Pascal Mkanda, coordinator of the WHO Polio Eradication Programme, according to Devex.
This included vaccinating children while visiting market areas as well as expanding community surveillance of the virus.
The Seven Polio Heroes
PREMIUM TIMES brings you the seven categories of heroes who helped Nigeria fight the deadly infection to a stop.
With a combination of new tactics, their efforts ensured that the 600,000 children under the age of five missing out on vaccination three years ago was reduced to 60,000 today.
1) The Global Polio Eradication Initiative (GPEI)
The task of eradicating polio meant overcoming immense logistical challenges.
Without a combined effort of donors, local and international partners in collaboration with the Nigerian government, the goal will be stalled by funding gaps.
Nigeria has little cold storage for vaccines, poor infrastructure, and many remote communities coupled with a high level of illiteracy and awareness.
The Global Polio Eradication Initiative (GPEI), a public-private partnership launched in 1988 with a goal of ending polio worldwide, was most pivotal in bridging funding and technical gaps.
It was driven by the Nigerian government with five partners – the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC), the United Nations Children’s Fund (UNICEF) and the Bill & Melinda Gates Foundation.
Billions of dollars have been invested through WHO and UNICEF with the support of donors and partners including the Dangote Foundation, European Union, Rotary, GAVI, JICA, the World Bank and the Governments of Canada, Germany, Japan, among others.
The financial support saw the training and mobilisation of local volunteers who helped the rural communities across Northern Nigeria where polio prevailed to accept the polio vaccines.
Support from the initiative enabled the west African country to procure enough vaccines, store them and conduct widespread immunisation programs even in remote areas.
2) UNICEF-trained community volunteer mobilisers
Over the past few years, hundreds of thousands of volunteers have repeatedly vaccinated roughly 50 million Nigerian children under the age of five.
However, it was the resilience of a network of nearly 20 000 UNICEF-trained community mobilisers, influencers and communication experts deployed across 14 northern ‘high risk’ Nigerian states that heralded the final push to end polio in the last three years.
Despite billions of foreign aid pumped into polio eradication, the major challenge has remained to bridge the barrier of suspicion and acceptance of immunisation programs, especially in rural Northern Nigeria.
Anything that has to do with western medicine and vaccination is often treated with suspicion in those parts. Advocacy, however, found success with these 20, 000 mediators.
They were able to penetrate because they were mostly from the communities. They served as the link between interventions and the people.
Their job is to go for door to door counselling of parents about the importance of the polio vaccine in order to ensure that no child falls victim to polio or any other preventable childhood disease.
3) Nigerian Soldiers
Without the Nigerian army, vaccination would not have reached several violence-prone communities.
In the three countries where Polio has remained active, the most afflicted regions are those where the government’s reach is weakest and the presence of Islamic militants is strongest.
Borno is the stronghold of Boko Haram and the last state to document polio in Nigeria. Several communities in the state are under the grip of the dreaded sect, making health workers unable to get the polio vaccine to children in those communities.
The decision of the Nigerian military to get involved in conducting polio vaccination in these locations was key.
They led health workers into trapped communities in the state for routine immunisation.
4) President Muhammadu Buhari
Asides insecurity and funding gaps, the deep suspicions in many corners over the safety of vaccines heightened in the last years of polio.
PREMIUM TIMES in 2017 reported how false vaccination rumours caused panic within the country.
The resulting fright forced schools to shut down in many parts of the country following a rumour that an unusual injection was being administered on school children.
Asides the UNICEF-trained community mobilisers, President Muhammadu Buhari also played an important role in dousing the tension which eventually aided the penetration of polio vaccines.
His decision to vaccinate his own grandchildren against the virus helped ease the mind of many Nigerians.
5) Traditional Rulers
Traditional rulers with the leadership of the Sultan of Sokoto acted as vaccine advocates by easing the work of the nearly 20, 000 volunteers working in the frontlines with communities.
“The collaboration with the traditional rulers in the north and the Sultan Foundation has helped UNICEF to engage more than 42,000 traditional leaders at the community level in Nigeria,” said UNICEF.
“This has helped the government and all key polio partners to push towards the last mile.”
They worked tirelessly to ensure polio teams reach every house in the communities, while also helping families to understand, trust, and accept the vaccine.
6) Health workers
Any success story of ending polio around the world would not be complete without the mention of health workers. This is no difference in Nigeria.
At the heart of polio eradication efforts stand health workers across the country who put themselves on the frontline daily to get vaccines to children.
Combining the vaccination with other health services, including check-ups and malaria treatment, was one of the most efficient strategies devised by health workers to make routine immunisation more acceptable to especially the 87 million extremely poor Nigerians.
7) Nigerian Governors
The governors of the 36 states of Nigeria, especially those from key polio-infected areas of the country, were very pivotal to ending the viral infection.
The governors had recognized that to urgently fill ongoing vaccination coverage gaps during polio immunisation campaigns requiring active leadership, engagement, and accountability by the political leadership from the states and districts (Local Government Areas – LGAs) is much needed. To this effect, they signed the ‘Abuja Commitments to Polio Eradication in Nigeria’ in 2009, publicly committing themselves to provide the necessary active leadership which will mobilise the state and LGA civil administrations to reach at least 90% of all children with the polio vaccine.
Successive governments followed up with where their predecessors left off even while contending with insurgency and other violent crimes stalling progress.
Kano State was arguably the epicentre of Nigeria’s poliovirus epidemic, accounting for over 80% of total cases in the country as of six years ago.
A major setback in Kano came in 2003 when then-Governor Ibrahim Shekarau – banned polio vaccines on the premise that local scientists had discovered that the vaccines could lead to infertility, particularly among girls.
Nigerian Health Watch reported how the Boko Haram insurgency did its own damage ten years ago when 11 polio vaccinators were shot dead in the line of duty in Kano metropolis by gunmen suspected to be members of the dreaded sect.
Notably, upon assumption of offices, the Governors of Kano and Sokoto, Nigeria’s very high-risk polio states, promised to surpass the gains recorded by their predecessors in a renewed commitment to stamp out the paralysing disease.
Abdullahi Umar Ganduje, the Kano State Governor, convened the state Task Force on Immunization meeting with all the 44 local government chairmen (LGA) and other top government functionaries.
The Sokoto State government, on the other hand, led the charge in releasing counterpart funds to assist with, among others, campaign operations and procurement of pluses to increase immunisation uptake and contact tracing.
Shortly after the last two cases were found in Borno State, the state government swiftly set up an outbreak response (OBR) on August, 2016 to detect and vaccinate children below five years of age in the two affected local government areas (LGAs) of Jere, Gwoza and three (3) surrounding LGAs of Mafa, Maiduguri Municipal Council (MMC) and Bama.
By the end of the first day, a total of 201, 290 children were vaccinated with 662 receiving their zero or first-time oral polio vaccine polio (OPV) dose, according to data from WHO.