Polio Eradication: A Race against Time

As Nigeria joined the rest of the world to mark this year’s World Polio Day recently, experts believe only an intense and sustained campaign can truly earn Nigeria a polio-free status. Martins Ifijeh writes

The recent reported cases of wild polio virus in two children from Gwoza and Jere Local Government Areas of Borno State; an area in the North-east region once dominated by Boko Haram insurgents, has again brought experts, stakeholders and the government to the drawing board to find a sustainable approach to becoming polio free in few years to come.

This is as the country was already warming up to be certified polio free in 2017 by the World Health Organisation (WHO) if no new case was recorded from the last reported cases in August of 2014.

But as the anticipated celebration is cut short by the unfortunate report of polio cases, making Nigeria one of the three countries of the world still grappling with eradication of the disease, experts are of the opinion that only sustained and intense campaign by the government, citizens, health organisations and other stakeholders, can truly earn the country a polio free status.

The two other countries still recording wild polio virus is Afghanistan and Pakistan.

Speaking with THISDAY, a virologist, Dr. Ben Nkwoma, said the government should ensure that the target of reaching every child in the country, whether in the North or in the South where the disease is less common, adding that if all children under five years were truly immunised against the scourge, there remains a likelihood that Nigeria will achieve a polio free status at the earliest time possible.

He said to making this work, all hands must be on deck, including commitments from the citizens themselves, community leaders, religious heads, civil society organisations, health bodies, the media and other stakeholders in the country.

“We urge the government and other stakeholders involved in this new push against the disease to intensify it and continue to sustain the momentum, as only such approach consistently can help in reducing the scourge. We can’t say we have done enough when there is still one child somewhere who is not vaccinated,” he said.

He said health workers and the government must continue to tell Nigerians the benefits of bringing out their children and wards for immunisation, as according to him, only vaccination can truly establish a life long immunity against the disease. “In remote areas where apathy still persists, religious and community leaders should be convinced first of the benefits of accepting vaccination. When they are convinced, the likelihood that their followers or wards will subsequently follow suit is high. Advocacy must continue until every child is immunised in the country,” he said.

He explained that the inactivated polio vaccine needs to be given at two, four and between six and 18 months of age with a booster between ages four to six.

According to WHO, Polio is a highly infectious disease caused by a virus which invades the nervous system, and can cause total paralysis in a matter of hours. The virus is transmitted by person-to-person and spread mainly through the faecal-oral route or, less frequently, by a common vehicle (for example, contaminated water or food) and multiplies in the intestine.

The health body says the initial symptoms were fever, fatigue, headache, vomiting, stiffness of the neck and pain in the limbs, adding that one in every 200 infections lead to irreversible paralysis (usually in the legs), and among those paralysed, five per cent to 10 per cent die when their breathing muscles become immobilised.

“Like other typical viral infections, polio has no cure, but transmission can be interrupted through continued vaccination of children within the age bracket susceptible to the infection. The vaccines develop immunity in the children which helps to keep the infection at bay,” WHO says

Assuring Nigerians that the country will surmount the temporary setback, the Minister of Health, Professor Isaac Adewole, said the government has already spent over eight billion naira on immunisation of children against the polio virus, adding that the setback should be a wake up call for the country to put a stop to the spread of the virus.

“While this new outbreak is a setback for us, we must take it as a wakeup call for us as a government and people to ensure that we all play our part to stop the transmission of the virus in our shores. It is pertinent to state that the outbreak is not a failure of the polio eradication programme but mainly due to the fact that the activities of the insurgents in the North-east have resulted in limited access to children for immunisation and, indeed health services, for several years.”

He said since the declaration of the outbreak detected in Borno as Public Health Emergency for countries in the Lake Chad region, over 41 million children have been vaccinated across the five countries in the basin, of which over 1.6 million children were reached in Borno alone. He reinstated the ministry’s commitment to celebrate the 2017 World Polio Day as having one year without polio in the country.

He also commended the military for their continuos efforts in recovering territories from the insurgents which in the past had put a damper on the polio immunisation campaigns and other health services in the north eastern regions of the country. “Beyond enabling our health team access to the communities, the military is also assisting us in our response to this outbreak by providing protection for health workers, supporting movement of materials and personnel as well as providing vaccination services.”

The Chief of Health, United Nations Children’s Education Fund (UNICEF) in Nigeria, Mr. John Agbor made an appeal to the Federal Government to strengthen Primary Health Care (PHC) system in the country, noting that this has become important to enable the country solidify the little gains already made in its effort to put an end to the virus.

In the same vein, the Chairman of the Senate Committee on PHC, Senator Mao Ohuabunwa called on the executive to strengthen the routine immunisation of children under age five, as this would help eradicate polio and other preventable diseases in the country.

On his part, the Chief Executive Officer, Nigeria Centre of Disease Control (NCDC), Dr. Chikwe Ihekweazu restated the centre’s commitment towards improving response activities in controlling the scourge, especially in the North-east.

Ihekweazu, who spoke recently to mark the 2016 World Polio Day, reflected on the hard work that has gone into controlling the debilitating disease. “This time we are pushing further into those areas that have been previously inaccessible due to security challenges. We are determined to reach every child with the polio vaccine. We are also working with the National Primary Health Care Development Agency (NPHDA) to continuously improve response activities, and we are confident that ongoing effort would eventually eradicate the disease,” he added.

He said although Nigeria’s polio-free certification suffered a major setback in August 2016, due to new cases of wild polio virus reported in the North-east, the federal government immediate response curtailed the spread of the virus.

World Polio Day was established by Rotary International over a decade ago to commemorate the birth of Jonas Salk, the man who led the first team to develop a vaccine against poliomyelitis. The use of inactivated poliovirus vaccine and subsequent widespread use of the oral poliovirus, developed by Albert Sabin, led to the establishment of the Global Polio Eradication Initiative (GPEI) in 1988. Since that period, the world has witnessed a reduction in the number of wild polio virus cases from 350,000 in 1988 to 74 in 2015 and this has given impetus to setting the agenda for its eventual elimination.

Worldwide, record shows that polio cases have decreased significantly by over 99 per cent from an estimated 350,000 cases to 74 cases in 2015. The reduction is due to the global effort to eradicate the disease. Today, with the discovery of new cases in Nigeria, there now exists three polio endemic countries from as many as 125 in 1988.