Fred Ezeh, Abuja
On Tuesday, August 24, 2020, the World Health Organization (WHO), issued a polio-free country certificate to Nigeria. The action implied that Nigeria, and by extension, Africa, is free of wild poliovirus, after three years of no case recorded across the country.
The certificate of polio-free status presented by the WHO team to President Muhammadu Buhari marked the successful defeat of the disease in Nigeria and Africa, even though some stakeholders said it is not yet Uhuru.
Records show that since 1996, polio eradication efforts in Nigeria have prevented about 1.8 million children from the crippling life-long paralysis, and equally saved approximately 180,000 lives.
Medical books referred to poliomyelitis, otherwise known as polio, as a viral disease that has the capacity to cause life-long paralysis among children.
Polio, though, a vaccine-preventable disease could be transmitted through contaminated water, food or close contact with an infected person. If not treated quickly and properly, could lead to permanent damage to the legs or arms of an infected person, and has devastating effect on breathing muscles, and could lead to untimely death.
Poliovirus usually enters the environment through the faeces of someone who is infected and spreads freely in areas with poor sanitation. It also spreads from faeces into the water supply by touch or into food.
Genesis of polio fight in Nigeria
Data from the Federal Ministry of Health indicated that the war against polio began over four decades ago (40 years ago), with recorded ups and downs faced in the cause of the fight.
Nevertheless, with consistency and involvement of all relevant stakeholders, particularly traditional, community and religious leaders who helped amplified the message of vaccination against the disease and treatment of those already down with the disease, gradual and impressive progress were recorded over the years till the final declaration of Nigeria, a polio-free country.
As at 10 years ago, Nigeria was said to have accounted for half of the cases of poliovirus in the world. The implication was that its future generations were, then, in danger of poor health that could lead to limited global impact and socioeconomic contributions to national Gross Domestic Product (GDP), and make them irrelevant in global socioeconomic discussions.
For decades, Nigeria and its global donors have committed huge financial and manpower resources to the fight against poliovirus. But it seems as if each time victory was near, new case(s) would be recorded, as was the case in 2016 when two children got paralyzed in Borno State as a result of polio.
For instance, Rotary International, through the “End Polio Now” campaign, said they had contributed not less than $298 million in the past 15 years to the fight against polio in Nigeria, while globally, they have spent over $2.2 billion in the fight with significant success achieved.
Major setbacks in the fight
While the fight was on, setbacks came from time to time, which significantly contributed to the delay in the victory against the virus. But for the unexpected two cases recorded in Borno State in August 2016, Nigeria would have long had the opportunity to host Africa and the World to an elaborate event to mark the declaration of the country polio-free years ago.
Immediately the cases were confirmed, stakeholders responded swiftly to prevent further infection among the children, particularly those within the location where the cases were recorded. They were said to have adopted measures including large-scale immunization campaigns, strengthened surveillance systems to enable field officers contain the spread of the virus. Similarly, measures were taken in neighbouring African countries to avoid trans-border transmission.
WHO Regional Director for Africa, Dr Matshidiso Moeti, expressed sadness over the two cases: “Nigeria has made significant strides to stop this paralyzing disease in recent years but this case was a set back. Nevertheless, the overriding priority now is to rapidly immunize all children around the affected area and ensure that no one succumb to this terrible disease.”
In addition, WHO headquarters in Geneva, Switzerland, was confident that with such swift response and collaboration with the Nigerian Government, polio can be defeated in Nigeria, Africa and across the world.
Rejection of immunisation was another major setback to the fight against polio. Some years ago, some Nigerians, due to misinformation by some “uninformed” people that had access to the media, allegedly backed by religious and community leaders that command loyalty and support in the community, kicked against polio vaccination in early 2000s, which affected the programmes and further prolonged the victory against polio.
Chairman, Nigeria National Polioplus, a programme of Rotary International, Dr Tunji Funsho, recalled: “In 2001, there was misleading information in the media about the safety of the oral polio vaccine. Some northern political leaders jump to the untrue information and mobilised their people to the boycott of polio immunisation exercise particularly in seven states in the north between 2003 and 2004.
“Impressively, Federal Government took the matter seriously and followed it up with steps and assurances to the people that the oral polio vaccine was safe for use. Some respected political, academics, religious and community leaders in the affected northern states were deeply engaged and made to understand the safety guides in vaccine production, distribution and preservation, to further convince them that the vaccines are safe and not harmful as they were made to believe.
“Some of them were taken to several locations within and outside the country for proper education, enlightenment and necessary exposure to the truth behind the scene. Some were taken to countries that are partly Islamic countries, notably, Malaysia, Indonesia and several other places where they were exposed to the nitty-gritty of vaccine production and its efficacy thereof.
“Unfortunately, the disruption in vaccination programmes during the period led to significant rise in cases, from 200 cases annually to about 1,200 cases. That was a major setback for us in the fight. But shortly after that, we began to enjoyed massive support from local and international partners, and that led to the success we had recently.
“Insurgency was another challenge we had. It prevented our field officers from penetrating certain communities in Borno State, thus making it difficult to immunize the children. When some of the communities were liberated, we found four new cases among the children in the liberated communities by late 2016.”
Funsho observed that lack of confidence and trust in the system was also responsible for the unimpressive response to the option of vaccine, and that was why the people resisted the vaccine at the time: “Vaccines were free and always available for the people. We even had to literally beg and knock at their doors always for them to take the vaccines, which is free.
“The people had also wondered why it was difficult for them to get chloroquine or any other anti-malaria drugs at nearby health care centres whenever they suffer malaria or other ailments, but are being begged to take vaccine against polio.
“Regularly, when our field officers visit communities for immunisation purposes, they organize head counts, comprising health care workers to ascertain the availability of manpower in the facilities. We use that opportunity to administer vaccines to children of under the age of five that came with their mothers.”
He predicted that the earliest the world would be declared polio-free by WHO is 2024 because of the cases that are still being recorded and treated in Pakistan and Afghanistan.
Journey to final freedom
On June 18, 2020, WHO concluded the verification of documents presented by the Federal Government requesting that Nigeria be declared a polio-free country. The process of certification, which commenced few months ago culminated in the complete documentation by the officials of the National Primary Healthcare Development Agency (NPHCDA), and was accepted by the WHO team.
WHO Nigeria Country office, had in series of tweets on that day confirmed that Nigeria’s complete documentation for wild polio virus free status was accepted by the Africa Regional Certification Commission for polio eradication (ARCC).
On Tuesday, August 24, Nigeria was presented with a certificate of polio-free country, thus marking the successful defeat of polio in Nigeria.
Sacrifices made in cause of the fight
In every fight, casualties are always recorded in different ways. In 2013, six health workers engaged in immunisation were killed in Kano by some angry mob when a radio station announced that oral polio vaccine being administered was for birth control and dangerous to human health.
Also, several field officers deployed by UNICEF, Rotary International, NPHCDA and other intervention agencies have suffered one form of injury, physical or verbal assault or the other in the cause of search for children with polio for treatment and immunization.