Fight Against Polio Hits Stride in West Africa

KATSINA STATE, NIGERIA (HN April 7) - In the fight against polio in Nigeria, a variety of tools are being used to help get the country off the list of polio endemic countries.  The use of so-called traditional leaders to champion the call to parents to protect their children against the debilitating disease has proven among the most effective interventions.

Nigeria - the most populous nation on the African continent with more than 150-million people - is one of four polio endemic countries - along with Pakistan, Afghanistan and India.

By the end of 2009, the number of new cases detected in Nigeria was down from 782 in 2008,  to just 388.  Incredibly, there has been just one recorded case so far this year, earning the West African nation many plaudits for bringing it within striking distance of eradicating polio for good.

Globally the fight against polio has yielded impressive results. Polio cases have decreased by over 99% since 1988, from an estimated 350,000 cases then, to 1,997 reported cases in 2006. Currently, only four countries in the world remain polio-endemic, down from more than 125 in 1988. 

However frontline health workers are not being complacent.  Conditions still exist for spreading of the virus to uninfected children - and for exportation to neighbouring countries.  According to the World Health Organization as long as a single child remains infected, children in all countries are at risk of contracting polio.  Between 2003 and 2005, 25 previously polio-free countries were re-infected due to imports of the virus.

Indeed, Guinea recently recorded a handful of new polio cases. Since the end of 2008, the polio epidemic has been spreading from Nigeria to neighbouring countries in West and Central Africa and in 2009, there were 42 polio cases in Guinea, which had been polio-free from 2004 through 2008, according to the United Nations Children’s Fund (UNICEF).

In Nigeria - the only place in the world where all three serotypes are circulating: wild poliovirus type 1 (WPV1), wild poliovirus type 3 (WPV3), and a type 2 circulating vaccine-derived poliovirus (cVDPV2), the focus in the fight against polio is now on 11 high risk states - (especially 85 high risk, so-called Local Government Areas) - all of them located in the predominantly Muslim northern reaches of the country.

The integration of traditional leaders in the fight against polio has proven to be an effective tactic. In Katsina state, the current Emir of Daura has come out publicly to encourage people to make the state polio-free - instructing all his district heads to closely monitor immunization exercises.

In a country with pockets of low literacy rates, simply handing out pamphlets and posters can have little impact, health workers say.  Further complicating the situation is that few parents or caregivers have actually seen a child with polio. 

Says Naureen Nakvi, a UNICEF consultant who has worked on polio campaigns in Nigeria in her native Pakistan:  “If they really see the consequences of not immunizing the child, then they may really change their behavior.  Because there are now few cases in Nigeria, sustaining the community demand (for immunization) is a challenge. There is awareness - but we need to build an understanding among people that it could happen to your child.”

To eradicate polio in the region, a series of three-day campaigns, organized simultaneously in 19 countries is taking place now - including Nigeria and Guinea - aiming to vaccinate 85 million children. The next synchronized round will take place in late April, and in some areas will include the new bivalent oral polio vaccine which requires fewer rounds.

-- Michael Bociurkiw reporting