Today, Friday 24th July, marks one year without a detected case of wild poliovirus in Nigeria, one of the last remaining polio endemic countries alongside Pakistan and Afghanistan. This represents huge strides for the fight against polio in Nigeria, which reported 122 cases as recently as 2012.
But this is by no means the end of the story. For the African region to be officially declared polio-free, Nigeria must go three years without a case. Here we explore five ways they have made progress against the disease, which must now be sustained to see polio eliminated for good.
Maintaining the cold chain in Nigeria. Photo: Gavi/Adrian Brooks
Nigeria’s immunisation infrastructure has been hailed as a pillar of success. The improved infrastructure as part of the polio programme has also benefitted routine immunisation, facilitated the roll out of new vaccines and supported programmes to improve maternal, newborn and child health. For example, the purchase and installation of more than 1,600 solar powered fridges for the country’s cold chain supply will help keep the vaccines at the right temperature for effective use. Introduced in February of this year, inactivated polio vaccine (IPV) will play a crucial role in keeping Nigeria polio free as part of the routine immunisation programme.
2. Building community trust
Community discussion and engagement have been key to success. Photo: Gavi/Adrian Brooks.
In 2003, immunisation programmes in Northern Nigeria suffered greatly after political and religious leaders in the states of Kaduna, Kano and Zamfara advised parents not to immunise their children. They inaccurately claimed that vaccines contained ingredients that would cause sterility; as a result immunisation campaigns ground to a halt. To combat this, the Nigerian government worked with respected religious, traditional and community leaders to improve the reputation of vaccines. Dispelling myths about vaccines, especially in northern states, remains a priority.
3. Technology strong enough to fight Ebola
An example of GPS technology used to fight polio in Nigeria. Photo: Gates Notes.
To ensure that every child was reached with the polio vaccine, cutting-edge technologies including GPS satellite tracking technology, were developed with guidance from WHO polio programmes. By enabling real-time contact tracing and daily mapping of identified chains of transmission, this same technology has also been used to help track the chains of Ebola transmission. As a result, the outbreak was swiftly contained, and Nigeria’s Ebola-fatality rate was much lower than elsewhere.
4. Facing the challenges of conflict
Inactivated polio vaccine being administered in Kano state. Photo: UNICEF/Melissa Corkum.
In 2013 immunisation programmes were suspended in Borno and Kano States following violence against vaccinators, making close to eight million children inaccessible for immunisation. In June 2013, vaccinators resorted to “hit and run” tactics which involved working with community leaders close to the lines of conflict to gain quick access to insecure areas to reach as many children as possible. Challenges remain, particularly in the north eastern region, but the success of Nigeria in vaccinating children in Boko Haram controlled areas offers hope that security issues in Afghanistan and Pakistan can also be overcome.
5. National support
Routine immunisation in Nigeria. Photo: Gavi/Adrian Brooks.
Nigeria must continue its commitment to ensuring the delivery of vaccines to all children, including continued vigilance on the part of surveillance and collaboration between government, partners, community leaders and health workers across Nigeria. The Nigerian government has demonstrated its commitment to this end; domestic funding for polio for 2015 is US$ 80 million.
With continuing challenges of corruption, poverty and instability, it’s clear that there is still a long way to go, and routine immunisation and a strengthened health system must remain priorities. Nevertheless, this anniversary represents progress and hope for improved healthcare in Nigeria and for the elimination of polio world-wide.
The disease that once paralyzed hundreds of thousands of kids a year around the globe is now down to just a few dozen cases this year. “We are aiming to halt all transmission of wild polio virus next year,” says Peter Crowley, the head of UNICEF’s global efforts against polio.
If polio is stopped, it will be only the second human disease to be eliminated. Smallpox was the first — the last case was in 1977.
There’s reason to be optimistic that this gigantic feat of public health is within humanity’s grasp. The World Health Organization says polio transmission has stopped for the first time ever in Africa. Last month, Africa’s last bastion of polio — Nigeria — celebrated going an entire year without recording any new cases.
Though often used as a synonym of “isolation” (where sick people are kept from well people), quarantine is technically defined as “to separate those suspected of exposure to an illness to see if they become ill” - hence the quarantine laws for livestock and pets when moving between countries, especially countries where rabies or hoof-and-mouth disease isn’t endemic.
These signs were posted on houses and farms that had a patient (and, as such, exposed family or herd members) infected with, from top to bottom, hoof-and-mouth disease, scarlet fever, diphtheria, smallpox, and poliomyelitis.
Take a moment to ponder this GIF from the Council on Foreign Relations. Every dot represents an outbreak of preventable disease–and preventable suffering. This is why immunizations are so important for children and for their communities. #Vaccineswork.
By 1988, polio had disappeared from the US, UK, Australia and much of Europe but remained prevalent in more than 125 countries. The same year, the World Health Assembly adopted a resolution to eradicate the disease completely by the year 2000.
In 2015, polio remains endemic in only two countries - Pakistan and Afghanistan. No new cases have been reported in Africa for the past year.
On this day in 1921, Dr. Robert Lovett diagnosed 39-year-old Franklin Roosevelt with infantile paralysis, more commonly known as polio. The diagnosis came a few weeks after a fall into icy waters that left him unable to feel parts of his body and hold his own weight.
Although there was no cure for polio at the time, FDR participated in rehabilitation classes and swimming exercises to regain his strength before re-entering politics.
Photo: President Roosevelt in his wheelchair on the porch at Top Cottage in Hyde Park, NY with his dog, Fala, and Ruthie Bie, granddaughter of the cottage’s caretaker. February 1941. Wikimedia Commons.