By Lexi Elo
July 2014 was an auspicious month for Nigeria as two health related occurrences took place in that month. On Sunday July 20 2014, Patrick Sawyer, the Liberian-American flew into Lagos airport, a sick man with Ebola Virus Disease. Five days after, he died but not before infecting other people – his primary contacts -health workers who took care of him and who subsequently infected other people.
By the time Nigeria was finally declared free of the disease in October 20, 20 people had been infected with eight of them dying from the disease, and spent three months tracing nearly 900 contacts.
The second health issue occurred far away from Lagos. On July 24, 2014, a day before Patrick Sawyer died, a one year old child in Sumaila LGA of Kano State had an onset of a disease later confirmed to be polio.
This has been the last polio case confirmed in Nigeria for the past one year. Never has Nigeria gone on for so many months (12 months) without reporting at least one case of polio. The last time we went free of polio was for only 3 months between May and July 2014.
Prof. Oyewale Tomori, President, Nigerian Academy of Science and Chairman Expert Review Committee on Polio Eradication and Routine Immunisation noted that delisting from polio endemic countries is only a step towards Nigeria being declared a polio free nation.
Prof. Tomori stated that this will only happen if no polio case is reported in Nigeria for another two years,- after July 2017.
“So let us not bring out the drums and the palm wine tumblers in premature celebrations. If we get our acts together and maintain zero polio case until the end of July 2015, the Nigeria will be removed from the list of polio endemic countries, that is, countries that have never interrupted polio transmission. Do not expect WHO to remove out country from the ignoble list of polio endemic countries, until another late August or early September 2015, by which time all of the samples collected on or before 24 July this year, would have been tested and found negative for polio,” Prof Tomori ensued.
During the five-year period between 2005 and 2009, the total number of reported polio cases in Africa was 4,039 and Nigeria alone accounted for 3,729 (92 percent) of the African cases.
“This number is far above our contribution to Africa’s population- I think we boast that there is a Nigerian for every five Africans; this time Nigeria was contributing more than nine out of every 10 polio cases in Africa. In addition to the sub-optimal performance of the national immunisation programme and the poor routine immunisation coverage, the main stimulus for our poor performance was the call in 2003, for the boycott of anti-polio vaccination in northern states because of suspected contamination of the polio vaccine with anti-fertility steroids,” Prof. Tomori asked.
Medical experts believe that the resulting boycott brought a wobbling national polio eradication programme to a total collapse as the average annual number of reported polio cases increased from 400 (between 1998 and 2002) to 750 cases after the call.
Frantic national and international efforts were made to end the boycott. This included the adoption of a resolution in 2008 at the 61st WHA, calling on Nigeria to reduce the risk of international spread of poliovirus by ensuring that all children in the north of the country are vaccinated against polio.
For Prof. Tomori, “Unless we get sustained and real commitment for polio eradication and routine immunization at all levels of government, there is no guaranteed that we can keep polio out of Nigeria in the next 2 years to attain the polio free status. Stopping polio is a massive operation that requires meticulous coordination from top to bottom to succeed. Our progress against polio over the last few years has been a combination of this grand coordination and small-scale detail. Achieving polio free status in 2017 and maintaining the status require more massive efforts.”
The professor continued “We still have some distance to go to polio frees status. How far depends on what we do from now on. We must continue to stress that the end of polio is only in sight, and at the end of a two year tunnel. Twice in 2007 and 2011 when we shifted our focus from polio eradication to eradication our political opponents during electioneering campaigns, polio resurged. Insecurity in the northeast part of the country has left many settlements in the area inaccessible to health workers. A recent case of circulating vaccine-derived poliovirus (cVDPV) – a very rare form of the virus mutated from the vaccine that emerges in under-immunised populations – shows that polio vaccination rates in Nigeria are still not high enough.
“We must build on the achievement of the past government, so that Nigerian can be declared polio free during the watch of the current government. The Buhari-government must sustain political commitment to eradicating not only polio, but also controlling other infectious diseases that still plague our country- Lassa fever, yellow fever, Avian flu and many other yet unknown diseases.“
By the time Nigeria was finally declared free of the disease in October 20, 20 people had been infected with eight of them dying from the disease, and spent three months tracing nearly 900 contacts.
The second health issue occurred far away from Lagos. On July 24, 2014, a day before Patrick Sawyer died, a one year old child in Sumaila LGA of Kano State had an onset of a disease later confirmed to be polio.
This has been the last polio case confirmed in Nigeria for the past one year. Never has Nigeria gone on for so many months (12 months) without reporting at least one case of polio. The last time we went free of polio was for only 3 months between May and July 2014.
Prof. Oyewale Tomori, President, Nigerian Academy of Science and Chairman Expert Review Committee on Polio Eradication and Routine Immunisation noted that delisting from polio endemic countries is only a step towards Nigeria being declared a polio free nation.
Prof. Tomori stated that this will only happen if no polio case is reported in Nigeria for another two years,- after July 2017.
“So let us not bring out the drums and the palm wine tumblers in premature celebrations. If we get our acts together and maintain zero polio case until the end of July 2015, the Nigeria will be removed from the list of polio endemic countries, that is, countries that have never interrupted polio transmission. Do not expect WHO to remove out country from the ignoble list of polio endemic countries, until another late August or early September 2015, by which time all of the samples collected on or before 24 July this year, would have been tested and found negative for polio,” Prof Tomori ensued.
During the five-year period between 2005 and 2009, the total number of reported polio cases in Africa was 4,039 and Nigeria alone accounted for 3,729 (92 percent) of the African cases.
“This number is far above our contribution to Africa’s population- I think we boast that there is a Nigerian for every five Africans; this time Nigeria was contributing more than nine out of every 10 polio cases in Africa. In addition to the sub-optimal performance of the national immunisation programme and the poor routine immunisation coverage, the main stimulus for our poor performance was the call in 2003, for the boycott of anti-polio vaccination in northern states because of suspected contamination of the polio vaccine with anti-fertility steroids,” Prof. Tomori asked.
Medical experts believe that the resulting boycott brought a wobbling national polio eradication programme to a total collapse as the average annual number of reported polio cases increased from 400 (between 1998 and 2002) to 750 cases after the call.
Frantic national and international efforts were made to end the boycott. This included the adoption of a resolution in 2008 at the 61st WHA, calling on Nigeria to reduce the risk of international spread of poliovirus by ensuring that all children in the north of the country are vaccinated against polio.
For Prof. Tomori, “Unless we get sustained and real commitment for polio eradication and routine immunization at all levels of government, there is no guaranteed that we can keep polio out of Nigeria in the next 2 years to attain the polio free status. Stopping polio is a massive operation that requires meticulous coordination from top to bottom to succeed. Our progress against polio over the last few years has been a combination of this grand coordination and small-scale detail. Achieving polio free status in 2017 and maintaining the status require more massive efforts.”
The professor continued “We still have some distance to go to polio frees status. How far depends on what we do from now on. We must continue to stress that the end of polio is only in sight, and at the end of a two year tunnel. Twice in 2007 and 2011 when we shifted our focus from polio eradication to eradication our political opponents during electioneering campaigns, polio resurged. Insecurity in the northeast part of the country has left many settlements in the area inaccessible to health workers. A recent case of circulating vaccine-derived poliovirus (cVDPV) – a very rare form of the virus mutated from the vaccine that emerges in under-immunised populations – shows that polio vaccination rates in Nigeria are still not high enough.
“We must build on the achievement of the past government, so that Nigerian can be declared polio free during the watch of the current government. The Buhari-government must sustain political commitment to eradicating not only polio, but also controlling other infectious diseases that still plague our country- Lassa fever, yellow fever, Avian flu and many other yet unknown diseases.“