SPECIAL REPORT: Nigeria Marks Polio-Free Year, Raising Global Eradication Hopes

Editor’s Note: On Friday, July 24, 2015, Nigeria marked an important milestone which made world headlines: Nigeria marked its first year without a single case of polio on Friday, reaching a milestone many experts had thought would elude it. NAIJAGRAPHITTI BLOG publishes this SPECIAL REPORT to make that milestone. There is the news report first then an interview granted The Nation newspaper in 2013 by Professor Oyewale Tomori, a world renowned virologist, who has contributed to the WHO and Nigeria’s polio fight.

Professor Oyewale Tomori, Nigeria’s chairman of the Expert Review Committee on Polio Eradication

Nigeria marked its first year without a single case of polio on Friday, reaching a milestone many experts had thought would elude it as internal conflict hampered the battle against the crippling disease.

It means the country could come off the list of countries where polio is endemic in a few weeks, once the World Health Organization (WHO) can confirm that the last few samples taken from people in previously affected areas are free of the virus.

This achievement turns up the pressure on Pakistan, where most of the few polio cases in the world remain, to follow suit.

Nigeria’s polio-free period, dating from July 24, 2014, is the longest it has gone without recording a case. The hope is that next month the entire African continent will have gone a full year without a polio infection, with the last case recorded in Somalia on Aug. 11, 2014.

All this brings tantalizingly closer the prospect that polio will soon become only the second human infectious disease after smallpox to be eradicated.

“It’s an extraordinary achievement. It really shows the value of government leadership and taking ownership of the program,” said Carol Pandak, the director of Rotary International’s polio program.

A disease that until the 1950s crippled thousands of people a year in rich and poor nations alike, the poliomyelitis virus attacks the nervous system and can cause irreversible paralysis within hours of infection.

It often spreads among young children and in areas with poor sanitation – a factor that gives it freedom in areas of conflict and unrest. But it can be halted with comprehensive, population-wide vaccination.

Nigeria had struggled to contain polio since some northern states imposed a year-long vaccine ban in mid-2003. Some state governors and religious leaders in the predominantly Islamic north alleged the vaccines were contaminated by Western powers to spread sterility and HIV/AIDS among Muslims.

Traditional leaders throughout the country pledged in January 2009 to support immunization campaigns and push parents to have their children vaccinated. But at about the same time Boko Haram militants began a bloody insurgency to carve out an Islamist state in the northeast.

DRIVING THE PROJECT

In 2012, Nigeria still seemed to be losing the battle against polio, recording more than half of all the world’s cases.

But Oyewale Tomori, Nigeria’s chairman of the Expert Review Committee on Polio Eradication says Abuja’s prioritization of the polio fight, including establishing emergency operations centers to coordinate vaccination campaigns and reach children in previously inaccessible areas, helped drive the project on.

Tactics such as engaging the traditional and religious leaders, and polio survivors in immunization campaigns and using thousands of voluntary workers to build trust, were also vital, as will be the continuation of high levels of vaccine coverage to keep the virus at bay.

“We’re well on the way,” Tomori told Reuters. “It’s a time of great happiness, but we don’t want to celebrate prematurely.”

Since the Global Polio Eradication Initiative was launched in 1988, there has been a more than 99 percent reduction in polio cases worldwide.

Back then the disease was endemic in 125 countries and caused paralysis in nearly 1,000 children a day. By contrast, so far in 2015, there were only 33 new cases worldwide – 28 of them in Pakistan, with the rest in Afghanistan.

Nigeria still has two more years before it, along with the whole of Africa, can be certified officially polio-free by WHO, but health experts say its achievement bodes well for wiping the disease out. Global health experts still hold out hope for an end to polio worldwide by 2018.

Pandak says it’s now Islamabad’s turn to feel the huge international pressure Abuja came under to commit itself to finding every last polio case and vaccinating every last child.

“When you’re the last country in a region to still have polio, there’s a lot of pressure from the global community and from your neighbors,” she said.

“Everybody spurs you on, polio gets talked about at the highest levels of government, and that pressure is something Pakistan is acutely politically aware of.”

While Pakistan has more polio cases than anywhere else this year – neighboring Afghanistan has recorded five – it is doing better, with 70 percent fewer cases this year than last.

FOR THE RECORDS: ‘Nigerian Scientists Have Failed Woefully’ – Tomori

Professor Tomori

Interview By Ibrahim Apekhade Yusuf, The Nation; Published May 05, 2013

Professor Oyewale Tomori, a renowned virologist, has earned many plaudits both nationally and internationally for his contribution to the field of virology. Tomori, who is a former Vice-Chancellor, Redeemer’s University and current president, Nigerian Academy of Science, a foremost science institute in the country, has been leading the campaign against polio eradication for decades. In this interview with Ibrahim Apekhade Yusuf, he shares his concerns on the polity. Excerpts:

You have been in the forefront in the campaign against polio eradication these past decades. How far are we close to winning this war?

Nigeria’s eradication campaign faces substantial challenges. However, we can say that we have made remarkable progress. This year, we expect nearly 50percent drop in cases in 2013 compared to last year.

But thankfully, the Eradication and Endgame Strategic Plan was shared at the Global Vaccine Summit in Abu Dhabi, where world leaders showed their support through a series of historic commitments, including the UK’s Department for International Development commitment of £300 million. The Gates Foundation pledged US$1.8 billion, and a new group of philanthropists committed an additional total US$335 million.

His Highness, General Sheikh Mohamed bin Zayed Al Nahyan, Crown Prince of Abu Dhabi and Deputy Supreme Commander of the UAE Armed Forces, pledged US$120 million

Qatar Charity and the Gates Foundation signed a co-operation agreement in support of the eradication effort.

The Global Vaccine Summit in Abu Dhabi which held from April 24-25 2013, was hosted by the Crown Prince of Abu Dhabi, Bill Gates and the UN General-Secretary. The Summit endorsed the critical role that vaccines and immunisation play in saving lives and protecting children from preventable diseases such as polio. The Summit is expected to continue the momentum of the Decade of Vaccines – a vision and commitment to reach all people with the vaccines they need.

The new commitments make clear the confidence of global leaders and the vaccine community in the new plan’s ability to both achieve a lasting polio-free world by 2018 and help build systems that will deliver critical health services, including vaccines and maternal healthcare, to those most in need. The commitments bring the world almost three-quarters of the way to the US$5.5 billion needed to fully fund the plan.

As at the last count, a total of US$3billion has so far being raised leaving a shortfall of US$2.5billion.

The endorsement of the Global Vaccine Action Plan by the World Health Assembly which again set 2018 as the new target for the global eradication of polio saying Nigeria must ensure that no single case of polio is reported anywhere in the country by 2014.

The hope is that by the year 2014, the world will have the last country with the last case of polio and by 2018, the world will be declared free of polio.

Is 2014 realistic as far as Nigeria is concerned?

Presently, northern region specifically constitutes major concern for global polio fighters, who now worry over the quality of local personnel and efforts. At least, 12 percent of the Northern children population is said to be left out of polio vaccination due to numerous issues, including itinerancy, security challenge and other socio-political concerns.

But to answer your question, I think we are taking a gamble because the year 2014 is only subject to the fact that Nigeria, Afghanistan or Pakistan (the only three remaining endemic countries) will not have any case of polio in 2014. If we do have any of these countries having one case by 2014 it means we have to shift the year of eradication by an extra year. It is thus very important that we, as a country, must play our role, otherwise, we will be holding the world back.

But the question to ask again is, why should we be the last? Why can’t the Federal Government and other tiers of government for instance, accord polio eradication the kind of priority given the spate of flood disasters in some parts of the country where President Goodluck Jonathan personally garnered support from individuals and corporate bodies?

Has our President ever said anything on polio without stimulation from outside? The only time we’ve heard him make pronouncements are when he was invited by the Commonwealth, the United Nations or when Bill Gate came. We are not putting enough into polio eradication.

We need education. We need to get our people to know the advantage of immunization; we need good leadership and community involvement. Nobody should be left out of the fight.

Imagine Bill Gates the other day was bearing a list of state governments in Nigeria doing little or nothing to curtail the malaria epidemic. It is a shame. After all, we don’t need outsiders to tell us how many children to give birth to so why do we have to wait on them to take care of these same children for us? It doesn’t speak well of us at all.

Do you think the recent killing of vaccinators in northern part of the country can adversely affect the campaign against polio eradication?

The killings drew comparisons with a series of incidents in Pakistan last December where five female polio vaccinators were gunned down, apparently by Islamist militants. It also signalled a fresh wave of hostility towards immunization drives in the country, where some clerics have claimed the vaccines are part of a western plot to sterilize young girls and eliminate the Muslim population.

So to answer your question directly, the sad episode is certainly a setback for polio eradication in Nigeria, but not a stop. The best we can do is to work harder and see the end of polio … so their loss will not end as a useless sacrifice.

But like I have always advised, the war against polio should not be fought in isolation. We all must be involved.

There are lots of misconceptions and stereotypes about what the north wants and do not want. There is need for understanding. For instance, how do you expect a family which has just lost a loved one to the cold hands of death say through measles, happily come out to partake in vaccination? These are some of the issues. Unless we understand these peculiarities, we will continue to go round and round the circles.

If you go back in time, you will recall that the polio vaccine boycott which started in Kano in 2003 was as a result of the now infamous Pfizer’s Trovan clinical trial scandal in 1996. But what we are yet to find out is who gave approval for the clinical trials? Certainly, approval didn’t come from outer-space, someone, somewhere gave the approval. But there has been a lot of blame game here and there.

Is Nigeria still one of the countries in the yellow fever belt?

Of course, Nigeria is one of the 17 endemic countries in the belt. Unfortunately, while every other country in the yellow fever belt had immunized their citizens against the disease, Nigeria remains the only country yet to embark on mass vaccination against the disease.

But thankfully, the government currently had 66 million doses of the yellow fever vaccine and hopefully, should commence immunization soon in some endemic parts of the country adding that the quantity could not cover the entire country.

But we still don’t have enough yellow fever vaccine. There’s a plan to gradually go round the country and there’s hope that by the time we go round the country, the producer would have produced more. There’s not enough but the little that will be available, people should go for it.

Why can’t Nigeria produce enough vaccine to serve the teeming populace?

I agree it’s a big shame that Nigeria relies on other countries in the world for its vaccine needs. As I’m talking to you now, I know for a fact that we can’t manufacture reagents. But this wasn’t the case in the 80’s. There’s no reason why Nigeria should be depending on other countries for its vaccine. We had a vaccine manufacturing firm in Yaba, Lagos in 1994 which has gone under. We need to resuscitate it. Is it not lamentable that a country like Senegal is also one of the countries producing vaccine for us?

But again, a number of factors might be responsible for this. Brain-drain is a major factor. Most of our doctors and scientists, especially my generation, took flight out of the country when government policy practically reduced us into paupers. There was a situation in this country where professors could no longer live decent lives. What do you make of a situation where as a professor you could not have a roof over your head talkless of being able to eat three square meals a day. It was that bad.

So, like they say the first law of nature is the law of self-preservation. We had to leave in order to maintain our sanity. But then, those we left behind never had the benefit of good mentorship and that is why there is too much dependence on foreign vaccines because you are not so sure of the quality produced locally.

Is this not an indictment on our local expertise?

Yes, we all share in the blame one way or the other. In those days, we didn’t have improved techniques but we were able to detect any variant of yellow fever and thus were able to administer the right vaccines. But these days we rely too much on advanced techniques which come with a lot of baggage.

See what China has done, despite the advancement in science, China for instance, has not done away with its roots.

Take their traditional medicine, the acupuncture, it has become widely acclaimed. Right now, there is an acupuncture centre in New York. It is good to go back to the roots… China as a country keeps what makes them Chinese.

Let me also make this point that our scientists have not done creditably well over the years.

If you look at scientific journals all over the world, what make the news are the scientific discoveries, but what have Nigerian scientists done so far?

In my acceptance speech at the Academy, I made the point that as professionals we must make our impact felt in the society. Let’s see how we can make a change. My hope is that in the next four years, Nigerian scientists will become more relevant in the scheme of things because presently we have failed the country.

It doesn’t require a thousand people to change the world, it takes just a few people.
Little drops of water make an ocean but I always say that you must gather the drops in one place to be able to make the ocean because if the little is scattered, you can’t achieve the utmost aim. Let’s see where each of us has a common purpose and plug our force into that.