From an estimated 350,000 cases in more than 125 countries in 1988, incidences of wild poliovirus cases decreased by over 99 per cent to 33 reported cases in 2018. With ongoing concerted efforts, Nigeria stands a good chance of being among African countries that may be cleared to have taken an exit from the problem by September when certification would be granted to countries where there is no incidence of polio recorded in three straight years. The Bill and Melinda Gates Foundation (BMGF), which has spent about $1.6 billion in the past years in this regard, has proven to be a strong ally of Nigeria in the campaign to rid the country of polio.
“Once polio is eradicated, the world can celebrate the delivery of a major global public good that will benefit all people equally, no matter where they live. Economic modeling has found that the eradication of polio would save at least $ 40-50 billion, mostly in low-income countries. Most importantly, success will mean that no child will ever again suffer the terrible effects of lifelong polio-paralysis,” the World Health Organisation (WHO) said.
Speaking with The Nation, a team of BMGF officials comprising its chief strategy officer and president, Global Policy and Advocacy, Mr. Mark Suzman, BMGF’s country director for Nigeria, Dr. Paulin Basinga, and Mr. Rodger Voorhies, who is president of the foundation’s Global Growth and Opportunity Division, emphasised a sustained commitment to help Nigeria through some of its developmental challenges, with the battle against polio as a priority. “Yes, we are optimistic. We do believe it is absolutely possible, but we have to continue with political attention and good resourcing right now and we hope that by early 2020, we will all be here for a celebration, not just in Nigeria but for the entire continent of Africa being polio-free. It would be an amazing and true victory for all of us,” Mark Suzman stated.
According to the Global Polio Eradication Initiative, Nigeria is one of only three countries in the world endemic to wild poliovirus, alongside Afghanistan and Pakistan. The country is also affected by circulating vaccine-derived poliovirus type· 2 (cVDPV 2) outbreaks. As explained by WHO, polio is a highly infectious disease caused by a virus that invades the nervous system and causes total paralysis in a matter of hours. The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common·vehicle (for example, contaminated water or food) and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness of the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralysed, five per cent to 10 per cent die when their breathing muscles become immobilised. Those mostly at risk with polio are mostly children under five years of age.
No cure exists for polio, but it can only be prevented and polio vaccine, given multiple times, can protect a child for life. “It is our highest priority in Nigeria right now simply because it is achievable in the next six months, but that is only if we continue with good attention and resources. And if we get that, we will be laying a platform for much stronger primary health care across the country,” Voorhies stated while expressing hopes for a major celebration of Nigeria’s coming polio-free certification by September this year.
With the spirited support of the Bill & Melinda Gates Foundation, the Global Polio Eradication Initiative (GPEI) was launched, with the active involvement of national governments, WHO, Rotary International, the US Center for Disease Control and Prevention (CDC) and UNICEF.
According to WHO, since the GPEI was launched, the number· of cases has fallen by over 99 per cent. More than 16 million people are able to walk·today, who would otherwise have been paralysed. An estimated 1.5million childhood deaths have been prevented through the systematic administration· of vitamin A during polio immunisation activities. In 2016, three cases of wild polio virus type 1 (WPV 1) were discovered in three local government areas of Borno State, but the WHO and GPEI only certify a nation as being polio-free when standard surveillance indicates that wild polio virus is completely absent for at least three consecutive years in all states.
Both Basinga and Suzman emphasised the need for government and all stakeholders to keep up the pace for maximum vaccination as the nation approaches the goal of being polio-free. The BMGF officials also stressed that ongoing developmental efforts towards boosting agriculture, financial inclusion, women’s empowerment and other aspects of human capital development as captured by Nigeria’s Economic Recovery and Growth Programme (ERGP) remain vital aspects of their foundation’s ongoing work in Nigeria. While they all advocated increased budgetary allocation by federal and state governments to health challenges like polio, Suzman, a former journalist, explained that the foundation’s concern about flagging efforts in 16 states is now being addressed by Federal Government officials and members of the Nigeria Governors’ Forum with whom BMGF officials interacted few days ago.
“To be honest, the federal budget allocation is much smaller than we think it should be and historically, it’s been a very significant drop from previous years’. There’s active discussion on the way; we’ve asked the ministry whether the government can use some other funds. If you look at that as a signal of seriousness, if how you allocate your budget is a signal of your seriousness; I think that will get one worried.
“But we understand that the review is part of the result of success; because we’ve been successful and because you do not see polio case in three years, government may want to move on very quickly to the next challenge and we understand that temptation. We just met members of the Nigeria Governors’ Forum about the need to put this issue on their agenda; it requires the government checking the success of the (polio) campaign, down to the local government level and do necessary follow-up. This is critical in the six months period (before certification in September).
“We know there is still some challenge particularly in Borno, some small pockets that we haven’t been able to fully reach and that is an ongoing challenge but there has been some very significant progress in the last two or three years. We give significant credits to the governments of Borno, and the Federal Government for the efforts in Yobe; they have made significant progress and that is part of reasons why we’ve made progress. We do feel relatively confident that we have enough penetration and threshold that we will be able to reach that polio eradication target for certification by September but you just cannot just drop the ball at this critical phase,” Suzman said.
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