24 October 2008
editorial
Lagos — Recent reports indicate that there is an increase in the number of polio cases recorded in Nigeria this year. By the statistics of the Monthly Situation reports of the Global Polio Eradication Initiative, a total of 692 cases had been reported at the end of September 2008. Of this figure, 638 cases are type one, 53 are type-three, and one type-one/type-three co-infection. According to World Health Organization (WHO), the resurgence of polio has paralysed more than 600 Nigerian children so far. The figures of new cases and casualties keep rising on a daily basis.
Comparatively, 207 new cases were reportedly recorded in 21 states of the Federation in 2007 and 555 new cases by July 2008. What this translates to is that between August and September, this year, the number of new cases rose from 555 to 692, according to the Monthly Situation report. Polio, also known as poliomyelitis is said to be one of the most debilitating and contagious diseases in the world.
In 1988, at the height of the polio epidemic, WHO report maintains that a total of 355, 000 cases of polio in 125 countries were reported and by the end of 2004, it had drastically reduced to 1, 255 cases, with majority of the victims in Nigeria. However, with widespread vaccination, the number of Wild Polio Virus (WPV) cases or polio occurring through natural infection, had declined from 1,125 cases in 2006 to 279 in 2007, representing 75 per cent, while endemic transmission still prevalence in the North, according to WHO.
In 2008, the world body says Nigeria accounts for 91 per cent of polio cases in Africa, 87 per cent of global Wild Polio Virus (WPV) type-one cases and 10 per cent of WPV of type-three cases. Currently, Nigeria is ranked No.1 amongst countries yet to get the disease eradicated. Evidently, the significant strides, which had been made over the years, have been lost due to government's ineptitude towards the plight of children as well as lack of concern on the part of the parents and guardians. The polio crisis, which has brought shame to the country at every gathering of the world bodies, is avoidable if there is a clear vision and the willingness to do what is needful for the benefit of the citizenry. Nigeria does not lack the necessary resources to service such essential health obligation, but what she lacks are the political will and focus.
Kano state tops the list with 211 cases; and remains the epicentre of the type-one outbreak, accounting for one-third of the global type-one burden in 2008; Kaduna state has 44 cases, while Jigawa and Bauchi come next with 37 and 36 respectively. Also, there have been reported cases of polio in states, such as Enugu, Osun, and Ogun with one and three cases respectively. Whereas some states, including Adamawa, Gombe and Kebbi, which were hitherto the hot-bed of the virus, recorded massive improvement in their eradication efforts.
Nigeria is said to be the single greatest threat to polio eradication and one of the countries still exporting the virus to other countries of the world. Recently, at the 58th session of the WHO Regional Committee for Africa in Yaounde, Cameroun, the Director-General of the body, Dr. Margaret Chan, expressed concern over the resurgence of the WPV in Nigeria, saying that other African countries and the entire world were currently at risk of polio, following the new outbreak of type-one in Nigeria.
Dr. Chan said: "African countries are again at risk of polio. The most dangerous strain of the disease is affecting the Northern states of Nigeria. And this outbreak has already begun to spread to neighbouring countries." She accused Nigeria of dragging backward the progress made so far in the eradication of polio, adding that the key to its eradication is prevention.
WHO has attributed the resurgence of the virus to resistance of people to polio vaccines. The genesis of the resistance to polio vaccination dates back to 2003 in Kano when it was alleged that the vaccines contained infertility and HIV components. The anti-polio campaign, experts say, has had a negative effect on the smooth running of the immunization exercises. Several parents and guardians were brainwashed to believing that the exercise was not in their best interest and as such should be boycotted.
The almost one-year interruption of immunization of children with polio vaccines in Kano state and a few others in the Northern part of the country gave the virus opportunity to spread its tentacles. Only 30 to 40 per cent of children in the North were said to be immunized as against 80 per cent in other parts of the country. To curb the spread, health experts are of the opinion that since the anti-polio campaign is still adversely affecting the eradication efforts, those who started the campaign should be brought on board to pacify the people.
Failure of the campaign is also attributed to the collapse of the healthcare system. This is true because a properly funded healthcare system should be able to prevent certain diseases such as polio. There is no cure for polio, it can only be prevented. Polio vaccines, given multiple times to a child, can protect him or her for life, experts say. Prevention, they say, is better than cure. Moreover, it is always cheaper to prevent than to cure. The problem with polio is not availability of the vaccines, but the attitude of government towards health issues. The shoddy performance of our healthcare system coupled with inadequacies within the system, have given rise to poor handling of the immunization exercises in some states. Therefore, the outbreak of the new startling cases of polio should be a lesson to the Federal government to prioritize health issues.
Instructively, poor environmental sanitation, lack of potable water, low level of routine immunization and non-compliance on immunization rules by parents and guardians are other factors responsible for the resurgence of polio cases. Therefore, enlightenment campaigns should take into cognisance the various factors responsible for the spread of the virus. More importantly, campaigns should be on prevention and the consequences of the disease. Ultimately, people would see the need to immunize their children and wards. Governments at all levels should step up the campaign by providing potable water since children under-five contract the disease through drinking of contaminated water.
In all, every meaningful effort should be made to ensure that polio virus is kicked out of Nigeria. It is heart-warming to note that the Federal Government has set the first quarter of 2009 for eradication of polio. President Umaru Yar'Adua recently authorized the formation of both a National Task Force and a National Steering Committee to oversee the polio eradication efforts and on-going routine immunization activities in the country. The hope is that the steam, which the resurgence of the virus has generated would lead to concrete policy pronouncements and implementation for the good of the Nigerian child.
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