5 February 2013

Nigeria: Polio Eradication - Nigeria Makes Progress but Old Challenges Remain

IT was a weekend of new expectations and old challenges in the race towards polio eradication for Nigeria in particular and the world in general as the four-day synchronised Nationwide Immunisation Plus Days, NIPDs, commenced Saturday February 3.

In many of the high-risk and under-served local government areas, LGAs, immunisation teams set off daily at the crack of dawn - even amidst logistics drawbacks, rising security concerns in the North, delays in vaccine delivery, to begin immunisation of children aged 0-59 months with the bivalent Oral Polio Vaccine, bOPV.

Prior to the exercise, the continued transmission of the wild polio virus, WPV, in Nigeria,had been a major concern.

However, indicators from the polio Independent Monitoring Board, IMB, set up to verify global eradication progress, hinted that the goal of polio eradication is on course and the promise of it being seen to completion was "high".

Currently, Nigeria is the world's most endemic country for polio, followed by Pakistan and Afghanistan. India, which eradicated polio in February 2011, is no longer listed as an endemic country. In 2012, the total number of WPV cases globally was 222, with Nigeria having the highest number of 121, according to data from the Global Polio Eradication Initiative, GPEI. In some areas in Lagos, where Good Health Weekly monitored the exercise, the usual hitchesprevailed while the exercise lasted.

Few members of the vaccination teams expressed optimism about the overall success of the eradication drive, but others had reservations about logistics issues.

Specifically, issues such as the remuneration package, large areas allocated for coverage, delay in payment, and rejection of the vaccines among others, were top on the list of complaints.

Numerous incidents of arguments were reported between vaccinators and occupants of private and public residences and households, including churches where access could not be readily gained to conduct the immunisation.

In parts of Mushin, in Mushin LGA; Ebute Metta in Mainland LGA; Yaba Local Development Council, LCDA; Ogere opposite Ojo Barracks in Oriade LCDA in Ojo Barracks, vaccinators were initially observed attending only to children encountered on the street.

When quizzed, some of the vaccinators explained that many households who were reluctant to open up their doors to them, complained the vaccinators arrived too early in the day when their children were still in bed.

In virtually all areas covered, vaccinators complained that the sum of N4,500.00 they were being paid for the four-day service was too small.

"It is too small, but due to lack of employment in the country,we have no option than to collect the money, but we will render the service of N4,500," several of the vaccinators remarked. It was gathered that team supervisors are entitled to N6,500.

"It is not the money. If we are to look at the money, we won't render proper service, but our priority is to ensure that our younger sisters and brothers are polio free," one of the supervisors remarked.

She suggested training of Corps Members as independent monitors and vaccinators for effective eradication of polio as the move would solve the problem of missed children at every round.

In reaction to an alleged report of deliberate wastage of the OPV, one of the vaccinators denied the allegation. "I dont know anything of such. Right now, we are short of vaccines, and will have to come back tomorrow to continue from where we stopped. We don't throw away vaccines because we are given a target population that we must cover."

Generally, complaints about the poor attitude in some quarters towards the overall essence of ensuring every child is immunised against the wild polio virus.

In his annual letter published this week, Bill Gates, Co-chair of the Bill & Melinda Gates Foundation, underscored his personal and the Foundation's commitment to the global effort to eradicate polio.

Also last week, while addressed the prestigious Dimbleby Lecture in London, Gates declared: "We are on the verge of doing something we've never been able to do before-reaching the vast majority of children in the remotest places in the world.

"We are building systems, developing technology, and training workers that make it possible to help people who never got any help.

"When polio is gone, we can use the same systems, technology, and people to deliver other lifesaving solutions, especially routine vaccinations for diseases like rotavirus and measles," Gates remarked

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