Polio – Nigeria's role in the final push

Every quarter, an Independent Monitoring Board assesses progress towards the attainment of a polio-free world. The Independent Monitoring Board was convened at the request of the World Health Assembly to monitor the plan to interrupt polio transmission globally by the end of this year 2012…yes end of 2012! This is 10 months away and clearly the eradication programme is not on track to meet this goal. The report of the last meeting should be read by everyone interested in public health. It is that important – and can be found here
Below we highlight 2 of the most important sections: 

Success in India – one of the four polio endemic countries – shows that unswerving political commitment, outstanding public health leadership, clear lines of accountability, intolerance of weak performance and the systematic enforcement of best practice can stop polio.”

“Pakistan and Nigeria represent the gravest risk to global eradication.  Nigeria’s 2011 emergency plan had no meaningful impact. Nigeria is not heading for success, unless its plan currently under development is made into something very special.”

We as Nigerians, our government, our people, our leaders must pay attention. Every society has to figure out what matters to its people and act on it. At present Nigeria is at the verge of compromising decades of work, billions of dollars, thousands of lives so far spent on making polio only the second infectious disease ever eradicated. 
Polio cases in Nigeria, October 2011
Courtesy GPEI
So what are we doing wrong? There is a lot – and many of these can be read in the report. At this moment – The Nigerian Ministry of Health, the National Primary Health Care Development Agency, the WHO, CDC, Bill and Melinda Gates Foundation are all ramping up their efforts. They will do what they can – but we must do more. There is little discussion in Nigeria – in the ‘lay’ press and among health professionals on the gravity of the situation. People are preoccupied with security challenges. Maybe it is no coincidence that the areas most affected by the security challenges are also those reporting the most cases of polio. As of October 2011 85% of all the polio cases reported in Nigeria were from Kano, Kebbi, Jigawa and Borno. 
But most worrying really is the little apparent engagement of the Nigerian President, his Vice President, and the State Governors. Where is the political leadership required? Imagine the political capital that would be gained by President Goodluck Ebele Jonathan. This could re-define his tenure so that it seen as that in which the transmission of polio was interrupted in Nigeria. Imagine if we could read the words written about India – written about Nigeria in a year’s time….that 

“Nigeria has shown …. unswerving political commitment, outstanding public health leadership, clear lines of accountability, intolerance of weak performance and the systematic enforcement of best practice can stop polio.”

Just imagine what it will mean to us….to our children. To these children Those that were missed and now live their lives on sticks. Imagine what it would mean for our national pride and confidence if we can turn this ship around. Can we do it? Yes we can, because it does not require rocket science.  We know what works in terms of the vaccine and how to deliver it. But we must do the one thing that has proved to be our Achilles heal in Nigeria – organise ourselves better to deliver the vaccine, hold our leaders to account, and not stop until the job is done. We cannot afford to fail – we simply cannot. 
Picture courtesy of Immunization Action Coalition  

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (www.epiafric.com), which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

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