‘Eradicating polio is possible by December 2014’
How would you rate our chances of eradicating polio by the end of this year 2014 as President Goodluck Jonathan has assured? The trend that we have is in line with the declaration of the President. We have five cases in the data compared to about 38 cases this time last year. When you look […]
How would you rate our chances of eradicating polio by the end of this year 2014 as President Goodluck Jonathan has assured?
The trend that we have is in line with the declaration of the President. We have five cases in the data compared to about 38 cases this time last year. When you look at the extraneous factors not under your control, just like the insecurity issue that you cannot predict, it is beyond human control. But give or take, we are making progress in that direction. We are hoping that the five cases we have presently, will be the last that we will have and hopefully by December, we will stop polio transmission in the country.
Many are of the opinion that the country is giving unnecessary attention to polio. What is your take?
Its just like the Guinea worm, have we not successfully eradicated it now? So you can imagine how many millions of naira that have been saved from that. The next disease to be eradicated that you have the tools to do is polio. Most countries in the world have eradicated polio and money saved is now put into other areas like measles to fight other diseases or other sectors.
Somebody paralysed and not able to do anything in life is traumatic. If you look at what the person is passing through, how do you quantify the problem in terms of not being able to work, not go to school, the burden on the family, the society and all that.
Among all the disease for routine immunization, you have a disease you can remove from the list. They are about seven and if you remove polio, you’re left with six. The argument that attention is on polio to the detriment of others is because the polio programme has been on for too long. We started with Ghana, Liberia and all that but they left us behind because of the challenges we are facing in the country.
We should face the challenge squarely. There’s no challenge that is insurmountable. It depends on your perseverance and finding the right solution to it. So we don’t want Nigeria to be the only country in the world with polio. This is a disease that affected very high people in the society even in the USA as far back in the 50s.
Routine immunization is something that has been going on but its not everywhere. We are concentrating on 11 states and within these 11 states, we are working in about five states that are still transmitting. Some of them have stopped transmitting. But in the south and even north central states, we are not doing the exercise in those areas as frequent as we used to. We now concentrate on the areas transmitting the virus.
Now the routine immunization in those areas is going up. The coverage is rising. So when people are saying that polio is here because of poor routine immunization, the argument is not totally true because its just twice a year we conduct national polio programmes in for example, Plateau or Nasarawa from the middle belt.
The challenge we are having with our routine immunization is supply chain; getting the vaccines to the health facilities which currently has improved. Vaccine is being imported, its stored at the national stores and its moved to the zones, states and all that. But you know you can have relative scarcity when the flow does not get to the health facilities and the service delivery is poor.
Like I said, accountability; people at the service delivery level are not doing their work. So accountability issue is now being looked into and people are now doing their work.
On the demand aspect, people were not aware before but because of awareness now, people are now demanding for this vaccine. So its now picking up and invariably, the routine immunization too. Hopefully, within the next couple of years, routine will now be very strong in the country.
Polio eradication prog-rammes is a collaboration effort not that it’s done in isolation. It’s our children that are being infected. Moreover, the tool or vaccine may no longer be produced if other countries have eradicated it because a company cannot start manufacturing polio vaccine for only you. So how do you now get the vaccine? So these are some of the issues around it. So you have to work in line with the global objectives and vision. We are working effectively to ensure that routine immunization is strong and fair in the states.
Some of the teething problems we had in terms of funding, political support have been taken care of by the President.
What exactly does the center do?
We started operations since October 2012. The emergency centre was necessitated by the fact that the World Health Organisation (WHO), declared polio as a programmatic emergency and that countries should speed up this eradication efforts. So each country was asked to put up an emergency unit and Nigeria also did that. So the emergency operations centres encompass other partners like WHO, UNICEF, Bill and Melinda Gates Foundation, CDC and Rotary International.
The technical unit for the country is headed by NPHCDA through me. We work as a team and those who are members of the operations centre work are decision makers. We don’t delegate that responsibility to a junior staff, they are people who can take decisions on the spot. We make extensive use of data here and we meet here twice a week. When there are emergencies, we also call a meeting even on weekends.
The emergency centre were in five states initially which we have scaled up to seven now. They are in Borno, Kano, Katsina, Kaduna, Bauchi, Yobe and Sokoto. While Abuja is national, those ones at the states operate at the state level . We have incident manager, state immunization officer and the same WHO state coordinators, CDC at that level, are members. It’s a very small crack team that is focused, committed, determined using data to support the programme.
When we started, the number of cases was 122, we scaled that down to 53 last year and this year, we have five cases. As at 2012, we were at the bottom of the ladder. When we go to international conferences, all sorts of names are used for us; we are endemic, we are exporting virus to the whole world and all that. But we took it as a challenge that we could do it and we brought it down to five compared to our contemporaries now. Pakistan is 91 cases and that was the position Nigeria was occupying about two years ago. Afghanistan now has seven cases. We came down from the worst performing to the most improved country in terms of the three countries that are still transmitting. If you watch, the three countries that are still transmitting have one thing in common, which is insecurity. So our major challenge now is insecurity and where we have the virus currently is Borno, Yobe and Kano.
But in Kano, we had the killings but we will overcome that. But currently, we are working to access children in Borno and Yobe because the states are full of children that are not accessible especially in some local government areas that were mapped out. Those are areas that insurgents are really working and we find it difficult to work. But we try as much as possible to overcome the challenges. Though we still have operational challenges, we are trying to work in the LGAs rather that the whole state.
We tend to isolate those LGAs that are poor performing and we meet with them after each IPD round. We call for a meeting for those who did not measure up to the standard. We try to find out why they performed poorly and that informs our decision making and we try to change things around. So these are some of the strategies we have put in place. From each year, beginning from 2012, we developed the polio emergency plan that we are implementing and every year, we renew that plan, we amend it.