How polio clawed its way back to Nigeria

Borno state health commissioner Haruna Mshelia left Maiduguri for Abuja last Wednesday. Then the whispers began filtering. It was wild poliovirus, and it was back. Two fresh cases had been spotted in two separate council areas of Gwoza and Jere. “When I left Maiduguri, there was no news like that,” Mshelia tells Daily Trust.  He […]

Borno state health commissioner Haruna Mshelia left Maiduguri for Abuja last Wednesday. Then the whispers began filtering. It was wild poliovirus, and it was back.
Two fresh cases had been spotted in two separate council areas of Gwoza and Jere.
“When I left Maiduguri, there was no news like that,” Mshelia tells Daily Trust.
 He was to meet with health minister Isaac Adewole to get a grip on the situation before any public statements.
Adewole himself had declined earlier to speak about it. For hours through Wednesday night till mid-day Thursday, officials were unsure how to break the news that Nigeria’s dream to get polio-free certification was on hold.
It’s last case of polio on record was 24 July 2014, and its zero-case status had held firm for two straight years.
The new cases come only weeks after its second-year milestone-and months before it was to clinch World Health Organisation certification after solid three years without the virus.
“What that means is that the certification will start all over again,” said Mshelia.

Out of reach, inaccessible
One infection was found in a child in Gwoza council area, the other in Jere council area-two places that had been inaccessible in the height of the insurgency.
“It wasn’t that we were not doing the job. A chunk of the state was out reach. We couldn’t reach children there,” said Mshelia.
Gwoza is still partially accessible, and where people live without access to modern health care, anything can happen, the commissioner explains.
Borno has not had a case of polio infection since 2012, and its governor Kashim Shettima clinched an award for polio-eradication work.
The working plan was to immunise people entering communities with access.
“Where we had access, in the last two years, we have not had cases,” said Mshelia.
“All these cases are coming out of areas that were liberated by the gallant activities of our soldiers.”
Parts of Mafa council area were inaccessible, locking out health and humanitarian assistance. Many people displaced from Mafa flowed into Jere.
Insurgency, displacement and attacks on health workers disrupted health systems.
“With this confusion, where people were cut off and healthworkers were very big targets, we couldn’t reach these populations being liberated,” said Mshelia.
The two children making up Nigeria’s standing cases of polio virus infection are among thousands born since then and have “had no contact with civilisation since they were liberated,” he added.

“We did not expect polio”
As efforts continued to free areas of the northeast formerly held by Boko Haram, officials expected to see challenges.
The United Nations Children’s Fund had warned of the scale of humanitarian assistance needed in newly liberated areas.
“Mr. President himself when we had a meeting last week observed that as we liberate more areas, we should expect challenges,” said Adewole.
“But we did not expect that there would be polio. We were expecting nutrition and other problems.”
 “It is unfortunate that we have this development. It has set us back. But I can assure the nation that we will do everything possible to be on top of the situation. We are drawing out an emergency plan and in the next 48 hours, we are dispatching a team there and we are going to start immunization.”
At least three rounds of “special immunisation campaigns” are planned to contain the situation.
Professor Tomori Oyewale chairs the expert review committee, a group of professionals who review yearly Nigeria progress against polio.
He called news of the two cases “very disturbing” amidst fears more cases could surface in coming months.
And keen watchers could see it coming. A first detection of not wild polio but vaccine derived polio was a sign all was not well. Acute flaccid paralysis usually goes hand in hand with polio. It struck the child in Gwoza on July 13, and considered to have a high rate in inaccessible areas, where no one monitors or reports.
Lots of celebration and declaration against polio have filled headlines since July 24, 2014, but the wills against the virus differs between federal, state and local governments.
“If words of commitment were the tools for polio eradication, our President has said enough to banish polio from our land forever,” said Oyewale.
He’d earlier warned complacency could hold Nigeria – and Africa – from finally eradicating the virus.
Now he said though President Muhammadu Buhari vowed and declared, pledged, undertook and gave his word to see the end of polio, complacency on the part of governors and local government chairmen had pushed Nigeria a step back.
The Presidential Task Force on Polio Eradication hasn’t met in a some time. The task force is headed by the President himself and is the big baton for pushing governors into line against polio.
“Now is the time for the president to convene the meeting of his task force and get all the governors back to the drawing board, roll up their sleeves and commit to the declarations of the President,” said Oyewale.
“If not, Nigeria will not be declared free until 2019. Nigeria will set the entire world back on the issue of polio eradication. We were hoping that Afghanistan or Pakistan would be the last country. Looks like Nigeria, our country known for celebrating victory before the end of the match may yet be the last.”