By Jide Babalola
From an estimated 350 000 cases in more than 125 endemic countries in 1988, incidences of Wild poliovirus cases decreased by over 99% to 33 reported cases in 2018. With ongoing concerted efforts, Nigeria stands a good chance of being among African countries that have taken an exit from the problem by September when certification would be granted countries in which no incidence of polio has been recorded in three straight years. The Bill and Melinda Gates Foundation (BMGF) has proven to be a strong ally, especially for Nigeria where the foundation has spent some $1. 6 billion over the past years.
According to the World Health Organization, “Once polio is eradicated , the world can celebrate the delivery of a major global public good that will benefit all people· equally, no matter· where they live. Economic modelling has found that the eradication of polio would save at least US$ 40 – 50 billion, mostly in low-income countries. Most importantly, success will mean that no child will ever again suffer the terrible effects of lifelong polio-paralysis,”
Speaking with The Nation Health page in Abuja, a team of BMGF officials comprising its Chief Strategy Officer & President, Global Policy & Advocacy, Mr. Mark Suzman, BMGF’s Country Director for Nigeria, Dr. Paulin Basinga, and Mr. Rodger Voorhies who is President of the foundation’s Global Growth & Opportunity Division emphasized a sustained commitment to help Nigeria through some of ts developmental challenges, with the battle against polio as a priority.
“Yes, we are optimistic, we do believe it is absolutely possible but we have to continue with political attention and good resourcing right now and we hope that by early 2020, we will all be here for a celebration, not just in Nigeria but for the entire continent of Africa being polio-free, it would be an amazing and true victory for all of us,” Mark Suzman stated.
According to the Global Polio Eradication Initiative, “Nigeria is one of only three countries in the world endemic· to wild· poliovirus , alongside Afghanistan and Pakistan. The country· is also affected by circulating vaccine-derived poliovirus type· 2 (cVDPV 2) outbreaks.”
As explained by W.H.O., polio is a highly infectious disease caused by a virus. It invades the nervous system , and can cause total paralysis in a matter· of hours . The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common· vehicle (for example, contaminated water or food) and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness of the neck and pain in the limbs. 1 in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralyzed , 5 % to 10 % die when their breathing muscles become immobilized. Those mostly at risk with polio are mostly children under 5 years of age.
No cure exists for polio, it can only be prevented and polio vaccine, given multiple times, can protect· a child for life.
Said Roger Voorhies: “It is our highest priority in Nigeria right now simply because it is achievable in the next six months but that is only if we continue with good attention and resources.
“And if we get that, we will be laying a platform for much stronger primary health care across the country,” he stated while expressing hopes for a major celebration of Nigeria’s coming polio-free certification by September this year.
In 1988, following the certification· of the eradication of smallpox in 1980, progress during the 1980s towards elimination of the poliovirus in the Americas, and Rotary International’s commitment· to raise funds· to protect all children from the disease, the 41st World Health Assembly adopted a resolution for the worldwide eradication of polio. With the spirited support of the Bill & Melinda Gates Foundation, the Global Polio Eradication Initiative (GPEI) was launched, with the active involvement of national governments, WHO, Rotary International, the US Center for Disease Control and Prevention (CDC) and UNICEF.
According to a WHO publication: “Overall, since the GPEI was launched , the number· of cases has fallen by over 99%… More than 16 million people· are able to walk· today, who would otherwise have· been paralysed. An estimated 1.5 million childhood deaths have· been prevented through the systematic administration· of vitamin A during polio immunization· activities .
In 2016, three cases of wild polio virus Type 1 (WPV 1 ) were discovered in three local government areas of Borno state but the World Health Organization and the Global Polio Eradication Initiative only certify a nation as being polio-free when standard surveillance indicates that wild polio virus is completely absent for at least three consecutive years in all states.
Both BMGF’s Country Director for Nigeria, Dr. Paulin Basinga and its President (Global Policy & Advocacy), Mr. Mark Suzman emphasized the need for government and all stakeholders to keep up the pace for maximum vaccination as the nation approaches the goal of being polio-free.
The BMGF officials also stressed that ongoing developmental efforts towards boosting agriculture, financial inclusion, women’s empowerment and other aspects of human capital development as captured by Nigeria’s Economic Recovery and Growth Programme (ERGP) remain vital aspects of their foundation’s ongoing work in Nigeria.
While they all advocated increased budgetary allocation by federal and state governments to health challenges like polio, Mark Suzman, a former journalist explained that the foundation’s concern about flagging efforts in sixteen states is now being addressed by Federal Government officials and members of the Nigeria Governors’ Forum with whom BMGF officials interacted few days ago.
Suzman spoke extensively on the issue: “ Not all the sixteen states mentioned represent failure in vaccination campaign, not even in the United States can you achieve a ten percent vaccination rate; what you need (to achieve) is a critical level or threshold of vaccination which allows a wider immunity across the population. So, what we’ve just seen is some slippage in this sort of emergency.
“To be honest, the federal budget allocation is much smaller than we think it should be and historically, it’s been a very significant drop from previous years’. There’s active discussion on the way; we’ve asked the ministry whether the government can use some other funds. If you look at that as a signal of seriousness, if how you allocate your budget is a signal of your seriousness; I think that will get one worried.
“But we understand that the review is part of the result of success; because we’ve been successful and because you do not see polio case in three years, government may want to move on very quickly to the next challenge and we understand that temptation. We just met members of the Nigeria Governors’ Forum about the need to put this issue on their agenda; it requires the government checking the success of the (polio) campaign, down to the local government level and do necessary follow-up. This is critical in the six months period (before certification in September).
“We know there is still some challenge particularly in Borno, some small pockets that we haven’t been able to fully reach and that is an ongoing challenge but there has been some very significant progress in the last two or three years.
“We give significant credits to the governments of Borno, and the Federal Government for the efforts in Yobe; they have made significant progress and that is part of reasons why we’ve made significant progress.
“We do feel relatively confident that we have enough penetration and threshold that we will be able to reach that polio eradication target for certification by September but you just cannot just drop the ball at this critical phase,” Suzman said while explaining the need to sustain the battle against polio as it nears conclusion.
Indeed, the legacy of polio eradication is worth all necessary available inputs in terms of resources, personnel and political will.