Health specialists are increasingly optimistic that growing acceptance of the polio vaccine in northern Nigeria offers hope that an upcoming immunisation campaign across West Africa will succeed in “re-eradicating” the disease in countries affected in 2008 after several polio-free years.
Health officials in Benin, Burkina Faso, Côte d’Ivoire, Ghana, Mali, Niger, Nigeria and Togo, according to the World Health Organization (WHO), are vaccinating nearly 40 million children in a “synchronised” campaign in February and March.
In Nigeria, one of four countries worldwide - and the only one in Africa - where polio is endemic, some states suspended polio vaccinations in 2004 over religious leaders’ warnings that the vaccine was harmful.
Polio cases in northern Nigeria were blamed for re-infections in a number of West African countries in 2008, according to WHO.
"So in a way we have to ‘re-eradicate’," Oliver Rosenbauer, spokesman for WHO’s polio eradication group in Geneva, told IRIN.
Increased buy-in in Nigeria is crucial, health officials said. “A lot of positive change is happening,” said Alex Gasasira, immunisation team leader with WHO Nigeria, pointing to mobilisation efforts by government officials, traditional and religious leaders and aid agencies in recent years.
Parents whose children have been struck by polio have also gone public, saying they regret not immunising their children and urging others not to make the same mistake, he said.
“The real change that we have seen, particularly in recent months, is at the level of the state and local governments, where there is now much more active engagement and involvement of key leaders and stakeholders.”
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WHO says state governors from Nigeria met this month in the capital Abuja and publicly committed to reach at least 90 percent of children.
As part of the mobilisation efforts in northern Nigeria, the governor of Kano – the hardest-hit state – recently had his eight-month-old daughter publicly vaccinated. Of the 800 polio cases in Nigeria in 2008, 272 were in Kano, according to WHO.
“The burden of these paralysed children on their parents and relatives, and of course the children themselves, is unbearable,” Governor Malam Ibrahim Shekarau said at the opening ceremony for Nigeria’s 2009 immunisation campaign.
“It is therefore our collective responsibility at all times to stress the importance of immunising our children against polio.
“Now that we have ascertained the safety of the vaccine and found the rumour [that it was harmful] baseless, parents no longer have any reason for rejecting the vaccine.”
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If fear of the vaccine no longer hampered coverage in Nigeria, organisational and logistical glitches still could, said WHO's Rosenbauer.
He said in the past in some areas of northern Nigeria, vaccination campaigns had not been as efficient and coverage not as complete as required.
“Community buy-in is absolutely critical and we have seen great improvement and acceptance in the past five years,” he said. “There is much greater demand [in Nigeria]. Now success depends on service delivery.”
Rosenbauer said many government efforts, particularly by the Kano governor, had been encouraging. “What we really need is good district-level government oversight.” He said Kano authorities had set up local polio eradication task forces across the state.
Aside from Nigeria, which has an ongoing vaccination campaign, the synchronised effort in the seven other countries is expected to cost US$17 million, plus the cost of vaccines. Funding comes from WHO, the UN Children’s Fund (UNICEF) and some governments, WHO said.
The vaccination effort in West Africa will be run by national health authorities with the support of WHO, UNICEF, the US Centers for Disease Control and Prevention and Rotary International.