Nigeria and Nigerians have long worn the badge of ‘Giant of Africa’ with pride; as the most populous black African country. Perhaps the title is merited on the strength of numbers alone and not much else. Far too often, Nigeria finds herself on the wrong side of the divide concerning many issues, especially health matters. My University of Leeds Master’s in International Health class was many times an uncomfortable space to be in, especially when health indices were being discussed. It was rare for Nigeria not to be mentioned among the worst performing countries for many diseases of public health importance. None, however was as shameful as the discussion regarding polio.
Polio is a disease of the central nervous system (the brain and spinal cord) caused by the polio virus. While many children will come in contact with the virus, suffer a period of febrile illness and recover completely, in a small percentage of children, it is the cause of permanent disability in the form of an Acute Flaccid Paralysis that destroys the lower limbs, leaving the children permanently disabled and placing an extra burden on their families. Thirty years ago, Polio was the scourge of the whole world, from America to Australia, and everywhere in between. Since then, with the successful development and introduction of the Oral Polio Vaccine (OPV), it has nearly been eradicated from most countries, remaining endemic in only three countries.
In the coolness of that Leeds afternoon, I learnt that the only three countries left with an endemic spread, with a nice-sounding acronym like ‘PAN’, were Pakistan, Afghanistan and Nigeria. All eyes swung to me, and I slid a little lower in my seat, wishing I could disappear; why was the Giant of Africa endemic for Polio, along with countries with prolonged and documented histories of civil war – they had an excuse, what was ours?
It was only about to get worse.
The class listened with rapt attention, to how Nigerians, especially in the North, had a culture of rejecting vaccinations, including polio vaccine. About how Nigerians successfully exported the disease to countries which had previously been polio-free for many years, leading to fresh infections in 20 such countries, and single-handedly jeopardizing global eradication efforts. At this point, I really wished the ground would swallow me. Literally.
Nigeria’s polio vaccination efforts, and indeed vaccinations against childhood killer diseases suffered a crushing blow in the early 2000s, when religious and community leaders in the North successfully led a boycott of immunizations, on the allegation that vaccines were tainted with HIV virus, as a ploy of the Western world – the major funders of vaccine-developing companies and immunization-supporting NGOs to cull the population of the majority Islamic Northern Nigeria. Other allegations were that the vaccines were engineered to render their children infertile. In those days, it was a dangerous thing to be a house to house vaccine administrator in the North. Our Polio eradication efforts never quite recovered and have been further endangered by the longstanding insurgency in the North-East, which ensures that there is usually a pocket of children that are unreached by immunization services, even on national supplementary immunization days.
The closest we have ever come to receiving a polio-free certification from the World Health Organization was between 2014 and 2016, when there were no new diagnosed cases, for two out of the mandatory three years a country has to be polio-free in order to be certified. Unfortunately, in 2016, we recorded a new case of circulating wild polio virus, taking us back to square one. Since then, we have had sporadic polio outbreaks, with states stepping up Supplementary Immunization Activities (SIAs), through house to house administration of OPV. It is important that all children under the age of 5 receive these vaccines, regardless of previous immunization status. There is no risk of overdose with OPV, and no side effects. Let us work together to kick polio out of Nigeria. These are some of the low hanging fruits within our reach with which we can continue to boost our image as the giant of Africa.