August 25, 2020, will remain indelible in the minds of many Nigerians.
It will remain indelible because it was the day the World Health Organisation declared Nigeria and the African Region free of wild polio virus.
The declaration came after the independent Africa Regional Certification Commission, responsible for certifying the eradication of wild poliovirus in the WHO African Region, made its final decision about the region’s wild poliovirus – free status.
This is coming after Nigeria, the last wild polio virus endemic country in the African continent, recorded no new cases in three years – the requisite period – since it last reported cases of wild poliovirus.
On June 18, the African Regional Certification Commission accepted Nigeria’s Wild Polio Virus Free Documentation after 30 years, on June 18.
WHO revealed that the disease was at the moment, endemic in only two countries – Afghanistan and Pakistan, thereby bringing the world one major step closer to achieving the goal of ending polio.
For those familiar with Nigeria’s long, thorny journey to attaining a polio-free status, it is indeed, worth celebrating.
For years, Nigeria’s polio-endemic nature, according to WHO, posed a high risk to international health.
Nigeria was classified by the International Health Regulations, as a state infected with circulating vaccine-derived polio virus type 2 (cVDPV2) with the potential risk of international spread, and was subject to temporary recommendations as of June 2020.
Since 1988, when the international polio eradication campaign began, the incidence of polio has been reduced by over 99 per cent, and eliminated from over 120 countries, according to the WHO.
The UN health body noted that at the time, over 350,000 children were paralysed every year, in more than 125 endemic countries.
Polio is a disease caused by a virus that attacks the nervous system. In most cases, it causes paralysis that could lead to death by paralyzing the breathing muscles.
Children stand a high risk of being infected when they don’t receive the complete doses of either the Inactivated Polio Vaccine or the Oral Polio Virus.
Also, adults travelling to polio-endemic countries, laboratory workers and healthcare workers likely to treat patients stand a higher risk of infection without inoculation.
Poliovirus spreads through human waste, especially by drinking water or eating food contaminated with the stool of an infected person. Oral or nasal secretion is another method of contamination. The disease can spread widely before paralysis is reported.
According to the Disease Surveillance Unit of the WHO, Nigeria had the largest number of polio cases, accounting for 61 per cent of global polio cases in 2012, and 95 per cent of cases in Africa.
The WHO, therefore, had severally, urged Nigeria to reduce the risk of international spread of poliovirus by urgently stopping the outbreak, especially in the north, where two cases were reported in 2016, after over two years break.
The politics of polio has over the years, been described as running deeper than imagined, thus, making concerted efforts to wipe out the condition in Nigeria very tough.
For long, the myths that gained ground about polio vaccines and which made many northerners wary were centred on religious, tribal and political reasoning rather than the fate of young children whose lives hung on the balance because of polio.
There were Nigerians who believed that polio vaccines are part of the western ploy to sterilize and depopulate Africans as well as infect them with HIV AIDS.
These factors made Nigeria be consistently known for re-infecting neighbouring African countries.
As Nigeria bask in its new polio-free status, the WHO has, however, warned that – work must remain ongoing in the area of continued vaccination, despite the threat posed by COVID-19 globally.
The UN health body has reminded countries that the eradication of polio globally, now depends primarily on stopping the disease in Pakistan and Afghanistan, where it remains endemic.
It noted that as long as polio exists anywhere, it’s a threat to children everywhere.
Speaking on June 18, a day after the WHO accepted Nigeria’s wild polio-free documentation, the Executive Director, National Primary Health Care Development Agency, Dr. Faisal Shuaib, ha also warned that Nigeria was still at risk of polio.
Faisal said though, the certification meant that there was no wild poliovirus anywhere in Nigeria, it did not mean that work was over as the virus can still be imported from other endemic countries.
Shuaib, however, assured that all actions, particularly vaccination would be intensified to avert resurgence.
“We have to maintain this status. This means we have to continue to give our kids the vaccination that they need against the virus, and all the other vaccine-preventable diseases.
“We should not forget that we still have Afghanistan and Pakistan that are endemic for wild polio viruses, which means there is still a potential that this virus may be imported into Nigeria.
“We live in a global village, you can see how COVID-19 spread so fast from China, by the same token, we could have wild poliovirus spread from these two endemic countries,” he said.
Chris Elias, President, Global Development, Bill & Melinda Gates Foundation, said while the progress in Nigeria should be celebrated, it is also fragile, adding “It is critical that Nigeria goes two more years without a case of polio which will require the support of partners, increased accountability at all levels of the program led by President Buhari, and increased domestic funding commitments.”
The Minister of Health, Dr. Osagie Ehanire, has, however, assured that Nigeria can prevent polio resurgence by putting in place functional primary healthcare centres and well-established system of routine immunisation.
He said the possibilities of resurgence are chances that can be controlled by building the country’s routine immunisation, adding “We are now at about 70 per cent coverage. We know that the remaining 30 per cent is not difficult.
“So, we are developing strategies to expand the coverage up to 90 per cent.
“The difficult areas are hard to reach areas without means of transportation. But we have acquired motorcycles that will carry vaccinators to what we call the last mile.
“In addition, we are expanding our primary healthcare structure to provide services which routine immunisation is key.”
“Also, we are carrying out very strict Acute Flaccid Paralysis Surveillance which is the gold standard for poliomyelitis control and prevention. It is used to demonstrate the presence or absence of poliovirus and for certification of a country as polio-free.
“With all these measures, then, we should have control of polio eradication and be able to maintain it.”
The President, Major-General Muhammadu Buhari (retd), also assured that Nigeria will strive to retain the polio-free status as well as leverage on lessons learnt from polio eradication to strengthen her health system, especially primary health care.
Nigeria must sustain its remarkable progress against polio.
Immunisation and surveillance activities must continue to rapidly detect a potential re-introduction or re-emergence of the virus.
According to the WHO “it’s critical that we seize this opportunity to end polio for good and ensure future generations of children are free from this devastating disease.”
Many pundits have averred that the political will to fully implement proven strategies is what is required to keep polio at bay. They averred that Nigeria cannot afford to be complacent now and must strengthen its response.
In the words of Dr. Matshidiso Moeti, WHO Regional Director for Africa “Stopping polio in Nigeria has been a clear example that political engagement, strong partnerships and community engagement are the engines that drive the momentum of public health programmes, enabling them to achieve great things.”
It is fundamental for all these measures to be sustained as they are crucial to retaining Nigeria’s wild polio virus-free status.
