‘To be polio-free, Nigeria must sustain gains, address risks’

How would you describe Nigeria’s efforts to sustain wild polio virus interruption by July?
The Nigeria Polio Eradication Initiative has made remarkable progress in the last 2 years.

We noted a significant reduction in the prevalence of the Wild Polio Virus (WPV) in 2014 where there were only six cases recorded and five cases out of the six were in Kano state.

This is an indication that the Nigeria program has not only succeeded in reducing the number of WPV but also the geographical scope of the poliovirus.

With the virus now confined to a smaller demography allowing for a more strategic actions in finishing the job that Rotary started in 1988.

As at the end of March 2015 Nigeria had not reported a single case of WPV. The last case of WPV seen in Nigeria was on July 23, 2014.

Therefore, if Nigeria does not record another case of wild polio case through to 24rd July 2015, Nigeria would then be considered as a non-polio endemic nation.

However, that will mark the first milestone of the three years polio-free period required for World Health Organisation (WHO’s) certification of Nigeria as a polio-free country.

To succeed, Nigeria must sustain the hard fought gains and address the risks that threaten interruption of WPV transmission. Looking at the milestones achieved by the PEI in the last two years, I am convinced that Nigeria can interrupt polio transmission by July this year.

For instance, there has been 87 per cent reduction in type 1 WPV (WPV1) cases in 2014 compared to the same period in the previous year, a significant geographic restriction by 81 per cent with five infected Local Government Area (LGAs) in 2014 compared to 27 LGAs in 2013 for the same period, also there is the disappearance of WPV3, also the genetic clustering of WPV1 has been reduced from eight to one, that is 87 per cent reduction.

Kano state is the only known last sanctuary with active transmission, even at that, the last case was recorded in the third quarter of 2014.

What is the secret of success so far recorded‎?
The progress and achievements made by the Nigeria program were due to the continued commitment and leadership of the government of Nigeria with support from Rotary International and other partners; the persistence of the Nigerian health workers; and the sacrifice made by volunteers and local community vaccinators who risks it all to drop the polio vaccine in the mouths of the many eligible children in Nigeria. Also contributing to the success are the innovations that have helped the program gain traction in reaching children in communities with high rate of vaccine refusals.

The success factors abound. One can but mention just a few. However, each little effort, small idea, big strategy, moral support, endorsement made towards promoting vaccine uptake has contributed to the overall outcome.

The key innovations that have supported the Nigeria Polio Eradication Initiative (PEI) gain mileage in recent time include, but not limited to: expanded and strategic use of health camps and gifting of attractive pluses to children and caregivers in non-compliant communities, reaching missed-children by conducting outside-household immunization called Directly Observed Polio Vaccination (DOPV), heightened commitment of religious and traditional leaders in resolving non-compliance,

The Therapeutic Feeding Centers – the idea behind the Therapeutic Feeding Centers is to reach and vaccinate as many children as possible, especially those whose parents wouldn’t accept the polio vaccination during regular and supplementary immunization campaigns due to myths around the polio vaccine. Also, persistent disease surveillance has contributed in helping the program pinpoint vulnerability to polio transmission.

Nigeria recently introduced inactivated polio vaccine into the routine immunisation schedule. What is your view on this?
Yes, the Federal Ministry of health officially introduced the Inactivated Polio Vaccine (IPV) into the Nigeria routine immunization protocol in February 2015, thus, becoming the first polio endemic country to use inactivated polio vaccine in its routine systems. While Oral Polio Virus (OPV) is extremely safe and has led the world to the threshold of being polio-free, on very rare occasions, the use of IPV can lead to vaccine-associated complications.

The introduction of IPV into the Nigeria polio eradication programming at this stage is strategic, especially that the country is at the verge of interrupting polio transmission.

What does the introduction of the injectable polio vaccine represent for Nigeria’s quest to interrupt polio transmission?
The global eradication of polio requires the cessation of all OPV use. Once polio has been eradicated, IPV will then be the only option for countries to maintain immunity levels.

The combination of OPV and IPV had threefold benefits: acting as risk mitigation in the global plan to phase out the use of OPV, boosting immunity against type 1 and 3 wild poliovirus (WPV), and also tackling the risk of circulating vaccine-derived poliovirus (cVDPV).

For these reasons, the introduction of IPV into routine immunization systems in Nigeria is part of one of the four major objectives of the Global Polio Eradication Initiative (GPEI).