Eradicating Polio in Nigeria
Nigeria recently celebrated a full year and a half without a new case of wild poliovirus. The Global Polio Eradication Initiative states: “Wild polioviruses are those that occur naturally. Very rarely, vaccine-derived poliovirus can cause paralysis. Vaccine-associated paralytic poliomyelitis occurs in an estimated 1 in 2.7 million children receiving their first dose of oral polio vaccine.” The World Health Organization (WHO) has certified there has been no evidence of wild polio in Nigeria for more than a year and removed it from the list of polio-endemic countries. At the Polio Oversight Board meeting during the United Nations General Assembly in September 2015. These are milestones both for Nigeria and for the global campaign to eradicate polio. Nonetheless, continued effort and vigilance will be critical over the next two years to declare the country and the rest of Africa completely free of the disease.
Toward these ends, Nigeria has significantly increased polio immunity among its population over the past three years. As recently as February 2012, only 16 percent of local-government areas (LGAs) in high-risk states had achieved the target level of immunity coverage: vaccinating more than 80 percent of all children under the age of five. By September 2015, coverage had improved more than sixfold: 97 percent of LGAs in high-risk states had achieved the target (Exhibit 1). The success of Nigeria’s federal and state governments, Global Polio Eradication Initiative partners, and the Bill & Melinda Gates Foundation is all the more impressive given the climate of disinformation, intimidation, and violence that peaked with the 2013 murder of 13 vaccinators by insurgents in Kano states.
While significant work remains to rid Nigeria of polio in the next year and a half, the country deserves full credit for halting its transmission and eradicating Ebola. The effective use of emergency operating centers provides an excellent example of how national governments and their international partners can fight the world’s most dangerous diseases through strong leadership, intense collaboration, data analytics and performance management focusing on results. An important remaining question is where and how countries and international organizations can best deploy EOCs to overcome other health crises.