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Wednesday, February 26, 2014

Expert Spotlight

Dr Oyewale Tomori, Chairman of Nigeria’s Expert Review Committee on Polio Eradication and Routine Immunization


How do you think Nigeria’s polio programme is doing right now?

The programme is doing much better and this has resulted in the progress recorded so far.

Between January and September 2012, Nigeria reported 101 cases of polio in 13 states and 70 local government areas (LGA), compared to 49 cases in nine states and 26 LGAs for the same period in 2013. For the first time, except for Kano State, no polio cases have been reported in most parts of the northwestern states in the last year. So far in 2014, there has been only one wild polio case in the country, reported from Gaya LGA, Kano State, with onset on 1 February.

Behind this progress is improved national coverage of three doses of trivalent oral polio vaccine (tOPV), which increased from 73% in 2012 to 84% during January-September 2013. The nationwide proportion of children aged 6-35 months with non-polio acute flaccid paralysis (AFP) who have received four or more doses of OPV increased from 75% in 2012 to 87% in 2013.

However, in the northeastern parts of Nigeria, the high level of insecurity has hampered supplementary immunization activities (SIA) and created huge surveillance gaps, making it difficult to confidently determine the state of polio eradication in the area.

What have been the most important factors contributing to Nigeria’s recent progress?

The programme used new methods to evaluate SIA data and implemented special interventions to improve performance in high-risk LGAs. For example, community leaders (including traditional and religious figures) became polio eradication advocates, working in the community to counter anti–vaccination lobbies and threats of violence. In areas where noncompliance was particularly high, polio survivors joined campaigns to highlight the permanent risks associated with polio. The programme also established tem¬porary mobile health camps during SIAs to help reach children with vaccines and simultaneously address other unmet primary healthcare needs.

Can you describe some of the innovative strategies Nigeria has been employing to overcome challenges?

The introduction of the polio Emergency Operation Centers (EOC) at national and state levels has allowed for real-time assessment, evaluation and response to field situations.

The deployment of inter¬agency support teams at the ward level improved supervision of SIA activities, while accountability officers ensured the proper use of funds and increased local accountability.

The programme used global positioning systems (GPS) to help implement microplans and track vaccination teams during SIAs.

How has Nigeria’s polio work affected other health programmes?

The latest and greatest beneficiary of the polio activities in Nigeria is routine immunization (RI). In the past, RI was abandoned and neglected. The polio programme recognized that ending polio and strengthening immunization went hand in hand, and in 2012 made serious efforts to ensure that eradication programmes enhance RI. Today, the country is reaping the benefits of high RI coverage, evident in the much reduced number of polio cases.

The health camps established along with the SIAs are also providing other health care services.

What do you see as the biggest challenges Nigeria’s polio programme will face this year, and how can we overcome them?

The greatest challenge to the polio programme in 2014 will be the preparations for the 2015 elections. Currently, the election is the only thing that matters in Nigeria. Every election year since 2003 has been characterized by abandonment of good governance, and subsequently accompanied by a surge in polio cases.

We are so close to victory. In 2010, Nigeria recorded only 48 cases of polio, but because we did not press victory to the end, we recorded 95 cases in 2011 and 130 cases in 2012. We suffered and continue to suffer as one of only three nations that have NEVER stopped the transmission of polio.

We must not allow the 2015 election to set Nigeria back in the race to eradicate polio. It is important for all stakeholders to ensure that the polio eradication programme is not neglected. We must engage the press, civil society organizations, parents, and academics to call governments’ attention to health in general and polio eradication in particular.

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Dr Oyewale Tomori is Chair of the Expert Review Committee on Polio Eradication in Nigeria and President of the Nigerian Academy of Sciences. Dr Tomori also serves on several advisory bodies, including WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization, the WHO Polio Research Committee and the WHO Africa Regional Polio Certification Committee. From 1994-2004, Dr Tomori served as the WHO’s African region laboratory coordinator and established the Africa Regional Laboratory Network for the diagnosis of polio and other viral diseases.

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