Disease eradication entails the total stopping of the transmission of an infectious disease, reducing the prevalence of the disease to zero. To date, only one disease — smallpox — has been successfully eradicated. The next disease set for eradication is poliomyelitis, popularly known as polio.
Global efforts to eradicate the polio virus date back to 1988, when the World Health Assembly passed a resolution to eradicate the disease globally by the year 2000 and launched the Global Polio Eradication Initiative. Since then, polio eradication has enjoyed varying degrees of success from country to country. With 350,000 children affected and over 1,000 paralyzed daily, achieving the polio eradication resolution seemed like a tall order.
The first breakthrough was made six years later when the Americas were certified polio free. It took another six years for the western Pacific to be certified polio-free in 2000. And in 2002 the European region was also certified polio free. Since then it has been a herculean task for the remaining two regions of Africa and the eastern Mediterranean regions.
Nigeria holds the ace to a polio-free Africa. The country has been battling with the polio scourge since 1996, when formal polio eradication campaigns commenced. This was the outcome of the late Nelson Mandela’s formal launch of the Kick Polio Out of Africa Campaign. For Nigeria, the eradication of polio thus became an issue of both national and regional dimensions.
Until 2014 — when cases of polio declined dramatically from 53 at the end of 2013 to only six — Nigeria was globally considered a pariah state, touted as the last country that would eradicate polio. The question is often asked: what happened in Nigeria?
The answer is obvious: strong government leadership and oversight. This included the setting up of a presidential task force on polio eradication and the establishment of NPHCDA National Polio Emergency Operations Center, which pooled experts from government and development partners in the various components of the polio eradication program.
The systematic engagement of community gatekeepers and humanizing the campaign through the involvement of polio survivors in building community trust contributed immensely to achieving the success of stopping the transmission of the polio virus. Above all, the greatest game changer was the enforcement of an accountability framework by government at all levels, including partner agencies.
It was therefore with a great sense of fulfillment that the country received the World Health Organization’s formal pronouncement in September — the delisting of Nigeria as a polio endemic country. As the country marks this historic achievement, it is pertinent to state that the program and people of Nigeria must remain focused on the ultimate objective: eradication!
Achieving the goal of polio eradication in the next two years is going to be a tough task. It is therefore expected that all stakeholders sustain — and where need be, increase — their support for the polio eradication program in Nigeria. Government at all levels should continue to provide the necessary leadership, oversight and funding.
To achieve eradication in the next two years, surveillance requires further improvements to make it more sensitive. The quality of the polio campaign must be maintained, by sustaining and scaling up innovative strategies such as health camps, edutainment, street vaccinations, using the Directly Observed Polio Vaccination, as well as deploying the polio infrastructure to strengthen routine immunization and the broader health system.
The program therefore needs sustained funding and the commitment of all personnel, especially the frontline health workers, as well as the support and understanding of all Nigerians as it heads towards eradication in 2017. This is a gift Nigerians and indeed the entire African region deserves.
Dr. Ado Jimada Gana Muhammad was appointed executive director and CEO of the National Primary Health Care Development Agency in 2011. Prior to his appointment, he served as a special assistant in the Abuja state house. He has a distinguished medical career with a wealth of experience spanning almost two decades in the health and public service sectors. He is a graduate of the School of Medicine, University of Ilorin Nigeria, and also holds a master's degree in public health from University of Wales, United Kingdom.
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