HEALTH INTERACTIVE WITH DR AMINU MAGASHI

Polio Spread: An Appeal to W.H.O and Kano

healthinteractive@hotmail.com

In my introductory paragraph of an article published on this page entitled ‘Rivalry Among Health Professionals: The Polio Experience not too long ago, I made an assertion that the heat concerning polio saga was off then ,  I was under the impression that since there was very few reportage, features writings and commentary about the imbroglio, all was well and the only issue that remained, was to ensure the return of Kano State to flag off immunization days for the final push.

Recent happenings and the bad news emanating from Geneva , the home of World Health Organization (WHO) has really proved me wrong and of course the world is far from achieving polio free environment in the near future. In a story captioned ‘Nigerian Fear Lead To Wide Spread Outbreak on page 22 of New Nigerian Newspaper of Friday, June , 25^th, 2004 . Dr David Heymain, WHO representative of Polio Eradication was reportedly quoted to have mentioned that fear and rumors in northern Nigeria about polio vaccination have led to an outbreak of polio undermining an ambitious campaign to eradicate polio by the end of this year (2004). The disease has swept from Nigeria into 10 other African countries that had been declared polio free, threatening the largest epidemic seen in years.

WHO officials have also confirmed that a child in crisis-ridden Darfur In West Sudan had been paralyzed by polio , the first case in the country in 3 years and the polio virus in Darfur was closely related to the virus found in Nigeria . While Dr Heymann reportedly said more recent figure shows that there are closer to 300 polio cases in Nigeria , WHO officials fear that with the approaching rainy season, thousands more could contract the disease since the virus is spread by poor hygiene and contaminated water. The story is corroborated in a press release by WHO  in its website entitled ‘Polio Experts Warn Of Largest Epidemic In Recent Years, As Polio Hits Darfur (22nd, June, 2004). The additional information which was not contain in New Nigerian story, is that the re-infection of the Sudan is the largest set back to the strong progress Africa has achieved in eradicating polio. At the beginning of 2003 only two countries in sub Saharan Africa were polio endemic. Today, how ever Africa accounts for nearly 90 % of the global polio burden, with children now paralyzed in ten previously polio free countries across the continent. Equally same report mentioned that the virus found in Darfur in Sudan is closely linked genetically to polio virus endemic to northern Nigeria and Kano state remains the epicenter of the outbreak

Going by this worrisome and awesome report, it is obvious that all the collective effort by stakeholders is more or less like pouring water in to a basket and the scenario of reported outbreaks here  and there in Africa make the attainment of polio free world a very herculean task, but what is more worrisome is the attitude of WHO officials and their remark insinuating that the suspension of polio eradication programme in some states in northern Nigeria was based on rumors and suspicion. If they mentioned that last year, no one will blink, but at this stage when all previous investigations by Kano State, Jamaatul Nasril Islam, NPI and NAFDAC had confirmed traces of Estradiol and I believe such findings were made available to WHO officials, by that assertion of rumor and suspicion, they left people with no choice but to assume that, they are either being mischievous and have some prejudice or they are not current and out dated about Nigeria’s polio controversy. Both the former and latter portray them as poor advocates.

The bone of contention in Nigeria is an issue of whether the Estradiol level can cause harm or not and of course the majority of the polio stakeholders are of the belief that it will cause no harm, hence the declaration of the vaccines currently being used in the country safe for human consumption. WHO officials should bear in mind that Nigeria has out grown the era of rumor and suspicion. Another abracadabra   being exhibited by WHO is to always point one directional accusing finger to northern Nigeria and  particularly Kano state as the depot when ever a case of polio is discover else where in  Africa . One directional accusation will definitely lead to overlooking some salient issues of paramount importance to polio spread. In all the reports and news from the body, it is either the virus is closely related or closely linked genetically to the polio endemic in northern Nigeria . The language being used indicates that there is no certainly but assumption and that is always the case. My appeal to WHO is to look beyond the possibility of exportation of polio virus from Nigeria to other African countries  but to  other human nature and error. As we all know that some of those impoverished countries are devastated by war and drought. The people in those regions are bedeviled by poverty, hunger, diseases and dirty environment which may precipitate outbreak of communicable diseases like cholera, other diarhhoeal diseases and poliomyelitis. How ever, not with standing, there is a possibility of exportation from Nigeria but a very rear chance, but nothing stop WHO from making a comparison between the genetic component of the virus discovered recently in Sudan with the genetic component of the cultured and stored virus in the same country when it was an endemic area of polio 3 to 4 years. Until such comparison is made and publish for all to see, the respected body will continue to be jumping from one dilemma and another in trying to solve the puzzle and mystery of polio spread in Africa.

On the part of Kano state, I strongly frown over the delay in the take off of polio immunization programme , as we were made to believe that the state has purchased its own vaccine from Indonesia as was reported in Daily Trust of Monday, 17^th May, 2004, one is really in a dilemma as to what is responsible for the delay in the implementation of the programme. Despite the alledge exaggerated media report about the state being the major reservoir of polio in Africa, I believe polio virus exits in the state and there is the need to hasten preparation for the flagging off , so that the non- immunized children will not suffer an endless and lifetime debilitation of poliomyelitis.

Overall, my general appeal to all polio stakeholders ( International Donor Agencies, NGOs, foundations, governments and media ) is to expand the horizon of polio eradication by ensuring immunization side by side with  environmental hygiene and sanitation through effective policy reform and funding on environment, that way African states will follow other sister states in the West in ensuring polio free environment.

Dr Magashi Is The Executive Director Of Community Health and Research Initiative, Kano, Nigeria and can be reached at healthinteractive@hotmail.com