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HEALTH
INTERACTIVE WITH DR AMINU MAGASHI Malaria, Polio and African Child In the past before the resumption of Polio Eradication Program by Kano State Government in northern Nigeria, when ever a sporadic case was discovered in some African countries, the World Health Organization ( WHO ) was always ever ready to point one directional accusing finger to northern Nigeria, particularly Kano State, the alleged major reservoir of polio virus. How ever such accusation to some extent was being done with some dignity and doubt, the adjectives being used was that, the virus discovered else where was closely related and link genetically to the virus obtained in kano and being exported else where. As I argued in the past, one is bound to miss a lot of links as to the actual problems and certainly the programmes will continue to suffer a set back due to that deficiency. Astoundingly WHO is no longer using the adjectives ‘ closely related or link but has changed the strategy for a reason best known to them. In the recent new infection in Guinea and Mali as well as three new cases in Darfur region of Sudan as it was reported by WHO in a press release ‘New Polio Cases Confirmed In Guinea, Mali And Sudan On 24th August, 2004 (www.who.int/press releases) . It was reported that the ongoing polio outbreak which ORIGINATED (emphasis mine) from northern Nigeria continues to infect new countries under scoring the threat of a major epidemic across West and Central Africa. The epidemiologists from the Global Polio Eradication Initiative today (referring to 24th, August) confirmed the reinfection of Guinea and Mali as well as three new cases in Darfur region of the Sudan. In the past, there were only 6 polio endemic counties : Nigeria, Niger, Pakistan, Afghanistan, India and Egypt, but as at 24th August, 2004 with 602 cases reported cases globally, other African countries have had their share of polio cases , among them are Chad ( 12 cases ) , cote d ‘ Ivories ( 9 0, Burkina Faso ( 6 ), Benin ( 6 ) , Sudan ( 5 ) , the central Africa republic (3 ), Mali ( 2 ) , guinea ( 1 ), Cameroon ( 1 ), Botswana ( 1 ). The reader will agree with me that these sporadic cases in so many African countries purportedly and allegedly being exported from Nigeria , if something is not drastically done the problem may escalate else where and affecting non immunized children, which if that happen, attainment of polio free world in 2004/05 will remain a fantasy. As WHO, UNICEF, Rotary International and US Center For Disease And Control and other donor countries and private foundations and other stakeholders are desperately and aggressively campaigning and implementing Polio Eradication Program through immunization only, I want to believe they are misleading themselves by looking at only one alleged reservoir of infection. And also to use one approach in eradicating polio, there are missing links and gaps which to my opinion is being deliberately overlook and carpeted by the leading two agencies on Polio ( WHO and UNICEF ), I will come to that later. Let me take a look at another notorious problem in Africa, Malaria which is eliminating children at every second mostly as a result of complications (Anemia, Convulsion, Cerebral Malaria And Hypoglycemia). Malaria is among the major disease burden in Africa afflicting mostly children and pregnant women. It is part and parcel of the goals set up by world leaders in September, 2000 tagged ‘Millennium Development Goals (MDGs) and of course one will remember with nostalgia, The Roll Back Malaria Project which was launched in April 2000 in a world summit at Abuja, Nigeria. A lot of people were hopeful and enthusiastic about the concept then, such hope has turn to hopelessness as the project is not taking any heed and recording success in African countries. The overall goal is to half the burden of Malaria by 2010 (50 % reduction). As the project enters its 5th year, even the major stakeholders of the project (WHO, UNICEF, World Bank, UNDP and African leaders and DFID) will agree with me that we have along way to go. A lot of funding promises were not met and among the 4 components of the projects which focus on treatment of vulnerable groups, malaria prevention and control, response to epidemic and provision of Insecticide Treated Mosquito Net (ITN). The stakeholders unfortunately priorities the objectives according to their own perception without looking objectively as to what measure will reduce the burden and realize the set goal. They are more interested in provision, supply and marketing ITN and five years in to the project, it is still not available, accessible and affordable to the common man. Also discouraging the use of a cheaper anti malarial drug (Cloroquine) in a guise of having resistant parasite and advocating for an expensive drug as a replacement (Artemisinin derivatives). One major area which has been totally neglected is the environmental problems in Africa. The approach being undertaking by stakeholders on Malaria in Africa will more or less push the burden forward and attainment of even reduction of 25 % not 50 % burden by 2010 will remain a night mare. What do Polio and Malaria have in common and to my understanding that is the missing link, which deliberately overlooked by all of us. In another press release by WHO on 26th August 2004 entitled ‘World Facing Silent Emergency As Billions Struggle Without Clean Water or Basis Sanitation Say WHO And UNICEF. It says that more than 2.6 billion people over 40 percent of the world population do not have access to basic sanitation and more than one billion people still use unsafe sources of drinking water. The global sanitation target which is part of MDGs will miss by half a billion people-most of them in rural Africa and Asia- allowing waste and disease to spread, killing millions of children and leaving more on the brink of survival. The report recommended that to meet the 2015 targets, countries need to create the political will and resources to serve a billion new urban dwellers and reduce by almost 1 billion the number of rural dwellers without access to adequate sanitation facilities. Both
the Polio And Malaria spread are entirely related to environment, the
breeding site for mosquito are gutters, bushy environment, slums and
ponds and the Polio virus which is excreted in faeces is being spread by
sewage contamination with source of water, food and soil and in a
typical African setting, Malaria and Polio and Environmental
problems are the missing links in eradicating Polio by 2004/05 and
halving Malaria burden by 2010. The approach how ever should be
immunization and provision of insecticide treated nets and an aggressive
and desperate campaign, programmes, and policy reforms towards investing
in Environment which will
definitely ensures Polio Eradication And Malaria Control. Dr Magashi Is He Executive Director, Community Health And Research Initiative, Kano, Nigeria. |