Re: Nigeria: Polio cases 2009
Source:
http://www.ngrguardiannews.com/focu...t, a concert of efforts against polio, others
Monday, March 30, 2009
On the West Coast, a concert of efforts against polio, others
As Nigeria at the weekend joined other West Africa countries for the second round of the regional synchronized immunization campaign against polio, recent figures from the World Health Organisation (WHO) indicates that the number of children in the high risk states in Nigeria who has been paralyzed by the wild polio virus in 2009 has declined by over 80 per cent as compared to the same period in 2008.
By Chukwuma Muanya and Collins Olayinka
The second round of the regional synchronized polio immunization campaign involving Nigeria, Benin, Niger, Togo, Ghana, Mali, Burkina Faso and Cote d'Ivoire, which kicked off on Saturday March 28, 2009, has re-emphasised the renewed efforts by stakeholders to eradicate the disease.
The exercise which ends on Tuesday March 31, 2009, according to the Count Down to polio eradication in Nigeria, is to consolidate on the first synchronized round held from February 28 to March 3, 2009 during which government officials, partners and stakeholders from various countries rallied to ensure the vaccination of eligible children in the border and other areas.
The Count Down on polio eradication in Nigeria is a monthly online publication by stakeholders.
Also, latest statistics from the World Health Organization (WHO) indicated that the number of children in the high risk states in Nigeria who has been paralyzed by the wild polio virus in 2009 has declined by over 80 per cent as compared to the same period in 2008.
According to Count Down to polio eradication in Nigeria, as at March 20, 2009, 98 children were paralysed by polio in 74 Local Government Areas (LGAs) in 21 states. This is compared to 103 cases in 77 LGAs in 19 states, same period of 2008.
In 2008, the WHO reported a nine-fold increase in new cases of wild poliovirus type 1 (WPV1) compared with the same period in 2007. This outbreak in northern Nigeria caused major international outbreaks, as occurred in 2003-2006. Also, Nigeria, last year, accounted for 86 per cent of WPV1 cases in the world.
There is also a strong drive by the European Union Partnership to Reinforce Immunization Efficiency in Nigeria (EU-PRIME) to use improved routine immunization coverage to fight polio.
Specifically, the project by the European Union was meant to strengthen routine immunization-related activities in the 23 select states with a view to replicating success stories in other states of the federation.
Routine immunization is a programme, which ensures that a child, from birth, gets vaccination against vaccine preventable childhood killer diseases such as polio, tuberculosis, diphtheria, meningitis, whooping cough, measles, chicken pox.
Partners of the Government of in the fight against polio include: United states Centre for disease Control (CDC), Canadian International Development Agency (CIDA), Dangote Ltd, British Department for International Development (DFID), European Union (EU), Gates Foundation, Government of Japan, Korea National Committee, Rotary International, United Nation Children Fund (UNICEF), United States Agency for International Development (USAID,) WHO and World Bank
Medical experts insist that the time has indeed come for a paradigm shift. They say routine immunization holds the key to the early eradication of polio and other vaccine preventable diseases on a sustainable basis in Nigeria.
WHO Country Representative in Nigeria, Dr. Peter Eriki at the occasion of the Presidential flag off of the March 2009 Immunization Plus Days (IPDs) Campaign at the Maitama Hospital in Abuja described the reduction in polio spread as 'very significant.' He said the WPV1 causes more paralysis than other forms of wild polio virus and spreads more rapidly.
"There is early evidence of improving quality of coverage of immunization campaigns particularly in the highest risk states. The proportion of un-immunized and under immunized children in some of the highest risk states is declining," he said.
Eriki, however, sounded a note of caution about the renewed immunization efforts in the country: "Although the evidence so far is promising, the renewed efforts to improve immunization coverage needs to be further intensified and sustained, if the goal of stopping transmission is to be achieved."
He suggested that every effort should be made to ensure that the renewed political commitment is translated into improved quality of immunization particularly at the community and settlement level where the interaction between parents and service providers takes place.
Eriki spoke on behalf of development partners working in the area of health in Nigeria.
The immunization exercise; was flagged off by Vice President, Dr. Jonathan Goodluck. Others present were Health Ministers, Professor Babatunde Osotimehin and Dr. Aliyu Idi Hong and the Federal Capital Territory (FCT) Minister, Senator Adamu Aliero.
Eriki commended the strong commitment of the Nigerian government, especially with the new leadership at the Federal Ministry of Health and the National Primary Healthcare Development Agency.
He reaffirmed the full commitment of the development partners to stand by the Government and people of Nigeria in this initiative to eradicate polio, which he aptly described as 'historic'.
Minister of Health, Professor Babatunde Osotimehin assured all concerned that the government and people of Nigeria are determined more than ever before, to make sacrifices to rid the society of the paralyzing effects of poliomyelitis and other childhood killer diseases. He said the gains made in the 2008 Integrated Measles Campaign and the efforts to contain the recent outbreaks of Cerebro Spinal Meningitis (CSM) and Lassa fever are testimonies of the federal government's resolve.
An immunization Expert and Team Leader of EU-PRIME, Dr Abba Umar said stamping polio out of Nigeria squarely rests on efficient routine immunization at the community level.
"The first step in the six initial states was to build the capacity of the participating states to deliver immunization services within the ambience of the primary healthcare system," he said.
Abba explained: "The EU-PRIME project developed institutional capacity by providing cold chain equipment that is used for vaccine storage to make them potent. 148 vehicles have been procured for distribution to the 23 states to ease movement of vaccines and ensure monitoring and evaluation. Apart from these, the project has also procured 500 motorcycles for distribution to the participating states. With these equipment therefore, it is not surprising that routine immunization coverage has gone up in many folds in these states.
"The realization that the burden of vaccine preventable diseases is more in the rural areas where there is no constant power supply influenced the introduction of solar-powered refrigerators to ensure potency of immunization vaccines."
Abba explained the rationale behind the adoption of the community-based approach. "You and I know that power is not constant in most parts of the country especially in rural communities. The intention is to take solar refrigerators to these areas where there is no electricity or erratic power supply. If the potency of the vaccines should be maintained, there is the need to use a specific system that can work in such an environment and that was the reason we went for solar refrigerators in order to make sure that we administer potent vaccines on the children," he said.
The EU-PRIME boss highlighted that the reason for increasing the number of participating states from the initial six to 23 was informed by the desire to replicate the success story that the project recorded in the initial six states.
To ensure that the routine immunization in the newly added 17 states is shored up, contract for the construction of cold stores was recently awarded in Abuja. The project is being implemented in the following 23 states: Abia, Akwa Ibom, Anambra, Bauchi, Cross River, Ebonyi, Edo, FCT, Gombe, Jigawa, Kaduna , Katsina, Kogi, Kebbi, Kwara, Lagos , Ogun, Osun, Plateau Yobe, Rivers, Sokoto and Zamfara states.
Project Officer for Health, Delegation of the European Commission to Nigeria, Dr. Anthony Ayeke said that the project was midwife to address the burden of vaccine-prevented diseases, which was quite high at the time. In doing this, he said, it was found that there was the need for management coordination of immunization services and coordination of various stakeholders.
His words: "The EU-PRIME has two basic components. The two components were routine immunization and polio eradication. The technical assistance was engaged sometime in 2004 but it did not come on board actively until 2005. So, to adequately quantify what the project has done one has to begin from June 2005 when the technical assistance started. From the indicators that we used such as DPT 3 to measure how well we have done in terms of coverage, reports we got from various states like Kebbi at the inception of the technical assistance, the routine immunization coverage, using DPT 3 as an indicator, was about 1.8 per cent. As at last year when we conducted another study, the coverage was about 82 per cent. In addition to this, we discovered that in states like Kebbi and related states, in 2007 and 2008, the state governments were motivated to buy cold chain equipment on their own which cost almost N1billion. This step is most impressive because it is one of the expected multiplier outcomes of projects like PRIME."
Ayeke said EU-PRIME has helped to provide items such as refrigerators, vaccine carriers and cold chain stores to address the infrastructural gaps and to support the weak routine immunization infrastructure at state and local government levels. Vehicles were also procured for vaccine distribution, monitoring and supervision in the participating states.
Ayeke also said there is no reason to get worried because the project is ending adding that it has achieved the purpose it was set out to achieve.
"There is a financial agreement that cannot be flouted. The project, apart from providing physical structures, has also done very well in awakening the consciousness of key stakeholders on why routine immunization must be strengthened. This awakening is shown in the concerns that have been expressed that the project is ending. The Commissioners of Health in some states have publicly come to say that they will not allow the initiatives spearheaded by the project to die in their states and that they are ready to do whatever it takes to ensure that what the project began is sustained," he explained.
In his assessment of the project, the Executive Director of the National Primary Health Care Development Agency (NPHCDA), Dr Mohammed Pate the agency has recorded resounding success in the effort towards strengthening routine immunization in Nigeria.
He said: "The programme on the whole tried to address a gap in our primary healthcare system by trying to tackling routine immunization. From the report available to me, as a project that has been on in the last couple of years, they have done very well in terms of providing infrastructure, transport logistics, training and capacity building efforts and advocacy in the states that they work."
The NPHCDA boss identified routine immunization as the bedrock upon which polio eradication rests. He also added that if polio would be eradicated from Nigeria, the current approach that has placed supplementary campaign in place of routine immunization must change.
He explained thus: "The supplementary campaign by definition is only supplemental. The polio eradication strategy has four pillars. The first leg is Routine Immunization, which is built around primary health care system to enable that level of care offer routine immunization. The second pillar of the strategy is supposed to be supplemental to routine but what we find in the last couple of years is that the supplemental is becoming the routine while the routine has become supplementary. That is not the way it should be. We are trying to reverse this ugly trend by advocating to state and local governments to invest in routine immunization through additional money, people and materials to ensure availability of routine immunization services while improving the quality and efficiency of the campaigns. The third element is the mop up where there are cases of outbreak and surveillance system. Routine Immunization, in its totality is a proxy for health system performance."
The Kebbi State Commissioner of Health, Alhaji Abubakar Dakin Gari submitted that the renewed efforts have opened a new vista of understanding on why government should commit more resources to strengthen immunization equipment such as cold chain, solar power-refrigerators in the rural areas.
"The project has been a very successful one in Kebbi State . The solar energy provided to power refrigerators in the rural has resulted into ensuring greater efficiency of vaccines. We now have 461 refrigerators spread across the 21 local government areas in the State," he stated.
The Commissioner added that the State is now taking the issue of routine immunization very seriously as it has empowered a technical committee for strengthening routine immunization. Free accommodation has equally been provided to encourage health workers to work in the rural communities.
The Abia State Commissioner of Health, Dr Sam Ahaiwe lauded the project for pushing routine immunization coverage from 21 per cent to 80 per cent in the state. He also said that all the 17 local government areas now have three solar-powered refrigerators each to boost routine immunization at the ward level.
Abba claimed that the impact of the project was also felt in the Niger Delta region where difficult terrain has been identified as a stumbling-block to the immunization drive.
According to Count Down on polio eradication in Nigeria, the quality of the second West Africa synchronized polio campaign at the community level will be the evidence of the commitment of all stakeholders involved.
