Polio last lap- Experts applaud Nigeria’s achievements but caution that more “work is required.”

Abuja, 4th December, 2019 - The 37th session of Expert Review Committee (ERC) on Polio Eradication and Routine Immunization (RI) in Nigeria, ends 2 days meeting but cautions that more needs to be done, to stop transmission of all types of polioviruses.

Making a presentation on behalf of ERC members in Abuja on 04 December, 2019, Dr Pascal Mkanda, the Coordinator, Polio Eradication Programme at World Health Organization (WHO) Africa Regional Office says, “the ERC acknowledges the work done by the programme, especially by the frontline workers who continually work in very challenging situations.”

If Nigeria gets it right, Africa could be certified Polio-free soon
Having achieved the  milestones of being three years’ wild polio-free, Dr Mkanda used the ERC meeting to inform government and people of Nigeria that the African Regional Certification Commission (ARCC) for Polio Eradication certification will start conducting field verification and reviewing documentation of interruption of wild polio virus (WPV) from next week (09 December 2019). If the ARCC is satisfied with the national documentation and field verification, the WHO African Region could be certified to have eradicated WPV by mid-2020.

Nigeria is one of the remaining four countries in Africa (Central Africa Republic, South Sudan, Cameroun and Nigeria) that are yet to have documentation accepted for Polio Certification. 

According to Dr Mkanda, “it is important that the Nigerian government and partners avoid any complacency that could jeopardize Nigeria’s removal from the list of polio-endemic countries and certification of wild polio virus interruption for the African Region”.

The ERC meets periodically to evaluate the progress made in ensuring a polio-free Nigeria. The monitoring body also provides guidance to the government and development partners on best practices in routine immunization in Nigeria. The 37th ERC members who converged to deliberate on key decisions concerning polio eradication and routine immunization strengthening in Nigeria identified critical gaps that should be bridged to maintain the present status towards polio certification.

Residual challenges, likely to threaten achievement 
While the ERC concurs with the Nigeria Programme that the transmission of WPV1 is unlikely, experts are calling on government to galvanize partnerships aimed at reaching children in inaccessible areas, having identified that Nigeria's polio resurgence in August 2016 was largely due to insecurity in the Northeast and waning political commitment. Their collective agreement hinged on the firm belief that interrupting transmission of polio requires systematic processes, focused on reaching children in inaccessible areas, providing timely and adequate resources as well as strengthening RI. The ERC noted rising issues of non-compliance in some communities in Northern Nigeria, especially in Sokoto state

Preliminary Recommendations from 37th ERC
To address issues identified, the ERC recommended that the programme collaborate with the military and take advantage of the dry season to accelerate implementation of reaching children in hard-to- reach and inaccessible areas.

Given the rising cases of non-compliance, ERC recommends that the programme should fast track the roll-out of key messages, including engaging journalists to create awareness and to address the circulating Vaccine Derived Polio Virus (cVDPV2) transmission in the context of zero WPV1 status in the country.

As part of its recommendations, “The ERC further recommends that the programme continues the engagement of traditional, religious and community leaders to sustain gains on immunization”, Dr Mkanda mentioned.

Government and partners renew commitment
Responding to the recommendations, the Executive Director of the National Primary Health Care Development Agency (NPHCDA), Dr Faisal Shuaib said, “The ERC is very important to us. It helps us to brainstorm and gives us the opportunity to do things many Nigerians never thought we could do.” 

Dr Faisal further thanked all the donors and development partners for working assiduously with the Nigerian Government in the fight against polio. 
“In six-months-time, I am confident Nigeria will be removed from list of endemic countries, however, paralysis is paralysis, we need to ensure no child is ever paralyzed again, from any type of polio virus.” 

On 24 October 2019, the World Health Organization (WHO) declared Wild Polio Virus type 3 (WPV3) eradicated globally.   However, the last case of WPV1 was detected in Borno State, Nigeria in August 2016. In collaboration with Government, intense surveillance and monitoring is ongoing across all 36 States of Nigeria and multiple supplemental immunization activities have been implemented nationwide to ensure every child is reached with the live saving vaccines. No case of WPV has been reported in Nigeria for over three years.

Before departing Nigeria, the ERC members debriefed the Minister of Health, Dr Osagie Ehenire on their observations and recommendation.
Support for immunization to the Government of Nigeria through WHO, is made possible by funding from the Bill & Melinda Gates Foundation, Department for International Development, European Union, Gavi, the Vaccine Alliance, Global Affairs Canada, Government of Germany, through KfW Bank, Japan International Cooperation Agency, Korea Foundation for International Healthcare, Measles and Rubella Initiative through United Nations Foundation, Rotary International, United States Agency for International Development, United States Centre for Disease Control and Prevention and  World Bank.

Technical Contacts:

Dr Richard Banda; Email: bandari [at] who.int; Tel: +234 803 535 4875

ERC Chairman, professor Oyewale Tomori(5th Right) ED of NPHCDA, Dr Shuaib (4th Left and members of the 37th ERC in Abuja
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