afrol News, 23 October - As polio was on the brink of extermination, a new polio outbreak is now spreading from Nigeria to neighbouring countries. 15 million children are at risk in Benin, Burkina Faso, Cameroon, Chad, Ghana, Niger, Nigeria and Togo, the World Health Organisation (WHO) says.

WHO in a statement said that the outbreak is requiring an immediate and massive immunisation campaign across these five countries in West and Central Africa. Beginning yesterday, hundreds of thousands of volunteers and health workers in Benin, Burkina Faso, Ghana, Niger and Togo "will aim to reach every child in those countries with polio vaccine in just three days," the agency reports.

The campaign, organised at a cost of more than US$ 10 million, comes in response to nearly a dozen children being paralysed in Burkina Faso, Ghana, Niger and Togo, from poliovirus genetically traced to northern Nigeria.

A further case recently reported in Chad means similar campaigns are planned in that country and Cameroon for mid-November. The polio-infected states in Nigeria, centring around the state of Kano, have re-infected other areas of the country, most worryingly the city of Lagos with its ten million inhabitants.

- Nigeria is now the country with the greatest number of polio cases in the world, said Dr David Heymann, Representative of the Director-General for Polio Eradication, WHO. "Polio continues to spread within Nigeria to areas which were polio-free and also to neighbouring countries. Polio and other infectious diseases know no national boundaries. We face a grave public health threat, and our goal of a polio-free world is in jeopardy."

Senior epidemiologists from the Global Polio Eradication Initiative convened a high-level meeting with the Nigerian Minister of Health at the end of September, at which the Minister provided his assurance and commitment to eradicate polio in Nigeria by end-2004.

- To successfully meet this goal, strong political support must be established or strengthened at the sub-national level, WHO however warns. "Political and community leaders must be engaged to facilitate the logistical organization of immunization campaigns, and ensure all children are reached during the activities."

- Nigeria is the most populous nation in the region, and in many ways it has been a good neighbour, contributing to peacekeeping in West Africa, commented Carol Bellamy, leader of the UN children's agency, UNICEF. "Now it has another crucial role to play in the region, and that is stomping out polio once and for all. We need all Nigerians, particularly community leaders, to step up and do their part to end polio."

Dr Bruce Aylward, Global Co-ordinator Polio Eradication Initiative, WHO, said that the situation in Nigeria had become the last major challenge on the road to global polio eradication: "Because of the tremendous progress made in 2002, the polio eradication tactics and resources were shifted in 2003 to focus on just those few remaining countries which remained endemic," he says.

- But the situation in Nigeria is now forcing us to go back to countries which had already eliminated polio, Mr Aylward adds. "We simply cannot afford to see these isolated viruses again paralysing children in areas which had previously been polio-free. That is why this massive campaign is critical.”

Epidemiologists attributed the marked increase in cases in Nigeria, around the state of Kano, to insufficient coverage during both polio immunisation campaigns and routine services.

Monitoring data had highlighted that in at least one Nigerian state, as few as 16 percent of children had been sufficiently immunised against polio, WHO found. A difficult environment had "severely compromised the quality of polio campaigns and helped spread rumours about the safety of the oral polio vaccine."

Despite the apparent setback, epidemiologists were convinced polio could be eradicated also from Nigeria. "Polio eradication is feasible in Nigeria," said Dr Walter Orenstein, Director of the US National Immunisation Program. "Much of the country was already polio-free for over two years, including Lagos. The challenge now is to increase the quality of polio campaigns in the key endemic areas of the Nigeria, and reach all children during activities," he adds.

- Further resources are required for this unforeseen campaign, WHO however emphasised. "The Nigeria outbreak is only one global risk to the goal of a polio-free world, as globally the Initiative continues to face a funding gap of US$ 210 million for activities through 2005," the UN agency added.

The Global Polio Eradication Initiative is spearheaded by WHO and UNICEF. The poliovirus is now circulating in only seven countries, down from over 125 when the Global Polio Eradication Initiative was launched in 1988.

The remaining seven countries with indigenous wild poliovirus are: Nigeria, India, Pakistan, Egypt, Afghanistan, Niger and Somalia. Additionally, in 2003, polioviruses from endemic countries had been imported into Burkina Faso, Ghana, Lebanon, Niger and Togo.

By staff writer

© afrol News

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