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HEALTH: The End of Polio Is Near

Gustavo Capdevila

GENEVA, Aug 6 2004 (IPS) - The spread of poliomyelitis could be totally curbed this year worldwide and the disease could be eradicated by 2005, thanks to the removal of the last obstacles in Africa, David Heymann, World Health Organisation (WHO) special representative on polio eradication, said Tuesday.

The polio immunisation campaign resumed over the weekend in the northern Nigerian state of Kano, where it had been suspended a year ago due to rumours about the safety of the vaccines, the WHO expert told reporters in Geneva.

Circulating around that largely Muslim area were ”rumours that either (the vaccine) was contaminated with HIV (the AIDS virus) or that it contained elements of family planning which sterilised young girls,” Heymann added.

Due to the rumours, Kano Governor Ibrahim Shekaru called off the vaccination campaign, as did authorities in other northern states in Nigeria.

The suspension of the campaign led to a resurgence of polio cases in Kano and other Nigerian states, and in neighbouring countries that had been declared free of the disease. Of Nigeria’s 37 states, 30 have reported cases of polio, and the disease has reappeared in a total of 10 African nations.

The Nigerian government subsequently set up a commission to evaluate the safety of the vaccines, and the authorities in Kano set up two separate teams of experts to do the same.

The verdicts handed down by the commissions cleared up the doubts and recommended that the immunisation activities continue in Kano state.

When the vaccinations were resumed on Saturday, Governor Shekaru himself administered the vaccine to four children of government officials, which ”seems to be a message many people were waiting for,” said Heymann.

He added that while there was still some resistance to the vaccination campaign from certain religious leaders, the Nigerian press had overall taken a ”very positive” attitude to the resumption of the campaign.

Heymann said the renewed vaccination efforts in northern Nigeria would allow that region to ”catch up” with the southern states and the rest of West Africa, and to prepare for the synchronised immunisation campaigns that are to be carried out in 22 countries of West and Central Africa from September to November.

Polio is an infectious viral disease of the central nervous system that causes muscular atrophy. The greatest incidence of the disease, also known as infantile paralysis, is in children between the ages of five and 10.

So far this year, 538 children have been infected worldwide, including 430 – 80 percent of the total – in Nigeria, said Heymann.

Other affected countries include India, Pakistan, Afghanistan and Egypt, which ”have the lowest ever reported numbers of cases of polio” this year, he added.

”We believe that they will be able to interrupt transmission…in the next few months,” said Heymann. The Asian countries ”are now in the highest transmission season for polio…and they have been able to maintain very low levels, which is highly encouraging.”

He warned, however, that there are still risks in those countries, like the possibility that governments will feel confident ”and say: we have done the job,” let down their guard, and allow polio to return.

The four bodies behind the global campaign – WHO, the United Nations children’s fund (UNICEF), Rotary International and the U.S. Centres for Disease Control and Prevention – have a goal of complete eradication of the disease around the world by 2005.

In the case of Africa, transmission could be cut this year. However, ”once transmission is interrupted they need at least a period of three to six months to be sure that you have interrupted transmission, and twelve months to be certain,” which means success would not be confirmed until next year, said Heymann.

With respect to the religious leaders, the WHO official said they are ”very important,” and that UNICEF is working closely with them in Central Africa.

President Mamadou Tandja of Niger expressed concern because the rumours in Nigeria about the safety of the vaccines reached southern Niger, which borders Nigeria to the north.

Tandja, fearing a drop in vaccine coverage in Niger, visited the southern part of the country accompanied by imams and other local religious leaders, swiftly dispelling the rumours, and ensuring that the immunisation was broadly accepted by the population, said Heymann.