As part of his campaign to be re-elected, Nigeria’s President
Goodluck Jonathan has reportedly said that his administration has
“totally eradicated” polio.
According to This Day newspaper, Mr. Jonathan said
that the World Health Organisation (WHO) should take the required steps
to declare Nigeria polio-free, as it did with Ebola. President Jonathan
is said to have made the remarks at the Palace of the Asagba of Asaba,
Chike Edozien, on February 27.
Mr. Jonathan’s claim follows that of the health minister, Halliru
Alhassan, who said in January that Nigeria would “be certified
polio-free” that month. Punch newspaper wrote that Mr. Alhassan had said
that the country qualifies “to be declared polio-free in line with
global requirements” because no polio cases had been diagnosed in the
last six months of 2014.
But the chairman of Nigeria’s expert review committee on polio
eradication, Oyewale Tomori, was widely reported to have said recently
that Nigeria can only be certified as polio-free in 2018 should there be
no further cases of polio before then.
Who is right? Could Nigeria soon be officially declared polio-free or only in 2018?
Six cases in 2014
Polio infections are usually symptom-free, but in about one in 200
cases it causes paralysis, usually in the legs and often for life.
People can die from polio when the virus paralyses the muscles that help
them breathe.
Thanks to immunisation, the disease has been eradicated from most of
the world. Only Nigeria, Afghanistan and Pakistan remain on the WHO’s
list of polio-endemic countries.
Its toll is highly visible on the streets of Nigerian cities like
Lagos, where victims wheel themselves around on skateboards. By
mid-2003, polio was on the verge of being eradicated in the country when
a group of religious and political leaders in northern Nigeria claimed
that the polio vaccine caused infertility. They advised their followers
against having their children vaccinated. What followed was a surge in
new cases.
Since then the Nigerian government and its international partners have
made steady progress in finally eradicating polio. In 2014, Nigeria’s
total case count was 6, compared to 53 in 2013, a reduction of almost
90%.
How polio certification works
To ensure that a country is truly free of polio, the WHO requires two waiting periods.
The first is measured from the date that paralysis commences in the last
case of “wild polio”. (Wild polio refers to a form of the virus that
was common in pre-vaccination times and caused a large burden of
disease. It has been virtually eliminated except in the countries where
polio is still endemic.) If a year passes without any new cases
diagnosed, the WHO removes a country from its list of polio-endemic
countries.
Nigeria’s last case was identified on 24 July 2014. The country could
therefore be taken off the WHO’s list of polio-endemic countries in four
months’ time should there be no new cases.
To be certified polio-free, WHO rules require that a country and its
regional neighbours prove that they have stopped the transmission of the
polio virus for at least three consecutive years. Detailed laboratory
testing data must be submitted to support this.
Therefore, if Nigeria experiences no further cases of polio, the region could be certified polio-free by 2018, at the earliest.
Backsliding still possible…
There are concerns that the upcoming elections may harm Nigeria’s
progress. A surge in cases followed every poll since 2003, because
outbreaks of violence prevented health workers from immunising children.
There are also worries that the focus on polio eradication undermines
routine immunisation programmes. But the systems put in place to tackle
polio were credited with helping Nigeria successfully manage its Ebola
outbreak last year.
Conclusion: Claims that Nigeria could be declared polio-free in 2015 are incorrect
Nigeria identified its last case of polio in July 2014. Should no
further cases be recorded, the country will be taken off the WHO’s list
of polio-endemic countries this July.
But it will take much longer for the region to be certified
polio-free, as WHO rules require three years to pass from the time the
last case is recorded in a country.
At best, Nigeria could be certified polio-free in 2018. Claims that
it could happen this year are therefore premature. Nigerians need to
stay extra vigilant, especially around election time later this month.
Dr Ike Anya is a Nigerian doctor, specialist in public health medicine, and co-editor of Nigeria Health Watch.
This fact-check was done by our partner, Africa Check, a non-partisan
organisation which promotes accuracy in public debate and the media. We
have its permission to republish. Follow the organisation on Twitter at
@AfricaCheck or visit its website at www.africacheck.org
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