Intensifying attacks by Islamist rebels are undermining a drive backed by donors including the Bill and Melinda Gates Foundation to eradicate polio in Nigeria, one of three countries where the disease remains endemic.
Gunmen abducted three health workers carrying out vaccinations in Bauchi state in March and killed nine others in attacks on polio immunization centers in the northern city of Kano last year. Police suspect the assailants were members of the Islamist group, Boko Haram, whose abduction of more than 200 schoolgirls on April 14 sparked global outrage.
“When security problems are there, it’s very difficult in terms of accessibility, but also in terms of mobilization of vaccinators,” Rui Vaz, the World Health Organization’s country representative in Nigeria, said by phone from Abuja, the capital. “There are always fears, logistic problems to reach those areas.”
Donors including the Gates Foundation and Rotary International are spending $1 billion a year worldwide to eliminate the virus, including in Nigeria and the two other countries that are polio-endemic, Pakistan and Afghanistan, a region where Taliban militants have attacked vaccinators.
In Nigeria, the biggest threat to the polio workers comes from Boko Haram, which means “western education is a sin” in the Hausa language and has waged a five-year campaign to impose Islamic law on Africa’s most populous nation. It has focused its insurgency in the northeastern states of Borno, Yobe and Adamawa.
The militant group was responsible for the abduction of at least 91 people, including 60 women, from June 19 through June 22 in the northeastern villages of Kumanza, Yaga and Dagu, Abba Aji Khalil, chairman of the local vigilante group, said yesterday.
“Access continues to be a challenge particularly in the high risk northern states of Borno and Yobe,” Melissa Corkum, a United Nations Children’s Fund, or Unicef, spokeswoman on polio, said in e-mailed comments from Abuja. “The security of everyone working in the program continues to be a concern.”
The WHO last month declared polio a global health emergency, less than two years after the virus was driven to the brink of extinction. Global cases of polio fell to a record low of 223 in 2012. The virus resurged last year, with 416 cases reported in eight countries, according to the WHO. So far this year, 103 cases have been reported globally, compared with 77 in the same period last year.
The consequences of Nigeria’s failure to eliminate polio are evident on the streets of major cities where victims with wasted limbs propel themselves on skateboards, weaving through busy traffic to beg for a living.
Nigeria missed a 2005 target set by the United Nations to end polio partly because people rejected vaccines after some Islamic preachers in Nigeria’s mainly Muslim north said it was a U.S. ploy to sterilize followers of the faith.
The vaccination effort made some progress after receiving the support of high profile regional Muslim leaders, including the Sultan of Sokoto Sa’ad Abubakar III, the spiritual leader of Nigerian Muslims.
“People are even willing more than ever before to bring out their children for inoculation,” Kano State Police Commissioner Adenrele Shinaba said in a May 22 interview at his headquarters in the northern city. “There was a time they had problems, they had issues trying to inoculate people, but now I think there are enough enlightenment campaigns.”
The West African country’s four confirmed cases of polio this year were in Kano and Yobe states, compared with 26 cases a year earlier, according to WHO. The most recent case was reported this week in the Sumaila district of Kano state, according to Unicef. Nigeria’s southern and central states have been polio-free for years and President Goodluck Jonathan’s government has set a target to stop new polio virus transmissions by the end of this year.
This is “the best chance we’ve ever had to stop polio in Nigeria,” said Michael Galway, the deputy director in charge of polio program strategy and implementation at the Bill and Melinda Gates Foundation. “All of the indicators that we need to see moving in the right direction are all pointing the right way.”
The intensification of Boko Haram’s insurgency is threatening to reverse that progress.
The risk of a resurgence of the virus is also rising as the country enters the rainy season that lasts from mid-May to the end of September, said Unicef’s Corkum. New outbreaks in neighboring Cameroon have increased the chances of the virus coming across the border, she said.
In the states most affected by the violence and emergency rule, intensive vaccination campaigns are run over a short period within two weeks instead of the typical six, Galway said.
Instead of sending one team to one village over a few days, five or six are sent to vaccinate in a single day when the area is safe, reducing the health workers’ exposure to danger, he said.
At least 16 percent of the children in Borno, the birthplace of Boko Haram, remain inaccessible, according to the Gates Foundation.
“There are parts of Nigeria where we don’t know what’s happening,” Oyewale Tomori, chairman of the Expert Review Committee on Polio Eradication and Routine Immunization in Nigeria, said from Abuja. “If the security situation doesn’t improve we still may have a major problem ahead of us.”
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