Sixteen years ago after Nigeria started serious activities towards achieving the initiative in 1996, Nigeria, Pakistan and Afghanistan remain the only countries endemic with polio virus, which has led to millions of deaths and paralysis of infants.
Alarmed that polio remained entrenched in these countries that had never stopped transmission and that an increasing number of polio-free areas were becoming reinfected, in May 2008 the World Health Assembly (WHA) called for a new strategy to complete polio eradication.
Only last week, two new cases were reported-WPV1 from Jigawa and Yobe states, bringing the total number of cases for 2012 to 57 as against 62 cases recorded in 2011. The most recent case was the newly reported case from Jigawa state with onset of paralysis on 25 June 2012.
While routine immunization, supplemental immunization and periodic mop-up campaign have been carried out in the country till date, this disease seems to have defiled all odds to nip the disease in the bud.
Jennifer Peters, a South Africa-based consultant for WHO and UNICEF, who visited Nigeria recently revealed that cultural/religious beliefs and free movement among border countries in the North pose serious challenges to tracking millions of missed children for vaccination against the dreaded polio virus.
The Independent Monitoring Board (IMB) of GPEI which recommended quick-fix measures to meet the 2012 target for polio eradication showed that at least 2.7 million children in six persistently affected countries have never received even a single dose of polio vaccine.
The IMB report stated that "Nigeria is now the only country in the world to have three types of polio virus. The country's programme understands its major problems, but is yet to show that it is overcoming them. Nigeria poses a substantial risk to the global goal, in part because it has many neighbouring countries that are vulnerable to the spread of infection.
"The risk of an explosive return of polio in Nigeria and West Africa is ever-present and raises the chilling spectre of many deaths and a huge financial outlay to regain control. The country's impressive political and public health leaders are to be strongly encouraged: they have made strong progress in the past, and need to do so again."
The Board was convened at the request of the World Health Assembly to monitor and guide the progress of the Global Polio Eradication Initiative's 2010-2012 Strategic Plan, with the aim of interrupting polio transmission by the end of this year.
The major challenge for Nigeria, Peters believe, will be fathoming out implementable strategy for capturing the missed children in the North with a view to having them immunized, as millions of children from nomadic families cannot be reached for immunisation.
The intermingling of nationals of Nigeria, Niger and Chad, among others, on the Northern borders poses another shade of challenge in statistics.
For Tukur Dahiru, Department of Community Medicine, Faculty of Medicine, Ahmadu Bello University, Zaria, Nigeria can only eradicate polio if it strengthens the nation's Primary Healthcare system (PHC).
Dahiru hinted that the Local Government Area level is the dormitory of PHC system generally characterized by inadequate qualified personnel, lack of basic equipment including the backbone of routine immunization - cold chain system - and commodity especially vaccines.
"Over the years, the neglect of this critical healthcare level has eroded public trust and therefore any public health programme championed at this level raises suspicion, lack of trust and confidence in the activities. Without a functional, strong and reliable PHC system, the routine immunization programme that is required to maintain community immunity at such a high level after being certified as polio-free may not be able to maintain such tempo. The result will be re-emergence of wild polio," Dahiru stated.
Only recently, the World Bank's Board approved an International Development Association (IDA) credit of N15.2 billion (US$95 million) for Nigeria's Polio Eradication Support Project, which will help it achieve and sustain at least 80 percent polio immunization across all states of the Federation.
According to Bank's website, "the project will finance roughly 655 million doses of oral polio vaccine for children under age five across Nigeria, with a special focus on the Northern states where polio is more prevalent."
The World Bank polio project continues a "buy-down" arrangement by which the Gates Foundation, the US CDC and Rotary International (via the UN Foundation), will repay the loan's present value when pre-agreed results are met.
Of the World Bank's lending commitments to Nigeria for polio from 2003 to 2012-a total of $195 million-Nigeria has already qualified for a 70 percent buy-down. This funding is coming on the heels of the FG in March 2012 to release $60million in two years for the eradication of poliomyelitis in Nigeria. This is in addition to the $17million and the existing funds in the battle against polio.
For years, many believed that the challenge of stopping polio transmission in India. They were proved wrong when in January 2012, India achieved the major milestone of a year passing without a single case of polio.
"Polio is gone from India - a magnificent achievement and proof of the capability of a country to succeed when it truly takes to heart the mission of protecting its people from this vicious disease," the IMB report showed.
