NIGERIA: STATUS OF POLIO ERADICATION

UNCLAS SECTION 01 OF 02 ABUJA 000734

SIPDIS

DEPT FOR AF/W, USAID/W FOR AFR/AA, CONSTANCE NEWMAN,
AFR/WA, MICHAEL KARBELING, GH/AA, ANN PETERSON, GH/CH
SURVIVAL, HOPE SUKIN, OES/IHA
LAGOS FOR ADMIN

E.O. 12958: N/A
TAGS: PGOV SOCI NI SOCI KHIV AID
SUBJECT: NIGERIA: STATUS OF POLIO ERADICATION
INITIATIVE (PEI)

REF: 03/25/04 POLIO ERADICATION INITIATIVE CABLE

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SUMMARY
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1. This cable provides an update on the current
situation related to polio eradication in Nigeria,
including actions in process and to be undertaken over
the next two-week period.
The Deputy Governor of Kano State told Charg April 26
that GON, UN and Kano were in agreement that polio
vaccine would be procured from Indonesia under State
supervision. Once the procurement is accomplished a
public education program would be launched to convince
Kano residents that the vaccine was uncontaminated.
Kano State leadership is now waiting for the GON to
arrange the procurement trip to Indonesia.
There has been no polio immunization activity in Kano
since mid-2003, resulting in a rapid increase in new
cases and a widening of the geographic area affected.
In 2003, Nigeria recorded 355 of the 745 cases
worldwide. From January 1 to February 24, 2004, 63
cases have been confirmed in 17 states - 17 of the
cases are in Kano and 14 in Kaduna.
The second round of 2004 National Immunization Days
(NIDs) has been concluded and debriefings held at the
national level. Currently round three (April 24-27) is
under way in all states except Kano.
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CURRENT ACTIVITIES
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2. Firm dates have been set for the remainder of the
2004 rounds: May 22-25; October 9-12; and November 13-

16. Responsive mop-ups will be conducted between June
and September. Further, all rounds for 2004 will be
full NIDs, as opposed to sNIDs (sub-National
Immunization Days) that would target only infected
states, in view of the fact that 24 of the 37 states
are now infected with the wild poliovirus and all 37
are considered `at risk.'

3. The Governor of Kano traveled to the United States
and returned on April 15. Prior to his departure, he
met with the US Charge d'Affaires (ref cable #00553)
and with Dr. (Mrs.) Awosika, Chief Executive of the
National Program on Immunization (NPI). In both
meetings, Governor Shekarau indicated a willingness to
resume implementation of the national immunization days
(NIDs) as soon as certain conditions are met (i.e.,
assurance and provision of "clean" vaccines). Kano
Deputy Governor Abdullahi met with the Charg April 26.
He affirmed that the GON, UN and Kano Governor had
agreed that a Kano State delegation would accompany GON
representatives to Indonesia to procure vaccine. If
the Kano delegation were convinced that the vaccine was
uncontaminated, the State would permit reintroduction
of the OPV. The Deputy Governor noted that a public
education campaign would be necessary to re-educate the
public that originally rejected the vaccine. Kano is
now waiting for the GON to schedule the procurement
trip. The Deputy Governor maintained that there is
frequent contact with the GON about the vaccine
procurement, but was unclear about a timeline.

4. Dr. (Mrs.) Awosika met, on Thursday, April 8, with
Dr. Bichi, one of the Kano scientists who initiated the
protest against the oral polio vaccine (OPV),the
Commissioner of Health and the Primary Health Care
Director of Kano State. At that time, they echoed the
sentiments of the Governor (above) and felt confident
of full participation by Kano in the near future.

5. The WHO Country Representative, Dr. Mohammed
Belhocine, contacted the Minister of Health on April 12
to obtain a status update. The Minister said he would
meet with the Governor as soon as possible and request
that he make a public statement in order to adequately
prepare for resumption of polio vaccination in Kano.
It remains now to wait for this public statement by the
Governor, declaring his acceptance of the OPV available
(most likely the batch from Indonesia) and his approval
for Kano to fully participant in subsequent rounds.
The Minister further stated that an Inter-Agency
Coordinating Committee (ICC) meeting would take place
on Tuesday, April 20, the first ICC meeting since
January. During the course of that meeting there was,
unfortunately, nothing new was reported on the status
of Kano State's participation in the polio eradication
initiative (PEI). The April round is now underway,
without Kano.


6. It is now known that poliovirus from Nigeria has
migrated as far away as Botswana, increasing the
pressure on Nigeria to step up both coverage and
quality of the NIDs nationwide. Adding further to that
pressure, it has been reported that a new outbreak of
meningitis is now occurring in some areas in Kano
State, and rejection of even that vaccine is taking
place in many areas throughout the state.


7. Advocacy efforts continue throughout the northern
states by the National Program on Immunization (NPI)
and other agencies, as appropriate.


8. The USAID initiative in Kano (participatory
learning and action for community ownership - PLACO)
has now completed the groundwork in all 44 of the local
government areas (LGAs) in Kano State. What this means
is that, once a green light is given to resume the PEI,
mobilization and implementation can happen quickly.

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DONOR COMMITMENT
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9. Government and donors have reviewed the first two
NIDs rounds of 2004 and have re-organized the strategy
for the remainder of the year, based upon the
debriefing reports from the field.

10. The Core Technical Group continues to meet a
minimum of once weekly, except during the
implementation of NIDs, at which time the participants
are in the field monitoring.
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NEXT STEPS
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11. Debriefing of the April round will take place
immediately following conclusion of the round (April
27) and preparation will begin for the May round.

12. ICC approval of proposed national-level structure
changes must be secured at the next ICC meeting,
scheduled for Monday, May 10, and subsequent actions
initiated to make the changes quickly functional (e.g.,
formation of new working groups to replace former
committees for training and social mobilization and an
operations center in Abuja).

13. A state of readiness will be maintained in Kano
State in order to quickly mobilize as soon as the way
becomes clear to resume vaccination activities in the
state.

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CONCLUSION
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14. The problem with polio eradication in Kano now
hinges on the GON to follow through on its commitment
to acquire OPV from Indonesia with adequate oversight
from Kano State. Once safe Indonesian vaccine is
acquired, the Kano Governor has committed to
implementing the PEI.


15. Post will continue to provide regular reports on
progress in the effort to eradicate polio in Nigeria.
ROBERTS