NIGERIA: U.S. MISSION PUSHES FOR LOCAL OWNERSHIP OF POLIO

UNCLAS SECTION 01 OF 02 ABUJA 002515 SENSITIVE SIPDIS DEPARTMENT FOR OES/IHA DANO WILUSZ USAID FOR GH/HIDN ELLYN OGDEN, RICHARD GREENE USAID FOR AFR/SD MARY HARVEY CDC FOR NCIRD/GID/DEEB SUE GERBER E.O. 12958: N/A TAGS: TBIO KISL PGOV SOCI ECON KOCI EAID NI SUBJECT: NIGERIA: U.S. MISSION PUSHES FOR LOCAL OWNERSHIP OF POLIO CAMPAIGN REF: A. STATE 102802 ¶B. STATE 65054 ¶C. ABUJA 1591 ¶D. ABUJA 815 SENSITIVE BUT UNCLASSIFIED - DO NOT DISTRIBUTE OUTSIDE USG. ¶1. (U) Summary: The Nigeria Polio Eradication Initiative Task Force (PEITF) Core Group held a meeting on November 11-12 in Kano to discuss current status of polio in northern Nigeria, assess preparations for upcoming campaigns, and strategize on steps to making future rounds more successful. Some state officials complained of public polio fatigue and called for improved approach to increased immunization. EMBOffs emphasized that state ownership and leadership is critical for the success of polio eradication and stressed that, barring a concerted and determined effort by all stakeholders to overcome ongoing challenges, the Government of Nigeria's (GON) objective of interrupting the polio outbreak by 2009 is unlikely to be achieved. The Ambassador is providing some recommendations to increase immunization to the Chairman of the Governors' Forum, which he has agreed to present to his colleagues at their next meeting in January. End Summary. Polio Campaign Fatigue -------------- ¶2. (U) Some state officials complained of public fatigue over the ongoing polio campaign. Despite years of polio campaigns, they said, there is little progress to show for it. Some pointed out that the very poor state of the healthcare system and its inability to provide basic community health needs, have made parents skeptical about bringing out their children for polio immunization. Lack of coordination and supervision, the hiring of unqualified and ill-trained vaccinators (nepotism was often sited as the reason), delayed distribution of funds and vaccines, and the lack of cold storage facilities and transportation were identified as major hindrances to success. Several states complained about non-compliant parents and advocated imposition of arrest as penalty. EMBOffs strongly cautioned against such harsh measures and instead encouraged to focus attention on the unscrupulous health workers and administrators who are not doing their jobs (falsifying data, dumping vaccines, hiring unqualified vaccinators, withholding of payment, etc) and suggested that a different strategy should be adopted to entice the voluntary cooperation of parents. Creation of State Taskforces on Polio -------------- ¶3. (U) To overcome challenges and provide overall leadership on polio campaigns, the PEITF has recommended that states establish a similar body under the authority of the Commissioner of Local Government, a powerful arm of state government that is capable of marshalling all the players within the state. Borno, Jigawa, Kaduna, Katsina, Kwara, Sokoto, and Zamfara have established such a task force. On November 13, the Katsina Polio Taskforce gathered all the 34 Local Government Area (LGA) Chairmen and held a day-long brainstorming session on the upcoming campaign. EmbOffs attended this meeting and encouraged the LGA chairmen to take ownership and provide leadership for a more successful outcome in their respective areas. Kano the Least Prepared for Polio Campaign -------------- ¶4. (SBU) Based on presentations made at the PEITF meeting, it was apparent that Kano state was the least prepared for upcoming campaigns. In a separate meeting with Kano Commissioner of Local Government, EMBOffs described Kano's disproportionate polio burden (the highest in the nation) and lack of adequate preparations to make progress in the upcoming campaign and encouraged increased state leadership by establishing the Kano Polio Task force. The Commissioner was surprised that he was supposed to establish and chair such a taskforce. He expressed appreciation for U.S. assistance, promised to bring the issue to the attention of the Governor, and to establish the task force. (Note: Since then Kano has established a polio task force. End Note). ¶5. (SBU) EmbOffs also met and discussed the polio situation in Kano with Professor Mohamed Kabir, a former Kano Health Commissioner and Dean of the School of Medicine at the local university. According to Kabir, active engagement by the state governor is crucial to success in the polio campaign. He pointed to past negative statements against polio vaccine by a highly respected octogerian ABUJA 00002515 002 OF 002 medical doctor and influential Islamic scholar (claiming that the vaccine is laced with anti-fertility drugs) as a source of lingering public reticence in accepting the polio vaccine. Kabir thought that engaging particularly the Saudi Consulate in Kano and getting their cooperation to deliver positive public message will be effective, both because of Saudi Arabia's influence on Islamic affairs and due to its polio vaccine requirement for visa to the kingdom, including for Hajj travelers. Additionally, he encouraged involving liberal Islamic scholars to deliver positive messages on polio in their regular Friday sermons. (Comment: Mission will follow-up on these suggestions. End comment.) Gezawa Local Government Area Pilot Project -------------- ¶6. (U) The Gezawa Local Government Area, east of Kano and one of the most polio affected localities, has adopted the Gezawa Polio Initiative (GPI),a pilot project to increase polio immunization. The GPI was developed by the U.S. Center for Disease Control (CDC) and World Health Organization (WHO) with inputs from community members and leaders, and if successful, will be replicated in other LGAs in Kano and elsewhere. Under the GPI, enhanced training will be given to religious leaders, traditional birth attendants, barbers, town announcers, singers, leaders of local Muslim women associations and female Hisbah (security officers). To raise public awareness, the GPI will take a very popular "Majigi" (film in Hausa) on a roadside show to all the 59 villages in the LGA preceding future campaigns. The Gezawa LGA Chairman has announced five awards to the best performing traditional rulers and their settlements. Initial feedback indicates very high acceptance of the initiative by traditional rulers and religious and community leaders. ¶7. (SBU) Comment: Holding the meeting in Kano had symbolic value, as Kano is the epicenter of the polio epidemic in Nigeria. The meeting provided a platform for assessing the polio situation in the north, evaluating ongoing challenges, and for exchanging best practices within the region. The fact that several states have established a task force under the leadership of their respective Commissioner of Local Government is expected to provide improved leadership in future campaigns. The Ambassador has engaged the Chairman of the Governors' Forum on this issue and is encouraging improved sate leadership on polio eradication efforts. The Gezawa Polio Initiative seems to have generated local interest and if successfully implemented might bear promising fruits. If so, the U.S. Mission will encourage replicating the model in other states as appropriate. End Comment. ¶8. (U) This cable was coordinated with Consulate Lagos. SANDERS