NIGERIA: NORTHERN PARENTS REJECT VACCINES

UNCLAS SECTION 01 OF 02 ABUJA 000876 SIPDIS STATE FOR AF/W DOE FOR GEORGE PERSON E.O. 12958: N/A TAGS: PGOV SOCI TBIO KISL KOCI NI SUBJECT: NIGERIA: NORTHERN PARENTS REJECT VACCINES THIS MESSAGE IS SENSITIVE BUT UNCLASSIFIED. NOT FOR INTERNET DISTRIBUTION. ¶1. (U) SUMMARY. POLOFF and PolSpecialist spoke with Dr. Muhammad Kabir, professor of community medicine at Bayero University in Kano, and Bashir Sanusi, community health specialist with the Kano State Ministry of Health, on April 16. Two themes clearly emerged: 1) despite the recent outbreak of deadly diseases like meningitis, measles and chicken pox in Kano and other parts of the North, Muslim parents still resist immunizing their children; and 2) poor federal funding of the medical sector leads to the emergence and reemergence of fatal (though entirely preventable and/or treatable) diseases. Polio has also reemerged as a major health threat in northern states like Kano. END SUMMARY. -------------- PARENTS RESIST POLIO VACCINES -------------- ¶2. (U) Kabir and Sanusi maintained that, on the basis of cultural sensitivities, some Muslim parents in northern Nigeria continue to resist calls to immunize their children against serious diseases, noting that parents most often rejected polio immunization. In particular, they noted that skeptical parents wondered why the GON sends medical personnel to far-flung communities on polio immunization campaigns while it fails to provide medical services for more common diseases, including malaria, cholera and typhoid. In addition, the mode of delivery of the polio vaccine (orally as opposed to an injection),exacerbated these parents' suspicion, some of whom otherwise approved of vaccines for their children delivered by injection. Even the fact that the polio vaccine is administered free of charge heightens suspicion, they contended, as even poor Nigerians must pay for basic drugs to treat common, even fatal, ailments like malaria. These suspicions also fuel conspiracy theories and rumors of ulterior motives. Kabir and Sanusi maintained newspaper coverage of a court case pending against Pfizer for alleged problems resulting from the testing of a meningitis drug in Kano and Jigawa states in 1996, has further heightened concerns and provided ammunition to opponents of immunization. -------------- INFLUENTIAL MUSLIMS BEHIND SUSPICIONS -------------- ¶3. (U) Kabir contended that suspicion of polio immunization in the North initially had been advocated by two prominent northerners: Datti Ahmad, a Kano-based physician turned Muslim cleric and Chair of the Supreme Council for Sharia in Nigeria, and Najib Adamu, Emir of Kazaure (Jigawa State) and a respected traditional elder. Ahmad and Adamu argued that the polio vaccine was injurious to health and urged fellow Muslims to reject the vaccination campaign altogether. Considering the amount of influence both a medical expert and a traditional elder held in the North, Kabir averred, most northerners acceded to claims that the campaign's objectives were anything but innocuous or beneficial. Other religious and traditional leaders continue to spread this faulty message. According to Kabir, the average northern Nigerian, already suspicious of mass polio immunization, believes the vaccine may be a plan by the West to control or eliminate the Muslim population and/or to spread the HIV virus among the Muslim population in Nigeria. -------------- MENINGITIS, MEASLES, CHICKEN POX ON THE RISE -------------- ¶4. (U) Kabir and Sanusi told us that air-borne diseases like meningitis, measles and chicken pox are ravaging families and communities in the North, leading to hundreds of deaths in Kano and elsewhere. They maintained a source told them as many as 700 people have died in Sokoto State as a result of cerebral-spinal meningitis. Hundreds of children have been diagnosed with measles. (NOTE: A recent media report quoted a Nigerian Red Cross official that "an estimated five million persons, mostly children are at risk of being affected by the health emergencies of measles and cholera" across the North.") -------------- EMERGENT AND RE-EMERGENT DISEASES -------------- ¶5. (U) Kabir and Sanusi complained that insufficient immunization coverage, corruption and poor funding of the health sector have led to the emergence of new infectious diseases (HIV-AIDS, lassa fever, ABUJA 00000876 002 OF 002 ebola virus) and the reemergence of formerly contained diseases (polio, tetanus, malaria, river blindness and tuberculosis). Predictably, Kabir and Sanusi said, families that refuse routine immunization are also the worst hit by these emergent diseases, with the exception of HIV-AIDS - the rates of which have declined in urban centers like Kano and risen in rural northern areas. ¶6. (SBU) The Ambassador raised immunization issues, and particularly our concern about the resurgence of polio, with the Sultan of Sokoto, who is senior to most of the emirs in the central and northeast regions. The Sultan said he would be willing to continue to voice support for polio immunization, but also wants to ensure that the new immunization campaigns address the new strains in the virus. He added that he would "work with the other emirs" to bring a better understanding of the issue. The Ambassador promised to send the Sultan the most recent information on polio eradication campaigns. -------------- COMMENT: OPPORTUNITY TO CHANGE PERCEPTIONS -------------- ¶7. (SBU) Perceptions that polio immunization is either harmful to one's health or part of a global conspiracy to eliminate Muslim populations pervade northern Nigeria. Limited access to reliable health information undermines USG and Nigerian NGO efforts to counter suspicion and carry out successful immunization drives. USAID and its Nigerian NGO partners regularly bring together religious leaders, including northern imams, to discuss immunization and other public health services and are working with stakeholders to develop an Islamic HIV/AIDS policy. Nigeria's preeminent traditional Islamic leader, the Sultan of Sokoto (in conjunction with other health professionals and religious leaders),has expressed an interest in partnering with the USG to promote development and improve perceptions toward immunization in the North. To this end, the Sultan has already recorded public service announcements promoting public health services, including immunizations. Such initiatives offer our best chances for changing public perceptions and combating both emergent and re-emergent diseases. END COMMENT.