Polio Cases Sharply Decline
Between 2003 and 2007, Nigeria registered an average of 1,000 cases of polio each year. This year, however, just three cases of the dreaded disease have been registered in the country so far. This sharp decline is extremely significant because communities were reluctant to have the polio vaccine given to children in Nigeria just a few years ago. Clearly, something has changed.
“I would attribute this dramatic turnaround largely to the fact that a strong attempt was made to engage traditional leaders in northern Nigeria,” said Dinesh Nair, Senior Health Specialist at the World Bank. “There were widespread misconceptions about the vaccine, including that it would affect fertility, but there is far more trust today than there was even a year ago.”
Although three reported cases could mean that infection is still prevalent, Nair said the turnaround has been phenomenal. And Nigeria’s Primary Health Care Development Agency (NPHCDA) emphasized in a 2010 report that working with socio-political structures on the ground was key to success.
In a very short span of time, there were major observable differences in results. Even though these results are still provisional and incomplete, they are extremely significant. As the graph below shows, the polio burden fell by 92 percent between the first and second halves of 2009, from 360 confirmed cases between January and June to 28 cases between July and December.
Dr. Muhammad Pate, head of the NPHCDA (and a World Bank staff member currently on external service), cautioned that it is much too early to declare victory against polio in Nigeria, and that vaccination efforts must be sustained, building on this recent success, before eradication can be achieved.
“The polio eradication effort is not only about polio—it is about delivering an effective vaccine to prevent a serious disease that depends on a functioning health system to succeed,” Pate noted. “Polio eradication can be a potent arrow head for transforming routine immunization and primary health care systems. Financial and human resources technical capacities for the Polio Eradication Initiative can be used to move the health systems agenda forward.”
“Lessons from the effective engagement with traditional leaders could find application in the effort to improve maternal and child health outcomes,” said Nair, “It has been hard to gain traction on this, particularly in Northern Nigeria, and so we look forward to more successes.”
The polio program in Nigeria involves the harmonized efforts of many partners. The World Bank has provided US$135 million; approximately 25 percent of the funding needed for polio vaccines in Nigeria.
A unique feature of this operation is its “buy-down” nature. The buy-down mechanism aims to convert a normal International Development Association (IDA) development credit to grant terms through provision of external donor resources under clearly defined performance criteria.
In Nigeria’s case, donors, including Rotary International, Centers for Disease Control, U.N. Foundation and the Bill and Melinda Gates Foundation, have agreed to pay off the net present value of the debt once pre-determined performance indicators are achieved.
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