A year after Nigeria was removed from the polio-endemic list, two cases have been reported in Borno state, where the insurgent Boko Haram still controls territory.
The eradication of polio, reported in 2015 by the World Health Organization, was called an “historic achievement” by the Global Polio Eradication Initiative, a public-private partnership leading the effort to eliminate the disease.
As recently as 2012, Nigeria accounted for more than half of all polio cases worldwide. Since then, a concerted effort by all levels of government, civil society, religious leaders and tens of thousands of dedicated health workers resulted in Nigeria successfully stopping polio.
More than 200,000 volunteers across the country repeatedly immunized more than 45 million children under the age of 5 years. Innovative approaches, such as increased community involvement and the establishment of Emergency Operations Centres, were also pivotal to Nigeria’s success.
Then, last month, a 4-and-a-half-year-old girl named Aisha was the first new case. In May her extended family had escaped from Boko Haram-controlled territory and trekked 2 days to an internally displaced persons camp. The girl, who became paralyzed on July 6, has since recovered “and now walks without a limp,” said Michael Zaffran, the new director of polio eradication of the world health body.
Health officials, under military escort, are still investigating the second case, a 12-month-old boy who was paralyzed on July 13, not far from Chibok where Boko Haram abducted 276 school girls in 2014.
Because of the 2-year break in new cases, many of the government experts who led the battle to wipe out the virus in Nigeria have moved on. The presidential task force on polio eradication hasn’t convened in at least a year. Although the central government has budgeted money for polio eradication this year, officials have not yet released it, and interest among some local government officials is waning.
“New people will have to come to grips with the problem,” says Muhammad Pate, the former minister of state for health who headed the country’s polio effort and is now an adjunct professor at Duke University in Durham, North Carolina.
More campaigns are in the works. A second one is scheduled to launch 27 August across four northern states, with the goal of reaching 4 million to 4.5 million children under 5. Chad, northern Cameroon, southern Niger, and parts of the Central African Republic will synchronize campaigns.
Pate worries that people will attribute the outbreak to insecurity alone. They “might miss the significance of this as a wake-up call to be more diligent even when there are no cases,” he said.