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Cablegate: Nigeria: U.S. Mission Pushes for Local Ownership of Polio

VZCZCXRO3459
PP RUEHMA RUEHPA
DE RUEHUJA #2515/01 3581355
ZNR UUUUU ZZH
P 231355Z DEC 08
FM AMEMBASSY ABUJA
TO RUEHC/SECSTATE WASHDC PRIORITY 4791
INFO RUEHOS/AMCONSUL LAGOS 0498
RUEHZK/ECOWAS COLLECTIVE
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHDC

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

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