Cablegate: Nigeria: Polio Eradication Initiative and Ds/Hhs

This record is a partial extract of the original cable. The full text of the original cable is not available.

221342Z Jan 04



NEWMAN, US UN Delegation, HHS

E.O. 12958: N/A


1. This cable highlights recent dialogue between USAID
and other donors intended to develop and implement a new
strategy to address the resurgence of wild polio virus
transmission in Nigeria. Key elements of the strategy

(1) A Ministerial-level declaration of commitment to end
polio virus transmission, issued in Geneva on January 15,

(2) A UNICEF Executive Board meeting in New York to
address global polio eradication;

(3) Implementation of four rounds of 2004 National
Immunization Days (NIDs) in Nigeria, commencing February
23, 2004;

(4) A renewed emphasis on routine immunization and mop-ups;

(5) Establishment of a dedicated inter-agency working group
to manage the strategy; and

(6) Heightened commitment to the devolution of authority
and responsibility for immunization to states and local
government areas.


2. Nigeria is the largest remaining polio reservoir
globally. As recently as mid-2003, transmission was
confined to the northern portion of the country in just 8
states and the Federal Capitol Territory (FCT), with most
of the cases occurring in Kano and Kaduna States. Since
August 2003, the virus has spread from the north of Nigeria
into an additional 15 previously polio-free states as well
as seven neighboring countries, some of which had been
polio-free for as long as two years.

3. USG support to polio eradication in Nigeria has three
focal areas: 1) build the capacity of field personnel
involved in the polio eradication initiative to deliver
high quality immunization services; 2) contribute to
advocacy and social mobilization campaigns to ensure that
every child under five years of age is adequately immunized
against polio; and 3) support for surveillance activities
through a grant to the World Health Organization (WHO).


4. Interruption of viral transmission in 2004 will
require an extremely well-coordinated effort. Toward that
end, USAID has begun meeting with other donors to
strategize on effective ways forward.


5. On 8 January 2004, USAID/Nigeria Mission Director Dawn
Liberi met with Dr. Jean-Marie Okwo-Bele, UNICEF
Headquarters Senior Advisor and Team Leader, Polio Plus;
Dr. Abdulai Tinorgah, Chief of Health and Nutrition at
UNICEF/Nigeria, and USAID Mission health staff. At this
meeting UNICEF advised the Mission that following a re-
grouping and strategizing retreat between WHO and UNICEF,
the two organizations arranged a meeting in Geneva for 15
January 2004 to bring together the Ministers of Health and
other government representatives from the six remaining
most polio-endemic countries -- India, Nigeria,
Afghanistan, Niger, Egypt and Pakistan -- with WHO and
UNICEF headquarters representatives. The purpose of the
meeting was to sign a Joint Declaration of Commitment to
end poliovirus transmission by 2005.


6. Following the Geneva meeting, the UNICEF Executive
Board will convene a meeting, scheduled for the end of
January 2004, to further address the issue of global polio
eradication, focusing mainly on key messages to go out from
the partners to endemic countries. In line with a renewed
commitment to improve the flow of relevant information to
all involved partners, UNICEF will debrief USAID and other
partners on the outcome of both meetings.

7. A newly-devised and staffed polio eradication
initiative (PEI) Working Group began operations on 15
January in Abuja to prepare for the launch, on February 23,
of first of four NIDs scheduled for 2004. Sub-NIDs and
mop-ups as needed are also planned. This group will serve
as the central operations center for all PEI activities in
Nigeria, with a similar structure to be set up in Kano soon
for coordination of activities in northern Nigeria. Both
operational groups will function under the leadership of
UNICEF, but will also include representation from all
agencies and the GON. Equal weight will be given in the
scope of work for this group to provision of routine
immunization services and dissemination of messages, and to
the ongoing decentralization of responsibility for
immunization to states and local government areas (LGAs).
Nigerian Youth Service Corps (NYSC) will be trained to work
in the two operations centers to assist with the
mobilization of communities and to convey routine
immunization and health messages other than polio to the
grass roots.


8. On 13 January 2004, a second meeting was held in the
office of the USAID Mission Director, with the Nigerian
UNICEF Country Representative, Dr. Gianni Murzi and USAID
health staff. Dr. Murzi apprised the Mission of the latest
developments and the strategic response of the UN Agencies.
It was agreed that a re-structuring of both the Inter-
Agency Coordinating Committee (ICC) and Core Technical
Group must take place, with only Agency Heads attending the
ICC (which is chaired by the Hon. Minister of Health) and
taking the final decisions. The Technical Core Group can
more appropriately serve as the body to prepare the issues
to be sent to the ICC for decisions and/or action.


9. The USG is the largest single donor to the PEI
globally. For this and myriad other reasons, we are
gravely concerned about the recent events and issues
arising from the north of the country. USAID fully supports
the new strategy being proposed for what is hoped to be the
final year of intensive PEI activities. Post has closely
followed the many recent articles in both national and
international press and is aware of the political issues
and sensitivities involved. Because these issues
frequently transcend the technical and managerial problems
in Nigeria, they have been fully taken into account in the
new strategy. We recognize the need to move cautiously and
in complete harmony with our donor partners, and we welcome
the opportunities provided us for advocacy to the top from
our high-level visitors.

10. The January 15-18 visit to Nigeria of Deputy Secretary
Claude Allen, U.S. Department of Health and Human Services,
helped raise USG concerns to President Obasanjo and the
Ministry of Health. The USG will continue to advocate
greater resource flows and commitment to polio eradication
through donors' fora, meetings with the GON and with other
partners. Deputy Secretary Allen offered to consult with HHS
Secretary Tommy Thompson to secure his support for UNICEF

to mount an international donor effort to eradicate polio in
Nigeria. He suggested that UNICEF identify noted Islamic
scholars and health practitioners from other Muslim countries
as advocates for polio eradication in Nigeria. These scholars
and health practitioners would hold discussions with their
Islamic counterparts to discuss culturally sensitive ways to
address the problem which has been eradicated in other Muslim

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