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Cablegate: Nigeria: Status of Polio Eradication

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

UNCLAS SECTION 01 OF 02 ABUJA 000731

SIPDIS

DEPT FOR AF/W, USAID/W FOR AFR/AA, CONSTANCE NEWMAN,
AFR/WA, MICHAEL KARBELING, GH/AA, ANN PETERSON, GH/CH
SURVIVAL, HOPE SUKIN, OES/IHA
LAGOS FOR ADMIN

E.O. 12958: N/A
TAGS: PGOV SOCI NI SOCI KHIV AID
SUBJECT: NIGERIA: STATUS OF POLIO ERADICATION
INITIATIVE (PEI)

REF: 03/25/04 POLIO ERADICATION INITIATIVE CABLE

-------
SUMMARY
-------
1. This cable provides an update on the current
situation related to polio eradication in Nigeria,
including actions in process and to be undertaken over
the next two-week period.
The Deputy Governor of Kano State told Chargi April 26
that GON, UN and Kano were in agreement that polio
vaccine would be procured from Indonesia under State
supervision. Once the procurement is accomplished a
public education program would be launched to convince
Kano residents that the vaccine was uncontaminated.
Kano State leadership is now waiting for the GON to
arrange the procurement trip to Indonesia.
There has been no polio immunization activity in Kano
since mid-2003, resulting in a rapid increase in new
cases and a widening of the geographic area affected.
In 2003, Nigeria recorded 355 of the 745 cases
worldwide. From January 1 to February 24, 2004, 63
cases have been confirmed in 17 states 7 of the
cases are in Kano and 14 in Kaduna.
The second round of 2004 National Immunization Days
(NIDs) has been concluded and debriefings held at the
national level. Currently round three (April 24-27)
is under way in all states except Kano.
------------------
CURRENT ACTIVITIES
------------------
2. Firm dates have been set for the remainder of the
2004 rounds: May 22-25; October 9-12; and November 13-
16. Responsive mop-ups will be conducted between June
and September. Further, all rounds for 2004 will be
full NIDs, as opposed to sNIDs (sub-National
Immunization Days) that would target only infected
states, in view of the fact that 24 of the 37 states
are now infected with the wild poliovirus and all 37
are considered 'at risk.'
3. The Governor of Kano traveled to the United
States and returned on April 15. Prior to his
departure, he met with the US Charge d'Affaires (ref
cable #00553) and with Dr. (Mrs.) Awosika, Chief
Executive of the National Program on Immunization
(NPI). In both meetings, Governor Shekarau indicated
a willingness to resume implementation of the national
immunization days (NIDs) as soon as certain conditions
are met (i.e., assurance and provision of "clean"
vaccines). Kano Deputy Governor Abdullahi met with
the Chargi April 26. He affirmed that the GON, UN and
Kano Governor had agreed that a Kano State delegation
would accompany GON representatives to Indonesia to
procure vaccine. If the Kano delegation were
convinced that the vaccine was uncontaminated, the
State would permit reintroduction of the OPV. The
Deputy Governor noted that a public education campaign
would be necessary to re-educate the public that
originally rejected the vaccine. Kano is now waiting
for the GON to schedule the procurement trip. The
Deputy Governor maintained that there is frequent
contact with the GON about the vaccine procurement,
but was unclear about a timeline.
4. Dr. (Mrs.) Awosika met, on Thursday, April 8, with
Dr. Bichi, one of the Kano scientists who initiated
the protest against the oral polio vaccine (OPV), the
Commissioner of Health and the Primary Health Care
Director of Kano State. At that time, they echoed the
sentiments of the Governor (above) and felt confident
of full participation by Kano in the near future.
5. The WHO Country Representative, Dr. Mohammed
Belhocine, contacted the Minister of Health on April
12 to obtain a status update. The Minister said he
would meet with the Governor as soon as possible and
request that he make a public statement in order to
adequately prepare for resumption of polio vaccination
in Kano. It remains now to wait for this public
statement by the Governor, declaring his acceptance of
the OPV available (most likely the batch from
Indonesia) and his approval for Kano to fully
participant in subsequent rounds. The Minister
further stated that an Inter-Agency Coordinating
Committee (ICC) meeting would take place on Tuesday,
April 20, the first ICC meeting since January. During
the course of that meeting there was, unfortunately,
nothing new was reported on the status of Kano State's
participation in the polio eradication initiative
(PEI). The April round is now underway, without Kano.

6. It is now known that poliovirus from Nigeria has
migrated as far away as Botswana, increasing the
pressure on Nigeria to step up both coverage and
quality of the NIDs nationwide. Adding further to
that pressure, it has been reported that a new
outbreak of meningitis is now occurring in some areas
in Kano State, and rejection of even that vaccine is
taking place in many areas throughout the state.

7. Advocacy efforts continue throughout the northern
states by the National Program on Immunization (NPI)
and other agencies, as appropriate.

8. The USAID initiative in Kano (participatory
learning and action for community ownership - PLACO)
has now completed the groundwork in all 44 of the
local government areas (LGAs) in Kano State. What
this means is that, once a green light is given to
resume the PEI, mobilization and implementation can
happen quickly.

-----------------
DONOR COMMITMENT
------------------

9. Government and donors have reviewed the first two
NIDs rounds of 2004 and have re-organized the strategy
for the remainder of the year, based upon the
debriefing reports from the field.
10. The Core Technical Group continues to meet a
minimum of once weekly, except during the
implementation of NIDs, at which time the participants
are in the field monitoring.
---------------
NEXT STEPS
---------------
11. Debriefing of the April round will take place
immediately following conclusion of the round (April
27) and preparation will begin for the May round.
12. ICC approval of proposed national-level
structure changes must be secured at the next ICC
meeting, scheduled for Monday, May 10, and subsequent
actions initiated to make the changes quickly
functional (e.g., formation of new working groups to
replace former committees for training and social
mobilization and an operations center in Abuja).
13. A state of readiness will be maintained in Kano
State in order to quickly mobilize as soon as the way
becomes clear to resume vaccination activities in the
state.

---------------
CONCLUSION
---------------

14. The problem with polio eradication in Kano now
hinges on the GON to follow through on its commitment
to acquire OPV from Indonesia with adequate oversight
from Kano State. Once safe Indonesian vaccine is
acquired, the Kano Governor has committed to
implementing the PEI.

15. Post will continue to provide regular reports on
progress in the effort to eradicate polio in Nigeria.
ROBERTS


5

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