Cablegate: Nigeria: Status of Polio Eradication Initiative

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

070456Z Jul 04




E.O. 12958: N/A


1. It is still anticipated that Kano will begin catch-up
immunization programs this summer and rejoin the nationwide
schedule when it resumes. It is less clear now, however,
what the schedule will be or when it will begin. The
Governor has now convened another panel to examine the latest
test results brought forward by Dr. Bichi. Workers sent to
the state from the National Program on Immunization (NPI) to
prepare for resumption of PEI were sent home and told to
cease their activities for the present. Solutions to the
latest concerns are being sought by GON, Kano State and the
donor community to enable resumption of PEI. WHO is
beginning travel advisories to cover the entire north of

2. Post renews its request for 2 million USD in ESF to move
this program forward; only substantial additional resources
will allow USAID work in Kano State to go forward. Please
see Embassy cable of July 6. END SUMMARY


3. Polio Situation: There are now - as of June 23, 2004,
259 confirmed polio cases in 30 Nigerian states recorded
since January 1, 2004. This accounts for 77 percent of the
total global wild poliovirus case count and 85 percent of the
cases in Africa since the beginning of 2004. As the virus
enters the highest transmission period, post anticipates the
Nigeria case count will increase significantly. The most
recent country to be re-infected with poliovirus originating
from Nigeria is Sudan, where a case has been identified in

4. With the far-reaching and growing spread of this virus,
the Director General of WHO has become personally involved in
seeking solutions, resulting in phone conversations with the
Governor of Kano State to offer support and convey concern of
all UN Member States over the current status. While the
governor was cordial and receptive, he declined to offer a
firm date for resumption of PEI.

5. WHO will be obliged, if the current situation continues
unabated, to impose a travel ban to cover the entire north of
Nigeria, for obvious epidemiological reasons (85.7% of total
cases in Nigeria are in the northern region). The ban will
apply to both incoming and outgoing travelers.

6. USAID's Child Survival Project in Kano State flagged off
Child Health Week on June 15 and ended the program a week
later, on June 22. All routine antigens were available and
administered to Kano children during the week, with the
exception of oral polio vaccine (OPV). It was previously
hoped that OPV could be reintroduced into Kano by this means
(at fixed-post sites rather than door-to-door) to remove the
onus that has gathered around the singular intervention of
polio. Other child health components offered during the week
were demonstrations of bed-net dipping, administration of
vitamin A, nutrition demonstrations and counseling, and
growth monitoring and promotion. The turnout during the week
was large, with many residents inquiring about OPV and
requesting it. A full report on Child Health Week will be
available in July.

7. The GON is in close contact with the Governor of Kano
State to find a solution to the recurrent stand-off. Donors
are also in touch to offer assistance as needed and
requested, although WHO declined a request by Kano State to
fund further international testing of OPV. WHO responded by
saying they see no need for further testing of vaccines from
a certified and approved lab, and that sufficient testing had
been done in the opinion of everyone else concerned. Dr.
Lawan Bichi, a pharmacist who has been serving as the
scientist for Kano State, has concluded more local testing of
available Indonesian vaccines and found them still to have
unacceptably (to them) high levels of both estradiol and

8. It seems clear that Dr. Bichi does not speak for either
the Governor of the state or for the majority of state
officials, since the Kano State Governor has now sidelined
Dr. Bichi and appointed a committee of eight (8) men to
review the latest, locally-produced laboratory report and
make recommendations. Word on the decisions of this
committee will be available during the week of July 5th. The
latest testing came as a surprise to all concerned, since the
Governor was making reassurances about and preparations for
the resumption of PEI in Kano State. This has created a
set-back, but sources in Kano tell us that at least five of
the eight committee members are favorably inclined to the
eradication initiative. Meantime, until all issues are
sorted out and laid to rest officially, all PEI personnel who
had been sent to Kano State to begin preparations were sent
away and ordered to cease their activities for the present.

9. Donors continue to meet to craft a unified strategy that
all can support. Heads of donor agencies met on Monday, July
5th, with the Minister of Health to spell out their concerns
and to enlist his support for a new way forward with PEI. The
Minister expressed his understanding of the major
impediments to the PEI and asked for a collective donor
position paper on immunization, to be submitted by the 26th
of July with a follow-up meeting on the 29th to take
decisions on a way forward. The paper and follow-up meeting
will include approaches to polio eradication in Nigeria as
well as a review of the NPI decree of 1997 determining the
mandate of this body.

10. A joint proposal is due from WHO and UNICEF to USAID by
July 12th. This proposal will fund the polio eradication
activities detailed in the previous cable, dated May 28th
2004. USAID plans to begin operationalizing the activities
in the proposal as soon as the requisite paperwork is
concluded and ESF funds made available.

--------------------------------------------- ---
--------------------------------------------- ---

11. USAID remains committed to devoting exclusive attention
to Kano State for the duration of the present Child Survival
contract with BASICS, which will terminate at the end of
August 2004. Our proposed grants to WHO and UNICEF will
allow us to continue our activities in Kano State with no
gaps in service including both routine and polio
immunization. It is our plan in the short term through this
mechanism to facilitate the reinstatement of PEI in the
state, and in the long term to continue immunization efforts
through the newly approved USAID social service delivery

12. Post reiterates its request for $2 million USD in ESF to
support proposed activities in Kano State for both short- and
long-term assistance.


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

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