Bill & Melinda Gates Foundation

What It Takes to End Polio in Nigeria

July 27, 2012

After reading the recent Wall Street Journal op-ed “Victory against polio is within reach,” I was reminded of the trip I took to Nigeria last month to look more closely at the polio work there and felt the need to write a response. The op-ed highlights the tremendous progress in the global effort to fight polio but also notes the critical need to fill a $1 billion funding gap and for strong political commitment to end polio forever.  My trip was only a few weeks after Nigeria joined Pakistan and Afghanistan at the launch of the Global Polio Eradication Initiative (GPEI) Emergency Action Plan.  At that launch, representatives from all three countries where polio has never been stopped emphasized their commitment to do what’s needed to boost vaccination coverage in their countries.  

There’s no question we’re facing an urgent funding challenge. However, everywhere I went in Nigeria, I was tremendously impressed and inspired by the political commitment at the national and state level.  The deputy governor of Kano walks through villages and slums to speak with families who don’t want to immunize their children and the former health commissioner of Jigawa pulls up vaccination campaign quality data on her phone at the drop of a hat. These “vaccinator heroes” underscored the dedication Nigeria has to ending polio forever and protecting children from this vaccine-preventable disease.

It’s also clear that concerns about vaccination teams missing houses where children live, and reaching more houses during vaccination campaigns, are being addressed. I saw exciting developments to help ensure vaccinators reach every child with the oral polio vaccine.  These include the use of GIS and GPS, which maps entire villages and gives vaccination teams the tools they need to make sure they don’t miss any houses.  Another development making a difference is a huge shift in team composition, from teams of eight to teams of three with a supervisor, allowing the teams to reach more houses and keeping the workload focused.

There are ‘weak links’ that can break the chain in vaccination coverage in Local Government Areas where children are persistently missed.   Allaying those concerns was my visit to Dodo village in Dawakin Kudu where I heard about efforts to get respected local women to ensure vaccinators go to every home. Getting that piece right – public acceptance – is key. So is choosing the right vaccinators and monitoring their work well.

Still, challenges remain and more needs to be done to bring the persistent reach of polio vaccinators together with routine immunization and other health initiatives.  I was reminded of the impact of this challenge when I visited a primary health care center in Nassawara in Kano and saw more than 100 mothers bring their children for DPT vaccination but only 20 doses were available.

The bottom line is that polio efforts in Nigeria are changing for the better, due to steadfast political commitment at all levels, accountability across the vaccination campaign chain and innovations that are having impact on children’s lives.  With this continued commitment, I’m more optimistic that victory against polio is indeed within reach.

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