Conflict drives the return of wild polio to Nigeria

Dr. Mariam Florence Ogo administers oral polio vaccine to a child in Pakka, Adamawa, Nigeria. (Mariam Florence Ogo/CDC/flickr)

Two children were paralyzed by wild poliovirus in northern Nigeria, the World Health Organization announced. They are the first cases in more than two years in the country, presenting a setback in the country’s effort to eradicate polio. UNICEF called on aid groups to re-double efforts in conflict zones and the Nigerian government to restore peace in the region.

“We cannot deny the connection between conflict and the continued threat of polio. The two new cases mean children across the Lake Chad region are now at particular risk. With our partners, we will not stop until we reach every child with polio vaccination,” said UNICEF Polio Eradication Director Reza Hossaini, in a statement.

The WHO said it is not surprising for children to fall ill with polio in areas where it is hard to conduct vaccinations. Nigeria has a strong surveillance system to track polio vaccines and cases. It shows that there are parts of Borno state, where the infected children live, that have low or no vaccine coverage. The lack of coverage is why the polio strain that infected the children is closely linked to the last polio strain detected in the state back in 2011.

Attacks carried out by the Islamist terrorist group Boko Haram have effectively cut off parts of Borno. As a result, children are suffering from higher rates of malnutrition than other parts of the country. The two cases were discovered after authorities were allowed to enter previously inaccessible parts of the state. With only 21 cases of wild polio reported globally in 2016, tracking down cases is vital to reaching the goal of global eradication.

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“We are confident that with a swift response and strong collaboration with the Nigerian government, we can soon rid the country of polio once and for all,” said Dr. Michel Zaffran, director of polio eradication for the WHO, in a statement. “This is an important reminder that the world cannot afford to be complacent as we are on the brink of polio eradication – we will only be done when the entire world has been certified polio-free.”

Zaffran went on to characterize the discovery as a “true disappointment,” in his comments to the media. He said that new vaccine rounds would be needed in the Lake Chad region of West Africa in order to ensure that more children do not get infected by polio. Campaigns are expected to take place in Chad, Cameroon, the Central African Republic and Niger. This week will likely see a vaccine campaign in Borno state and other parts of Nigeria.

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While the total number of wild polio cases are down compared to last year, eradication groups are concerned by the challenges posed by conflict. Nigeria is joined by Pakistan and Afghanistan as the only places to have recorded wild polio cases this year. And just like northern Nigeria, the parts where cases have been found in Pakistan and Afghanistan also happen to be where conflict has reduced the ability to carry out robust vaccine campaigns.

It is not just the lack of vaccines that is the problem. People who flee fighting are likely to end up in areas where the wild virus exists. That means that it is hard for public health officials to know where precisely to target a response. The good news is that Nigeria has gone from the country responsible for half of the world’s polio cases in 2012 to no cases by 2014. But those systems to track cases and provide vaccines will be limited when Boko Haram makes it impossible reach some parts of the country. If the group persists, the chance of more wild polio cases occurring remains.

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Tom Murphy

Tom Murphy is a New Hampshire-based reporter for Humanosphere. Before joining Humanosphere, Tom founded and edited the aid blog A View From the Cave. His work has appeared in Foreign Policy, the Huffington Post, the Guardian, GlobalPost and Christian Science Monitor. He tweets at @viewfromthecave. Contact him at tmurphy[at]humanosphere.org.