NIGERIA: THE FIGHT AGAINST POLIO SUFFERS SIGNIFICANT SETBACK

Worryingly, one has become rather immune to horror stories emanating from Africa’s most populous country such that news of the killing of nine health workers said to be administering polio vaccines in northern Nigeria has not come as a shock.

 

Boko Haram: The History

 

Regular visitors to the 1worldinternational weblog will be aware of the origins of Boko Haram, the terrorist group with Nigerian origins which has over the last few years masterminded attacks against the Nigerian government, public infrastructure, civilians and churches. In a previous article entitled “Boko Haram: The New Al-Qaeda?”, 1worldinternational highlighted the threat posed by the group. The article also covered fears raised by the U.S. about the Nigerian government’s inability to deal with the insurgency and the prospect that the national problem may spiral into an international concern.
 

As always, the Boko Haram Islamist sect which opposes polio vaccination programmes, for what many term the misguided reason that it is a Western-led ploy to inflict AIDS on Muslim children and cause infertility within that cross-section of the Nigerian society, have been blamed for the killings.  This week’s attack follows a similar attack against aid workers in Pakistan who had been administering polio medicine to those most prone to the disease. Police spokesman Magaji Musa explained: “Gunmen on bikes opened fire on a health centre in the Hotoro district killing seven, while an attack on the Zaria Road area of the city claimed two lives.” Musa continued: “They were working for the state government giving out polio vaccinations at the time of the attack.”

 

Blow to Worldwide Fight against Polio

 

The latest attacks on health personnel in Pakistan and Nigeria, allied with the continued threats to the lives of aid workers in these regions, is indeed a massive blow to worldwide efforts currently geared towards the eradication of the disease. In June of last year, 1worldinternational reported, in an article titled ‘Global Polio Eradication Initiative (GPEI) Declares Last Stand against Polio’, the Global Polio Eradication Initiative’s launch of an emergency action plan following fears of a resurgence of the disease in countries where the disease was thought to have been eradicated. By way of information, the GPEI was formed in 1988 and was spearheaded by the WHO, Rotary International, the United States Center for Disease Control and Prevention and UNICEF. It is also supported by polio-affected and donor governments, private foundations, development banks, humanitarian and non-governmental organizations, corporate partners and more than 20 million volunteers.
 

It is perhaps no coincidence that the countries in which the most stubborn and obdurate opposition to the administration of medicine emanates are those – Afghanistan, Pakistan and Nigeria -  in which polio remains endemic to levels needed to prevent the transmission of the disease. The December 2012 and January 2013 attacks by alleged Taliban-linked militants in Pakistan is indication of the continued lack of understanding which is required from leaders of these communities if the Ban Ki-moon led quest to “stamp out polio for good” is to be achieved in our lifetime.

 

Sound-off

 

In the circumstances, the GPEI and those leading the fight against the dissease are left with essentially three options. The first and least favoured is continuing with the same course of action, i.e. sending in aid workers against the background of the real and severe risks of attacks on their person. The second and middle of the road option entails praying and hoping that the military might of the North Atlantic Treaty Organisation (NATO), the International Security Assistance Force (ISAF) and the Nigerian government will prevail over those of the Taliban, its allies and the Boko Haram military sect. The third and most preferable option, and which in the writer’s view is most likely to yield the most dividends, is that of engaging and educating the opponents of the vaccination programme about the advantages of immunization to future generations of Muslim children. Perhaps this will, to some extent, assuage fears which manifests itself in the form of misguided views in respect of the aims and objectives of the programme.
 

In this regard, charity organisations who operate within the Islamic world such as the Red Crescent may act as mediators and/or negotiators owing to the fact that they may not face the same allegations levelled aganst Western-backed organisations and aid workers which is that they are acting as agents of the West and that they are essentially, propagating and cultivating a Western-backed agenda. Unfortunately, without the co-operation of the current opponents of the vaccination programme, who also wield such overarching power and influence over the regions in which it is most prevalent, the battle against the disease will be one with which future generations will be saddled.

WEST AFRICA: U.N. APPROVES MASS VACCINATION IN BID TO BEAT SEASONAL MENINGITIS IN WEST AFRICA

The U.N. has stepped up the fight against seasonal Meningitis in West Africa with the news that 50 million people in the region are set to be immunized within the next three months. The campaign is expected to reach inhabitants of the West African countries of Benin, Cameroon, Chad, Ghana, Nigeria, Senegal and Sudan.


The campaign is being led by the Geneva-based GAVI Alliance, a public-private partnership which is backed by the World Health Organisation (WHO), the United Nations International Children’s Emergency Fund (UNICEF), the Bill and Melinda Gates Foundation and the pharmaceutical industry amongst others. According to the GAVI Alliance, the region is said to have been targeted as a result of its vulnerability to ‘seasonal severe outbreaks of meningitis’ which places up to 430 million people at risk of the disease.


The Meningitis bacteria is transmitted between people through droplets of respiratory or throat secretions and affects the lining surrounding the brain and spinal cord. The disease can be spread by way of person-to-person contact such as through sharing, eating or drinking utensils, kissing, sneezing and coughing. The disease can lead to brain damage, hearing loss, learning disability which occurs in 10 to 20 per cent of survivors and in extreme cases, death.


“Meningitis takes a terrible toll on the people living in vulnerable parts of Africa every year. It is a painful disease which can kill quickly and often leaves victims with disabilities that will blight their lives,” said Seth Berkley, CEO of the GAVI Alliance. Dr. Berkley added: “Nobody really understands exactly why just in that region. But every five to seven years there would be an epidemic. There would be hundreds of thousands if not millions of cases. And it would completely drive the economies to a halt.”


Reports of the renewed campaign against the disease comes on the heels of last year’s development of a new vaccine MenAfriVac, the revolutionary meningococcal A conjugate vaccine developed through the Meningitis Vaccine Project (MVP) which aims to eliminate group A meningitis epidemics which has plagued the sub-Saharan African region for more than a century. MVP aims to eliminate meningitis as a public health concern through the development, testing, introduction, and widespread use of conjugate meningococcal vaccines. The Meningitis Vaccine Project is a partnership between the WHO, the global non-profit organisation PATH and the Bill and Melinda Gates Foundation.


News of the immunization campaign is certainly welcome not least because of the myriad effects including economic and social which the outbreak of the disease – outbreaks are said to occur every 7-14 years – brings along with it. It is widely known that people tend to avoid large or social gatherings when these outbreaks occur with associated consequences being that children often miss school and adults avoid the workplace. Following news that the West African country of Burkina Faso has reported no new cases of Meningitis since the introduction of the MenAfriVac vaccine, hopes abound that Meningitis will be eradicated by the turn of the present decade.

GLOBAL POLIO ERADICATION INITIATIVE (GPEI) DECLARES LAST STAND AGAINST POLIO

Today, 1worldinternational reports on the UN and WHO's redoubled efforts to tackle the resurgence of polio. The piece was recently written by the weblog's author and published by the NGO, RESULTS UK.





The fight against Polio (poliomyelitis) received a boost last week with the launch of an ‘emergency action plan’ by the Global Polio Eradication Initiative (GPEI). The news follows recent fears about the resurgence of the disease in countries such as the Congo and China where the disease was thought to have been eradicated.


Polio

Polio is a disease caused by a virus which operates within its victims’ nervous system. It affects children mainly under the age of five and often leads to paralysis and in some cases death.


The Master plan

The plan devised by the GPEI involves increasing the WHO’s current vaccination programmes in Nigeria, Pakistan and Afghanistan, the only three countries where polio remains endemic, to levels needed to prevent the transmission of the disease. If the programme is successful in eradicating the disease, polio will become only the second disease ever to have been eradicated after small pox.


The Global Polio Eradication Initiative (GPEI)

The GPEI was formed in 1988 and was spearheaded by the WHO, Rotary International, the United States Centers for Disease Control and Prevention and UNICEF. It is also supported by polio-affected and donor governments, private foundations, development banks, humanitarian and non-governmental organizations, corporate partners and more than 20 million volunteers.


Vaccinations and Difficulties

Vaccinations have to date been the most effective means of preventing the spread of the disease. The most common vaccines are oral polio vaccine (OPV) and inactivated polio vaccine (IPV). However, the programme has faced various challenges in the countries in which the disease is still endemic such as insecurity, weak health systems and poor sanitation. Adding to the mix are the volatile concoctions of political and religious problems which have also hampered the gains being made. For instance, extremist Islamic leaders in Pakistan and Nigeria continually denounce the vaccination programme as a western conspiracy thereby preventing health officials from administering vaccinations to populations who remain prone to contracting the disease.


The Last stand

The UN has joined the WHO in publicly highlighting the threats posed by the disease if left unchecked. "Wild viruses and wildfires have two things in common. If neglected, they can spread out of control. If handled properly, they can be stamped out for good,” the organisation’s Secretary-General Ban Ki-moon said last week. According to Ban Ki-moon the Global Polio Eradication Initiative has only half of the $2 billion it needs to procure vaccines and deploy staff to cover the areas in the countries in which the disease is prevalent. The UN anticipates that about $40-50 billion will be saved in the cost of treatment by 2035, not to mention the countless lives of children at risk across the globe, if its last stand against polio is successful.

FEMALE GENITAL MUTILATION: LESS TALK, MORE ACTION

Recent reports that Female Genital Mutilation (FGM) laws are to be toughened by the United Kingdom government is strong indication that the internationally endorsed battle against the perpetuation of the practice is far from won.


The World Health Organisation (WHO) defines FGM as “all procedures that involve the partial removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.” The practice of FGM is not expressly required by any religion. However, advocates for its continuance argue that it prepares women for adulthood and marriage, ensures pre-marital fidelity, and reduces a woman’s libido thus enabling her to resist “illicit” sexual acts.


Despite the creditable attempts made by international bodies such as the UN, WHO, UNICEF and Amnesty International at eradicating FGM, the WHO’s 2010 Report Global Strategy to Stop Health-Care Providers from Performing FGM revealed that the practice is still prevalent in 28 countries in Africa and the Middle East. These include Nigeria, Guinea, Kenya and Yemen. The WHO’s Eliminating FGM: An Interagency Statement also stated that about 100 to 140 million girls and women worldwide are currently living with the consequences of FGM. Further, an estimated 3 million girls are said to be at risk of undergoing the procedure every year.


Aside the fact that the practice violates several internationally endorsed legal instruments protecting the rights of girls worldwide – The Declaration on the Elimination of Violence against Women and The Convention on the Elimination of all Forms of Discrimination against Women – FGM is also associated with many health risks including infections, infertility, increased risk of childbirth complications, chronic pain, psychological problems and in extreme cases death.


However, it cannot be said that the west, international bodies and NGOs have sat idly by whilst the practice has prospered. Notably, there has been a marked reduction in the prevalence of the practice over the last 50 years. Several countries including Liberia, Ghana and Burkina Faso have criminalised the practice and have also successfully prosecuted individuals. The EU also marked the International Day of Zero Tolerance to Female Genital Mutilation on 6th February 2011by condemning “the abhorrent practice that severely violates the human rights and the dignity of hundreds of thousands of women and girls.”


Encouragingly, the WHO’s campaign on the negative health implication of FGM in the developing world has led to a significant increase in the proportion of FGM operations carried out by trained health-care personnel. The organisation’s FGM and other Harmful Practices Report reveals a widespread practice of this new “medicalised” form of FGM. For instance 76% of FGM operations in Yemen in recent years were carried out by trained medical personnel, 65% in Mauritania and 46% in Kenya. However, critics argue that whilst immediate health consequences of the practice such as pain and bleeding may reduce as a result, victims rights are still being violated and the psychological effect on those subjected to the practice are not only unquantifiable, but are in many cases, irreversible.


Undoubtedly this deeply entrenched ancient practice will be impossible to eradicate without resources being invested in education, as well as wider publicity of its associated health risks within practising communities. In this vein, the UN should support international and national initiatives by providing financial support to educate individuals, families, communities and FGM practitioners of the health risks in order to dissuade them from the practice. Further, alternative jobs and sources of income should be made available to FGM practitioners to prevent them from returning to the profession. Perhaps the media should also be utilised as a means of publicising the health risks and to raise public awareness of the topic.


Additionally, strengthening enforcement and prosecution mechanisms in these communities should be of paramount importance. Therefore, penalties should be imposed on anyone including medical professionals, nurses and midwives who assist or are involved in carrying out the practice. The penalties should include long-term jail terms and significant fines to serve as a deterrent. Also, victims should be provided a means of seeking redress by bringing civil action against perpetrators. It goes without saying that these preventive and punitive measures will be impotent without the political will of the international community and national governments.