Francis Awowole-Browne
Penultimate week, business mogul, Aliko Dangote, and his American counterpart, Bill Gates, embarked on trouble-shooting trips across and beyond Nigeria in their quest to ensure Nigeria becomes polio-free.
For the Africa’s riches man, “it is quite embarrassing that Nigeria is one of the only three countries in the world that are yet to be certified polio-free.”
The other two being Pakistan and Afghanistan.
Therefore, for the whole week, the Dangote Foundation and the Bill and Melinda Gates Foundation, which have been at the forefront as private sector partners in the process of elimination of polio, went on assessment of the situation in areas earlier affected by the disease and the neighbouring Chad Republic, where the two and their teams met with President Idris Deby and other key government officials in Ndjamena.
Polio is a crippling and potentially fatal infectious disease. It is an infectious viral disease that affects the central nervous system and can cause temporary or permanent paralysis, most especially in the leg.
Children not older than five years are more likely to contract the virus than any other group, therefore, the epidemic inflicts economic loss of colossal dimension on a nation as youths, the future generation, which forms a plank of the productive population are affected.
Polio is caused by a highly contagious virus specific to humans. The virus usually enters the environment in the faeces of someone who is infected. In areas with poor sanitation, the virus easily spreads through the fecal-oral route, via contaminated water or food. In addition, direct contact with a person infected with the virus can cause polio. The infection with poliovirus and direct contact with persons increase the risk.
According to World Health Organisation (WHO), a country is regarded as polio-free if no cases have been detected for a year. However, no cases of the virus have been reported in the last 16 months in Nigeria, but it is feared that it is still possible polio circulates under some prevailing circumstances as was the case, where a particular strain of virus resurfaced after five years in 2016, which professionals adduced to inadequate surveillance and under-vaccinated populations. Even a single case is considered an epidemic.
Over the years, Dangote Foundation has been involved in causes that guarantee healthy life for the Nigerian child and reduce extreme poverty among the vulnerable, especially women. It was in this spirit that Aliko Dangote had deployed his resources, for critical interventions, among which are issues bordering on nutrition, routine immunization and commitment to eradicate polio.
The Centre for Strategic and International Studies (CSIS) identified multiple factors hampering eradication of the virus especially in the North. Many of the factors, it stated in one of its reports on polio eradication, are embedded in the country’s broad socio-political dynamics and enduring chasm between the governed and the government and a decentralized governmental system that often neglects service delivery to marginalized communities.
Some of the obstacles to polio eradication in Nigeria as in many other countries are the lack of basic health infrastructure, which limits vaccine distribution and delivery, the crippling effects of internal strife occasioned by insurgents’ activities which have turned some areas in the North-East as hard-reach.
The visit to Chad was necessitated by the fact that Chad is next to Nigeria from the North-east axis where immunization penetration has been very difficult. Any movement of the virus across the border might put Chad into jeopardy hence the need to intensify immunization in the country, especially in the islands close to the insurgents’ enclave.
Besides, Chad is said to be spending less than before on vaccines and routine immunization operational costs – both in absolute terms as well as a proportion of total expenditures. Therefore, both Dangote and Gates were able to obtain commitment from Mr Deby to personally track the ability of the polio programme to access and actually go to all 800 Chadian islands in the Lake Convince with a promise to step up his political and financial support for routine immunization.
The Chadian president then signed a declaration, committing to increase immunization rates in Chad and end polio in the region. Though Chad has not seen a case of wild polio since 2012, a 2016 polio outbreak in Nigeria placed those in neighbouring countries at risk, particularly children who live on the hard-to-reach islands of Lake Chad.
President Déby reaffirmed his support to the region-wide effort to stop polio. “Improving the health of Chad’s children is critical. I am committed to working with neighbouring governments to end polio for good in Africa, and to protecting more of our country’s children with vaccines against other deadly diseases.”
After the signing of the understanding, Dangote said all countries in the region—including Chad—share a responsibility to protect every child with polio vaccine. Until this happens, the risk of wild polio cases spreading remains.
“We are close to stopping polio on the continent – but we are not done yet. We want to save the lives of 250, 000 child with application of right vaccines. Unless we protect all children in Africa with the polio vaccine, the risk of the virus spreading will remain. That is why the Dangote Foundation is determined to continue working with Nigeria’s neighbours including Chad, to improve immunization rates and end polio for good,” he said.
He stated that Polio eradication is a must because it is a disease that causes paralysis and in some instances, death. Thirty years ago, it paralyzed an estimated 350,000 people – last year there were just 22 cases confined to Afghanistan and Pakistan, a record low. But, the fight against polio is not over until there are no cases anywhere in the world for at least three years.
“As a Nigerian, I feel that I have a special responsibility to make sure that Africa is free from polio since my country has been the one exporting the virus for so many years.
“The polio outbreak in Borno a year and a half ago was a big setback. And a lot of work has been done to get it under control. Including your country. But I’m concerned, especially about the risks that still remain. Nigeria cannot reach thousands of settlements, and its islands in Lake Chad because of Boko Haram. And until we do, you will need to be super vigilant on your side.
“One of the risks I see is the islands on your side in Lake Chad. As Bill mentioned, they are difficult to reach, and they have not been visited on a regular basis by the polio programme. I think it would be very helpful if you give instructions for the military to help transport vaccinators to each of the islands we’ve been talking about – so that they are all visited at least 3-5 times this year. With logistics and planning support from the military, I think you can take the final steps to ensure Chad remains polio-free.
“If you personally lead a public review of the programme every six months – with the ministers of Health, Interior, Finance and Communication – along with the governors and administration, traditional and religious leaders, it would send a clear signal that it is not business as usual. I would be happy to come back for your first review, if you conduct it mid-year.
“Like Nigeria, Chad needs to spend more of its own money on routine immunization. If we cannot immunize our own children to protect them from disease, they have failed them. My recommendation is that you establish a clear budget line for routine immunization in the annual budget at least 40 per cent. That would get you back to the level of commitment the government was making in 2012. Bill and I will work hard with the global partners to try to secure the rest.
Francis Awowole-Browne, Dangote Group, Lagos