Long after
diseases such as polio, guinea worm, tetanus, leprosy, and measles,
among others, have been eliminated in many countries of the world,
Nigeria is still contending with these problems. Even today, the hope
of eradicating some of them in the nearest future remains dim.
The diseases have
been targeted for eradication and elimination by the World Health
Organisation (WHO) which hopes in the short run to lower their
prevalence so that they can more easily be managed.
According to the
Organisation, “Throughout history, only one infectious disease –
smallpox – has ever been eradicated. Today, polio and guinea worm
diseases are on the verge of eradication.” However, experts are worried
that the Nigerian government has at best shown a dubious attitude
towards their eradication.
Dearth of amenities
Some of these
diseases have been eradicated in most parts of the world, and their
continued presence in the country has been attributed to poor hygiene
and government’s inability to provide basic amenities that would help
keep them in check.
“Many of these
diseases have to do with good hygiene, good water supply for the
people,” said Edamisan Temiye, the chairman of the Lagos chapter of the
Nigeria Medical Association.
“For example,
guinea worm. You can contact it if you step into the water containing
the guinea worm larva; it will penetrate the skin and the person will
be infected,” said Dr Temiye.
“If somebody has
polio virus and his stool is not properly disposed of and it
contaminates water that is going to be drunk or food that is going to
be eaten, then the person is going to be infected. They have to do with
water so they are water-borne diseases.
“So, if the
country has been able to supply potable water for her citizens, we
would have eradicated these things; they will not be a big problem,” he
said.
Despite the
success recorded through mass immunisation campaigns, which officials
say had reached hundreds of millions of children, experts say some of
the diseases, like polio, are still widespread in some heavily
populated areas due to ignorance and poor reporting systems.
Ignorance and political interference
During the second
round of immunisation in Lagos State last year, some teams of
vaccinators met with stiff resistance in some areas of the state.
Tunde Oni, the
proprietor of Sam Debo Nursery and Primary School, Gowon Estate, in
Alimosho local government area of the state, resisted attempts to
immunise pupils in his school.
“It is not for the progress of this nation as the government has proposed, so I don’t want it done in my school,” he said.
Mr Oni believed
that the exercise had ulterior motives: “The government knows why it is
carrying this out. Maybe they don’t want it exposed to the people, but
I know the reason,” he said.
Afghanistan,
India, Nigeria, and Pakistan are the only four countries yet to
eradicate polio, according to a United Nations report.
Adebayo Onajole, a
medical professional, blamed the country’s inability to effectively
eradicate the disease on the irresponsible attitude of officials who
see the health institution as an avenue to engage in political
showmanship.
“The issue of
poliomyelitis is more of a political problem than us not doing some of
those things right,” said Dr. Onajole, an associate professor of
Medicine at the Lagos University Teaching Hospital (LUTH).
“And the political
problem came as a result of the religious strife from misinformation
about the vaccination against polio,” he added.
A few years ago,
some states in the northern part of the country rejected the polio
vaccines for the immunisation of children after rumours claimed there
was a chemical embedded in the vaccine which would sterilise male
children and destroy the womb of female children.
“That was one of the things that drew us back in terms of the polio eradication programme in Nigeria,” said Dr. Onajole.
“Because
immediately after that, paralysis as a result of polio that was noticed
in far away countries like Saudi Arabia was said to have originated
from Nigeria.
“A lot of people
were sponsored to go out of the country, even to purely Islamic
countries to be able to ascertain that the same vaccines that were
being used in Nigeria are the same that are used in those countries and
it was not deleterious to their health,” he said.
Immunisation is key but…
Various state
governments have embarked on immunisation campaigns to ensure that
these diseases are eradicated but, so far, polio seems to get all the
attention.
“Immunisation is
yielding some results, but they are concentrating only on polio. There
are so many diseases that are vaccine-preventable that are ravaging the
people of this country,” said Dr. Temiye.
“The focus is on
polio. There is no talk about measles, tetanus, and the rest, and some
of these vaccines are quite cheap; the system can afford them. We are
only concentrating on polio because we have funds from international
agencies to eradicate polio and governments have not put their money
down to eradicate other diseases, which are also there and there are
vaccines for them,” he said.
Dr. Temiye said
that a lot of children and adults are dying in large numbers as a
result of tetanus, measles, and meningitis, which are making a comeback
in epidemic proportion.
“If we have had a
system that ensures that every child born in this country is immunised
with all the available vaccines, then our health indices will increase.
We will also be able to eliminate diseases such as measles, tetanus
that are vaccine-preventable,” he further said.
In the case of
measles, however, the WHO states that global efforts to control the
disease have been hampered by low immunisation of coverage areas in
some countries.
“One of the
challenges facing measles eradication is that you can only administer
the vaccine via injection and it is only trained personnel that can do
that,” said Dr. Onajole.
“And you also know
the problems with injections today. A lot of us in the health sector
are trying to limit people getting injections because of diseases that
are spread via blood, especially HIV. Therefore, you will not want just
anybody to start administering injection because there is no advantage
in saving a child from measles, only for the child to have HIV,” he
added.
Ensuring that the
routine immunisation programmes are sustained and that people are able
to access immunisation at locations close to them would give the
necessary fillip to the fight against these diseases, according to Dr.
Onajole.
“Also, the
practice whereby local governments, primary healthcare centres, and
every other places are closed up because government wants to do her
so-called ‘special immunisation’ programme to immunise against one
disease, polio, is a major drawback.
“But, part of the
process of how the polio was eradicated in the Americas is that if a
case of acute flaccid paralysis is noticed as a result of
poliomyelitis, you do what we call a mop-up immunisation campaign
around five kilometre radius of that vicinity,” he said.
The migration of
people from disease endemic regions also weakens the fight against
eradication. Last year, more than 10 cases of paralysis as a result of
polio were reported in Lagos, where the disease was thought to have
been eliminated.
“The Lagos cases have been taken care of and the mop-up has been done,” said Dr. Onajole.
“Polio is easier
to eradicate because there is no reasonable extra human reservoir for
the virus and that means that somebody who has and is incubating the
virus must have been transmitting it to somebody else. So, if you can
eradicate it in the human population, then you are surely going to
eradicate polio virus,” he said.
Uniting to eradicate
Tremendous
achievement has also been made in the area of guinea worm disease, with
Nigeria recording her last case of transmission in 2008.
The WHO attributed
the success to the effective public/private sector partnerships towards
its eradication and elimination programmes.
Last week, some
African leaders demonstrated an unprecedented co-operation and
commitment to drive out polio when they launched a synchronised mass
immunisation campaign to reach 72 million children, capitalising on
gains made this year.
A report released
by the WHO stated that the “synchronised mass immunisation” became
imperative following the spread of the disease from Nigeria to 24
countries across West and Central Africa.
“As a direct
result of these immunisation campaigns, the polio outbreaks have slowed
to a trickle. Across West Africa, only Liberia and Mali have recorded
any case in the past five months, while Nigeria – the only country in
Africa never to have stopped polio transmission – has slashed polio by
98 percent in the past year,” the WHO report stated.
Also last week,
the World Health Assembly expressed worries over the $1.3 billion
funding shortfall, a 50 percent drop in the overall funding for the
polio eradication programme over the next three years.
Dr. Temiye
maintained that Nigeria should be looking inwards for finance, rather
than waiting for handouts from foreign agencies.
“Why should we
depend on donors? We have enough money to take care of ourselves. Why
should we depend on people dictating to us what to do when we know our
own problems?
“Nobody can solve our problems for us from outside. We must solve it
within. We should use our money to develop ourselves. Until we do that,
I’m sorry we’ll still have a lot of problems,” he said.