1. Is Nigeria “polio-free?”

Not yet. Global health organizations have not documented a case of polio in Nigeria–one of three nations that have never fully eradicated polio–since July 24, 2014. However, the World Health Organization (WHO) will not declare Nigeria “polio-free” until the West African nation reaches a full year with no new cases.

2. Is it probable that polio will permanently be eradicated in Nigeria?

That depends on whom you ask. On one hand, polio eradication in Nigeria has almost been successful, and recent media coverage seems hopeful that no new cases will appear in the twenty-some days before the WHO’s approval. Eradication of polio on the entire contiguous continent of Africa also seems plausible, as officials declared in June 2015 that the outbreaks in Equatorial Guinea, Ethiopia and Kenya are no longer health threats. This could mean that worldwide efforts to eradicate polio from Africa have improved since the outbreaks began in 2013.

However, some health officials warn that the world should not be too quick to celebrate. Hamid Jafari, the polio chief at the WHO, warned that the virus is very difficult to detect.

“We are not yet certain that the wild poliovirus is gone from the African continent,” said Jafari, “there are areas in the African region in the northeast of Nigeria, Lake Chad, the north of Cameroon where the situation is uncertain security-wise. We may have undetected transmission of poliovirus there.”

3. Why is polio so difficult to detect in Nigeria?

There are a variety of health and political concerns that have made the nation difficult to vaccinate since the early 2000s. From the medical perspective, people often spread the virus without showing any symptoms. Only one in 200 polio cases cause paralysis.

In short, the fact that health officials have not reported any cases does not mean that people in Nigeria are not infected.

Additionally, some areas in Nigeria–like the locations that Jafari referenced above–are near impossible for vaccination teams to reach because of the control of Islamic militant groups. Boko Haram, one of the most “lethal and resilient” jihadist groups in the history of Nigeria, has repeatedly denounced efforts to eradicate polio, claiming that vaccinations are a ploy by the West to sterilize Muslim children.

4. Is religious opposition to vaccinations in Nigeria the source of the problem?

Not really. Boko Haram’s skepticism and violence toward polio vaccination campaigns are based more on its opposition to Western culture than the specific religious beliefs of Islam. Boko Haram is a loose translation of “Western education is forbidden.” Present in Nigeria since 2002 and active in military operations since 2009, Boko Haram is a group of roughly 9,000 men (according to CIA estimates) that seeks to establish the Islamic State in Nigeria by purging the nation of Western influence.

Analysts say that governmental effort to reduce Nigeria’s chronic poverty and construct an education system that is inclusive of local Muslims is the only way to eliminate the threat of Boko Haram. However, the violent actions of jihadist groups against vaccination campaigns are not representative of the entire Islamic community in Nigeria.

Although resistant to vaccination efforts initially, Muslim leaders were actively involved and very influential in vaccination campaigns in the years before 2012, often citing moral principles as justification.

“We don’t care if it’s something that will affect you and your family alone. But [if] you don’t comply with us, you allow your child to go—he’s going to spread it to 200 other innocent children around the vicinity,” said Nigeria’s top-ranking Muslim and the “polio point man” for the region of Kano, Wada Mohamed Aliyu.

5. What outside assistance do foreign organizations provide to Nigeria?

National and local municipalities and organizations in Nigeria play a role in polio detection and prevention as well as immunization, but many global actors have greatly contributed to efforts in order to eradicate the virus. The Global Polio Eradication Initiative (GPEI), spearheaded by the World Health Organization, Rotary International, UNICEF, the United States Center for Disease Control and Prevention, and the Bill & Melinda Gates Foundation, have worked with Nigerian groups to lower the global incidence of polio by 99% since 1988. The GPEI and its associated organizations have not only financially funded eradication efforts but have also actively been strategic partners that have provided technical and political support to Nigeria. Gavi, the vaccine alliance, has also been a major player in facilitating the implementation of inactive polio vaccines, which work in tandem with oral polio vaccines to secure a polio-free world.

– Paulina Menichiello

Sources: NPR 1, NPR 2 , BBC, NPR 3, NPR 4, Polio Eradication
Photo: Monitor Healthcare