Vital Signs: The potential end of polio in Africa

“We want to reach every child, no matter where they are” – Sue Desmond-Hellmann, CEO, Gates Foundation

This month on CNN’s ‘Vital Signs’, host and CNN’s Chief Medical Correspondent, Dr Sanjay Gupta, ventures to northern Nigeria to document what was once thought impossible, the potential end of polio in Africa. The programme reports from the remote Kano State, where the aim is to vaccinate around three million children in some of the world’s hardest-to-reach areas.

Eradicated in 99 percent of the globe, Nigeria is the last remaining country on the African continent not to eliminate polio, but it has just surpassed a big milestone: its first year without a single case of the disease.

Join Dr Gupta and a team of healthcare workers as they find out more about the polio story in northern Nigeria and the challenges faced in the heroic efforts to vaccinate every child.

Dr Gupta’s journey takes him to the state of Kano, where most villagers are off the grid and without healthcare. The isolation in this region has enabled the wild polio virus, or ‘WPV’ to survive here decades after its eradication in most of the world.

This is also a region where insecurity thrives. A more than five-year insurgency by Islamic extremist group Boko Haram continues to have devastating consequences.

Sue Desmond-Hellmann, CEO of Gates Foundation tells ‘Vital Signs’: “Better healthcare and better security are absolutely linked. It is not surprising that the three countries on earth where we’re still grappling with polio are those countries that have had a lot of unrest.”

Taking on the last of the virus in Kano means taking the vaccine to the state’s three million children. The work is done by nearly 7000 teams of vaccinators who work five days a week delivering the immunisations needed.

Dr Gupta follows The World Health Organisation at work, who show him exactly what it means to go door to door, house to house in rural Nigeria distributing the vaccines.

One of the challenges faced by health workers are the myths that surround vaccinations. In 2003, the former Governor of Kano halted a vaccination campaign after there were widespread rumours that the vaccine would cause HIV, infertility in women and that polio was a Western conspiracy.

Kulchumi Hammanyero from the World Health Organisation tells the programme that when parents refuse the vaccination it poses a major challenge. She confides to ‘Vital Signs’: “It’s a big issue because for us there is no child that we want to leave unimmunised. If you leave even one child unvaccinated that can be a problem… Of course it means that child could be a potential case for WPV.”

Today, parents who refuse to have their child vaccinated can face up to seven years in prison. This is due to the stance of respected traditional leaders such as the Emir of Kano, who put his complete backing into the vaccine programme. He tells the programme: “The level of education is such that we do understand that getting treatment or prevention does not in any way contradict or conflict with Islamic law. But when you’ve got people who aren’t educated, and introducing new things, you now have either politicians or scholars who misapply or misinterpret religion, it becomes very easy to convince people that anything foreign is harmful, education is bad.”

At a health clinic in Sumaila District, Nigeria, ‘Vital Signs’, witnesses mothers patiently waiting in line, babies in their laps, green immunisation cards in their hands. Those in the clinic know of the threat of polio, but Northern Nigeria is vast. In the Sumaila District alone there are nearly 68,000 children under the age of five all who need immunisation.

Another challenge is complacency. Despite it being a year since the last case of polio, health workers in Nigeria are refusing to slow efforts. Kulchumi Hammanyero, quietly confident the team are making progress, tells Dr Gupta: “There are no WPVs, all indicators are showing us we have covered ground, then we can say, ok we have reached a certain point, but we are not out of the woods, we are not out of the woods at all.”

It will be at least two years before Nigeria can officially be declared polio-free, but as ‘Vital Signs’ discovers, the fight and ambition to eradicate the disease means there is light at the end of the tunnel.

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