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Ensuring vaccine accountability as experts warn on possible polio resurgence in Nigeria

A child receiving polio immunisation in northern Nigeria.

By Hassan Zaggi

In August 25, 2020, Nigeria was declared polio-free by the World Health Organisation (WHO). This is after over three decades of intensive war against the disease.

The struggle to end polio virus commenced in 1988 championed by global bodies including WHO, the United Nations Children’s Fund (UNICEF) and the Rotary Foundation.

These organizations, along with the U.S. Centers for Disease Control and Prevention (CDC) and The Gates Foundation, have spearheaded the campaign through the Global Polio Eradication Initiative (GPEI).

However, following the poor or low immunization coverage in recent times, partly due to the COVID-19 pandemic, experts have begun to warn that if proper care and action is not taken, the over three decades gain may be lost.

They fear that polio may resurface in the country is due to the fact that immunization of children under -5 is not given the desired attention by the government at all levels and critical stakeholders.

Even the federal government has disclosed that it has put in place mechanism to ensure integrity and accountability in the administration of vaccines in the country in order to tackle child-killer diseases including polio, experts say they are still not satisfied.

Speaking in an interview at a 3-day media dialogue put together jointly by UNICEF in collaboration with the Child Rights Information Bureau (CRIB) of the Federal Ministry of Information and Culture, the National Primary Health Care Development Agency (NPHCDA), Coordinator for COVID-19 vaccination in Adamawa State, Abba Muhammad Isawa, warned that if the country did not continue to give routine immunization to eligible children, polio may resurface.

According to him: “Nigeria was among the countries that were still polio endemic. We had Afganistan and Pakistan. But Nigeria was declared polio-free last year. As at now, we have not had a case of Wild Polio Virus (WPV) in the country again.

“If we do not continue to give routine immunization, there is the tendency that polio may resurface. So we have to continue to give the routine vaccination as at when due.”

Commenting on the current Routine Immunisation (RI) situation in Nigeria, he said: “When we established the National Emergency Routine Immunisation Centre (NERIC) few years ago, we used the Multiple Indicator Cluster Survey/National Immunization Coverage Survey 2016-17, which shows that Nigeria has 33 per cent national coverage.

“We were supposed to conduct another survey last year but due to the COVID-19 pandemic we could not do so. But we are planning to conduct another survey so that we can compare the figures and know where we are as a country.

“However, we have seen some progress with the National Demographic Health Survey (NDHS). It indicated that the Routine Imunisation coverage in the country has improved.”
Responding to a question on the possible reasons for low RI coverage in the country, the expert said: “Most of the reasons why Nigeria has low coverage is the lack of awareness and the lack of the involvement of the people at the community level.
“When a caregiver takes a child for immunization, she does not know that she needs to bring the child again for another round. She assumes that when the child is being vaccinated during campaigns, the child is fully immunized.
“This gap in knowledge is due to lack of the involvement of the community people and allow them take ownership of the immunization activities.
“This is because, we at the health system cannot really sustain this, it is proper to involve the community people and make it a community thing and drive the ownership so that we can sustain it.”
He, therefore, advised parents and caregivers to take the eligible children to receive routine immunization against Polio, yellow fever, meningitis, Tuberculosis and BCG as at when due.
“It is supposed to be five times for a child to be fully immunized. They should ask their relations who have eligible children for vaccination whether they have been given the immunization five times and as much as possible try to retain the card because this is the evidence that the child has been immunized,” he stressed.
On how to ensure vaccine accountability, Isawa disclosed that the federal government through the NPHCDA have taken some steps to ensure integrity and accountability in vaccine administration in the country.
“When declaring RI emergency back in 2017, we developed accountability framework where all those involved in the RI activities in the country will be held accountable.
“So even to the facility level where we give the vaccine to the recorders and people that are going to immunize, for every dose of the vaccine given, the person will be held accountable.
“We have people that go to the facility, the local government and even to the state level to conduct audit and they are going to compare the vaccine and the doses we give to who and the person that have been vaccinated.
“At the end of every vaccination session, they return the empty vials and we do a physical count. That vials of vaccine that we give is actually what will be returned and we will check the records to see the people that have been immunized and we conduct survey and go to the community and check the people and ensure that really they have been given the immunization as recorded in the card. To some extent, we have accountability in place,” he explained.
Corroborating her fear on the possible resurgence of polio virus in Nigeria, the Communication for Development Specialist, UNICEF, Mrs Elizabeth Onitolo, insisted that the media must support the government and other critical stakeholders in sensitizing the people on need for continuous immunization in order to avert the return of the deadly polio virus into the country.
She also called on Nigerians to accept the COVID-19 vaccine, as according to her, it is the only way of preventing the disease.
She noted that: “There is need for the media to do more awareness particularly for people in the Northeast to guide against the coming back of polio and other likely diseases into the country.

“No child must die of polio again in Nigeria; we sincerely plead with the media to help us out by creating awareness and sensitising the people on routine immunisation.

“This meeting is to improve the knowledge of key media practitioners on low routine immunisation coverage; it is also to strengthen alliance with the media.

“The meeting is for the media to support the national plan to strengthen immunisation on COVID-19 information, and provide the media with additional sources of information on COVID-19,” she said.

Speaking earlier while declaring the media dialogue open, the Minister of Information and Culture, Lai Muhammed, noted that Nigeria is at a critical point in ensuring access to RI by children across the country.

He, however, acknowledged that the immunisation challenge is compounded by the COVID-19 pandemic which has resulted in many children not receiving their routine immunization.

Represented by Temitoye Falayi of the Child Rights Bureau unit, the Minister reiterated that despite the certification of Nigeria as a polio-free country, there is the urgent need for partnership between the government and other critical stakeholders to address the immunisation situation in Nigeria.

Health experts interviewed our Correspondent expressed mixed feelings on how the country will get it right in administering both polio and COVID-19 vaccines in the country.

They, therefore, called for more stringent measures and strategies to ensure that there is accountability in the manner and way the vaccines are administered for optimum result.

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