Nigeria key to polio-free world

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Polio -- devastating to thousands of Americans less than two generations ago -- can be the second disease to be wiped from the face of the Earth in our lifetime, following smallpox. But health workers around the globe need a final boost of $100 million for Africa to complete the job in a few remaining countries where fear of vaccine safety, funding shortfalls, and conflict threaten to derail the effort.

This week epidemiologists warned that west and central Africa are on the brink of "the largest polio epidemic in recent years." The newest alarm comes from the war-torn Darfur region of western Sudan, where a child has been infected by the same poliovirus found in northern Nigeria. This represents the 10th African country to be reinfected with wild poliovirus after being polio-free several years.

Nigeria is the African country that deserves focus right now. From northern Nigeria, polio is spreading to polio-free countries and the eradication effort is moving backward. Already, 257 cases of polio have been confirmed between Jan. 1 and June 22, compared to 56 cases at this time last year.

The rainy season fast approaches; this will create the conditions for the poliovirus to spread more intensively. There is an urgent need right now to double our efforts to achieve a polio-free Nigeria -- necessary for achieving the goal of a polio-free world by 2005. The immense effort of health workers and polio partners around the world must not fail. Collective polio eradication efforts are working in all other areas of the world. But each month Nigeria continues to export poliovirus delays the time frame for eradicating polio.

Rumors, declaring the vaccine for polio produced in Europe and the U.S. unsafe, halted vaccinations in northern Nigeria, particularly Kano State. A solution, brokered in May, is that Nigeria's leaders will import polio vaccines from Indonesia, so the locals can be confident the vaccine produced in an Islamic country is safe. As this vaccine safety issue has been resolved, it is imperative we restart vaccinating in all of northern Nigeria now. Last month, the Kano governor, Ibrahim Shakarau, announced vaccinations would resume, but to date children are still not being vaccinated.

Health workers find Nigeria logistically and epidemiologically more challenging for immunization than other countries. Because it is common practice for some northern Nigerian families to move around, health workers require additional resources to track down and vaccinate every child.

In Nigeria, cultural and traditional differences in the north prevent outsiders from gaining the trust needed to do the necessary work. The assistance to Nigeria needs a new focus on supporting locally-defined solutions. This would encourage Nigerians to "own" this program and thereby break down current barriers in the country to eradicating the disease.

It may be prudent to immediately support two northern Nigerian states in developing model polio eradication programs. Success there could serve as culturally appropriate models for eradicating polio from the rest of the country.

The eradication of polio will not only ensure the disappearance of a crippling, highly contagious and sometimes deadly disease. A healthier well-trained work force will strengthen long-term development of impoverished countries.

Further, the global health force developed to eradicate polio can transfer its experience to combat other health problems such as HIV/AIDS. Let's finish off polio now. Africa's cost shortfall is $100 million. The human cost is unquantifiable.

David Newberry is CARE's senior health adviser and technical advisor for the documentary "The Last Child: The Global Race to End Polio" (www.lastchild.org).