Abuja, 20 September 2017-The 34^th session of the Expert Review Committee on Polio Eradication and Routine Immunization (ERC), cautions the Nigeria programme to guard against complacency as the country is ”not out of the woods yet”. The warning according to ERC is germane, given recent antecedents despite one year without any reported case of wild poliovirus (WPV) in Nigeria.

In 2016, the Government reported four laboratory confirmed WPV cases between July and August after almost two years without the detection of WPV.

Giving ERC’s preliminary findings and recommendations, Dr Pascal Mkanda, the Polio Eradication Programme Coordinator at the World Health Organization (WHO) Africa Regional Office, noted progress made with polio eradication programme in Nigeria in line with global best practices.

Increasing reach in security compromised areas

In order to reach chronically missed children due to insecurity, the experts recommends the continued implementation of innovations, in collaboration with security agents, to reach more children in inaccessible areas of Borno State and the northeastern Nigeria as well as the Lake Chad Basin

“Maintaining Nigerian security forces support is critical. It is estimated, using satellite imagery and profiling data from special interventions, that there are 162,616 eligible children in Borno state that are still currently unreached. In addition there are 178 inaccessible islands on the Lake Chad that have not been reached”, Dr Mkanda mentioned.

Therefore, ERC recommends the Nigeria programme implementers to ensure the periodic review and validation of inaccessibility data as well as revision of innovations such as reaching every settlement (RES) and reaching inaccessible children (RIC) for best outcomes.

Achieving sensitive surveillance

Earlier, members of the ERC had provided inputs following technical presentations and observed extra ordinary efforts put in place to strengthen surveillance among difficult to access populations through innovative strategies. They were particularly impressed that recommendations from various reviews and expert committees are implemented and monitored.

However, with Nigeria at risk of undetected polio transmission, the ERC stressed the importance of full   implementation of recent external surveillance review recommendations with focus on internally displaced persons and partially/inaccessible areas.

Furthermore, ERC recommends, “Extra efforts are required to ensure AFP surveillance network reaches the nomadic population”.

Focusing on routine immunization

With fewer supplemental immunization activities planned from 2018, building population immunity will be dependent on strong routine immunization (RI) coverage. The conviction stems from recent survey data indicating less than 30% of eligible children have received all the recommended vaccinations.

Realizing the magnitude of immunization work needed with human and financial resources required, the Executive Director of the National Primary Health Care Development Agency (NPHCDA) Dr Faisal Shuaib had declared RI as public health emergency. Therefore, ERC requested full implementation of the “Abuja Commitment” to urgently establish the political will needed to strengthen RI. The ERC also remained convinced that RI is the way to sustain and protect gains in population immunity against vaccine preventable disease, including polio.

Political commitment required to sustain resilience

Noting the waning political commitment, ERC recommended that the Presidential Task Force resume its meetings to review progress. Furthermore, ERC called for continuous advocacy to Nigeria Governors’ Forum to ensure states buy-in and release of local government area (LGA) level counterpart funding as well as increase active participation of LGA Chairmen in polio eradication activities, including attendance at evening review meetings.

The ERC meets periodically to evaluate progress towards the attainment of a polio-free Nigeria. The monitoring body provides guidance to the government and partners.

Support for polio eradication to the Federal Government of Nigeria through the WHO is made possible by funding from the Bill & Melinda Gates Foundation, European Union, Government of Germany through KfW, Global Affairs Canada, USAID, Community Chest Korea through KOFIH, DFID (UK), Rotary International and the World Bank.

•    Technical contact:

Dr Richard Banda; Tel: +234 803 535 4875; Email: bandari [at] who.int