Kaduna, 04 April, 2017 - The polio Outbreak Response Assessment (OBRA) team with representation from the Global Polio Eradication Initiative (GPEI) partnership has congratulated the Nigerian government for the significant progress so far made in response to the 2016 polio outbreak. The commendation was contained in a presentation to government and partners during a debriefing meeting in Kaduna on 03 April 2017.

The OBRA team was in Nigeria from 22 March to 03 April, 2017 to evaluate whether the quality and reach of current supplemental immunization activities (SIAs) are sufficient to stop transmission and assess if poliovirus circulation will be detected with the existing surveillance structures.

Borno and Sokoto states were selected for field assessment, primarily due to the detection of wild poliovirus (WPV) and circulating vaccine derived polio virus (cVDPV2) in 2016 respectively. The methods employed for the assessment included direct observation of SIAs implementations, health facility assessments, visits to environmental surveillance, special intervention sites, key informant interviews, document reviews and data analysis in the two states.

Presenting the preliminary findings of the assessment, the Team Lead, Dr Zainul Khan from World Health Organization Headquarters observed “Innovative local approaches have been effective in reaching children including those in partially accessible settlements”. He further highlighted the efforts at national and state level in coordinating the massive response to the  multiple outbreaks.

According to Dr Khan, it was the conviction of the OBRA team that strategies and approaches of polio surveillance have proven comprehensive and sensitive enough to detect polio virus transmission in most of the accessible and partially accessible areas where the programme has a reach by any approach.

The OBRA, whilst acknowledging the involvement of community leaders, partner agencies as well as the military and civilian Joint Task Force in outbreak response activities, also enumerated recommendations to improve communication with parents to engender more demand for immunization in high-risk areas.

However, the team noted gaps which are inevitable threats to the progress made so far  include low routine immunization coverage in Sokoto (30%) that has already reported three out of the five VPDVs isolated  in Nigeria in 2017; an indication of weak routine service delivery. For Borno, the team cautioned that with 40% of settlements still inaccessible due to extant insecurity, circulation of poliovirus in those areas cannot be ruled out. The team stated that the reality poses a grave danger on populations in accessible and partially accessible settlements.

Feedback on key findings and recommendations from the review were also presented to both Sokoto and Borno PEI teams prior to the national level debriefing. The team, which noted waning political interests, especially the low participation by Local Government Chairmen in evening review meetings during SIAs, called on the Governors’ Forum to reward high performance as well as sanction local government areas with dwindling SIA performance  indicators to dissuade complacency.

In their separate responses, both the WHO Country Representative (WR) Dr Wondimagegnehu Alemu and the Executive Director of the National Primary Healthcare Development Agency (NPHCDA) Dr Faisal Shuaib acknowledged the objective feedback and assured the OBRA team of speedy implementation of key recommendations.

Dr Alemu specifically appreciated the external assessment and pledged that WHO and other GPEI partners will “make sure that this time around, Nigeria kicks polio out for good”. 

The ED NPCDA in his parting words pledged that the government will not relent until the immunity of remaining children in the 40% inaccessible areas of Borno is boosted by administering adequate doses of polio vaccines, with support from the military.

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, KOFIH (Korea), DFID (UK), Rotary International and the World Bank.

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For more information, please contact:

Technical contact:
Dr Fiona Braka; Tel: +234 703 170 5252; Email: brakaf [at] who.int " target="_blank"> brakaf [at] who.int
Media contact:
Ms  Charity Warigon; Tel: +234 810 221 0093; Email: warigonc [at] who.int" target="_blank"> warigonc [at] who.int
Below:

01. Dr Zainul Khan presenting preliminary findings by OBRA in Kaduna

02. OBRA team briefing Sokoto state team. Photo - WHO J Swan

03. OBRA team in group photo   with WR (5th from  left), ED (middle) and participants  from government and partner agencies. Photo - WHO C Warigon