Mr Gbenga Olayiwole, the National Programme Coordinator for Rotary International’s Polio Plus Programme in Nigeria and a member of the National Polio Emergency Operations Centre (EOC), at a symposium organised by the United Nations Children’s Fund (UNICEF), in collaboration with the Federal Ministry of Budget, the National Guild of Editors and the Diamond Award for Media Excellence, with the theme ‘Reinforcing the Role of the Media in Mainstreaming Child Rights’, recently in Lagos, spoke with SADE OGUNTOLA. Excerpts from the interview are here presented:
What is the polio situation in Nigeria?
During the global COVID pandemic, Nigeria celebrated being wild polio-free. Then there was a lockdown. It prevented vaccination of children against polio. Routine immunisation was disorganised; we had no house-to-house vaccination campaign while the lockdown was going on. But despite the lockdown, people were still giving birth, and we were not protecting these babies against vaccine-preventable childhood diseases. So, after the pandemic, we had an escalation in the cases of childhood diseases like measles and polio. We were adding more children to the population, but we are not protecting those children against these diseases. The year following that pandemic, we had 419 polio cases in Nigeria, not wild polio which has been eliminated from Africa, by the way.
What we had is what we call the circulating variant of the polio virus, which is a product of our failure to immunise enough children with the polio vaccine. Since then we have been battling to bring it down. This year already, we’ve had almost 80 cases in 15 states. But it’s not widely discussed, so most people do not know. But this information is updated on the global polio eradication website and available for anybody wanting to be updated.
What is the difference between this circulating variant of the polio virus and the wild polio?
Well, the circulating variant of the polio virus is less severe compared to the wild polio. But it still causes crippling. A child can get crippled or killed by the polio virus. However, for the family involved, it doesn’t matter whether it’s wild poliovirus or circulating variant polio. Polio is polio to them.
What is the government doing to curb it or eliminate it?
The government is doing quite a lot. Kudos to the new executive director of the Nigerian Primary Healthcare Development Agency (NPHCDA), Dr Muyi Aina, and the Nigeria Polio EOC under the leadership of Dr Usman Abdulkadir Gana, who keeps challenging us every day that for us to have better results, we need to do things differently. For instance, we have an outbreak response going on around the country. But the challenge is, how do we do it differently and make it more data-driven and more effective? The current drive of the programme in Nigeria is to interrupt the transmission of the circulating variant of the polio virus by December of this year. Unfortunately, it does not appear we will meet that target. But we are working very hard to ensure that we interrupt all forms of transmission by 2025.
Why did you say you were not likely to meet the target?
What the data is suggesting to us is that the virus is actively moving. Recently, a state like Kogi State, which did not previously have the virus, reported two new viruses. The surveillance still tells us that the virus may still be in other places that we have not seen. So, we do not expect realistically that this will be the year that we get rid of that variant of the polio virus from Nigeria. Rotary, with other partners, including WHO, CDC, Gates Foundation and Gavi, is working together with the NPHCDA to ensure that if we don’t do it this year, we’ll do it in 2025.
Does it mean that the issue of the variant of the polio virus has been there even before Nigeria got its certification as polio-free?
As of the time we were celebrating polio-free Africa, the circulating variant was not this much. So we had every right to celebrate. Although I do say that we might have gone a little bit over, it was a significant achievement. There’s no gainsaying it; it was a significant achievement because other regions had achieved these. But it took so long for Africa to kick out all forms of wild poliovirus from the continent. However, what the government and the partners involved in polio did not mention is that despite this achievement, we still have a small problem. We still have the circulating variant of polio that we need to deal with. That is why we are coming back to you now, as our media partners, with this message that, oh, yes, it is true, we achieved wild polio virus-free Africa, but we still have a problem with the circulating variant polio virus, which also cripples and kills children. And we need your help in tackling it.
So, what exactly is the reason for this circulating variant polio virus? Is it because of insecurity or negligence of parents?
It’s easy to criticise the government. One thing we should understand is that the government is still the pillar of whatever we are doing in polio eradication. The main source of funding is still the government. The partners cannot fund what the government funds. For instance, last year, Rotary International committed about $14.7 million to surveillance activities in Nigeria and another $7.5 million towards advocacy, communication, and social mobilisation through UNICEF and WHO. In total, the Rotary Foundation has put over $40 billion into polio eradication in Nigeria in just one year. So, we are doing our bit, and the government is also doing their bit. But the thing is that when you have a situation where there’s expanding insecurity, making children inaccessible, and we have gated communities in places that are even secure, we will continue to have polio cases.
In Lagos, one of the challenges is the gated estates that won’t allow children to be vaccinated. A lot of our estates are like this. These children are unprotected. And the fear of many in these estates is that if the vaccine is coming from the government, it must not be good. What most people don’t understand is that even the vaccine they go and take from private establishments is also coming from the government, even though they will charge them for it. So, why not get it directly from the source and get it cheaply or without any cost rather than get it at a very high price?
Another factor is misinformation. People believe certain things about the vaccine. The vaccine will do this or that. But look at us. We had a population of about 88 million in 1987 when we started the Expanded Programme on Immunisation (EPI). If the vaccine was to reduce our population, does it make sense that we are now 250 million people? The misinformation is out there, and we need the press to help us give good information. The vaccine cannot be a source of reducing population if our population is even growing at a higher rate than it was before. Misinformation is a big factor. During the last HPV vaccination, there was a lot of misinformation. They want to reduce our population; they want to kill us and all that. And it affected the polio programme as well.
The COVID vaccination put stress on our health system as well. Our health system is also recovering from that. So there is a multiplicity of factors. But like I said, all of us are pulling together as a team, and the Executive Director of NPHCDA is leading us to think differently and to do things differently so that by 2025, we stop talking about polio in Nigeria.
As of 30 November, 2024, how many circulating polioviruses did we have?
The figures are available for anyone on the polioeradication.org, but as of today, the report on the website, which I monitor every week, is still reading 81 viruses for Nigeria, but the national team is reporting 79, even though we also acknowledge that the number is likely to go up because we have 13 viruses in the laboratory that we are also testing to see whether they are positive or not. That is in 15 states of Nigeria.
Rising from this meeting, what is your charge to journalists?
Please help us pass this information to mothers, fathers, and caregivers that our vaccination team is going around houses; we are all over right now trying to get parents and carers to help us bring out these children so that we can vaccinate them so that we can protect them. Ideally, two drops should do it, but when we give multiple drops, what we are trying to do is to build immunity faster. So there is no case of overdosing of the polio vaccine, but we can make your immunity stronger by repeated and multiple routes. That is why we keep coming, and then the more we come, the higher the chance that the child that we did not get in April, we will get in June, and the one we didn’t get in June, we will get in July, so we keep coming and coming until we are sure that we have vaccinated all the children because the goal is to make sure that no child is left unvaccinated.
It has been observed that some churches don’t allow vaccinators access to children during service, claiming that it disrupts their church service. Some claim that the vaccination officials should go for approval from the kids’ parents first. How do you tackle this challenge?
You are very correct. We are engaging churches more. And at the same time, we are also using other strategies like church vaccination teams. You know, there’s a loss of trust in the country. People suspect each other. So, we are now using Christian teams, who can also be members of the church. We train them on how to administer the vaccine; we give them the vaccine. We pay them a small sum to carry out the vaccination in their church by their members. So we are using different interventions just to get trust.
Also, there is something we call IBRA in between round activities. It’s a programme that the National EOC strongly supports and, in our own way, Rotary International. We target areas where we have low routine immunisation status and areas where we have previously reported the virus. Now we target them with specialist intervention. We have centres for the management of acute malnutrition in children. And a lot of them occur in the north. We know children will come for nutrition management, and so we put the polio vaccine also there. We also do market vaccinations.
We target nomadic populations, and we send teams after nomadic populations to go and vaccinate them against polio. We also go after those locations where we think we can get vulnerable children who have not been vaccinated and vaccinate them. Rotary International is also sponsoring things like roadshows in-between rounds to create awareness on polio. We also sponsor health camps in communities where they do not have enough health infrastructure or health support. All this is in a bid to ensure that we vaccinate more children.
You said the gated areas are also a problem. How do you mean?
Yes, they are a big problem. Most estate associations don’t allow our vaccinators to come in to vaccinate children in these gated estates. Even if the man of the house can afford to take his children to a private hospital, what about the security guard who is living there?
Mothers have complained that every month, every other month, their children are made to have different vaccines. Is that safe?
It’s safe; there’s no overdose of the polio vaccine. We have been vaccinating for over 40 years with the polio vaccine, and we have not had one single case of a child who was overdosed by the polio vaccine.
Two, sometimes you vaccinate a child, and that child may not be immunised because they did not seroconvert the vaccine. So repeated vaccination efforts will help us to make sure that that child is immunised. You can vaccinate a child, and that child may not be immunised because he may not convert the vaccine, maybe because he was sick or malnourished. But if he has another opportunity for vaccination and you do it repeatedly, you increase the chances that that child will become immunised.
So we are giving booster doses consistently and constantly to help us ensure that, one, we increase the immunity level of our children. Two, we increase the possibility that we cover every child and we do not miss any child. But like I said, it’s no danger to the child.
So, what is the best way to solve vaccine hesitancy as we continue to advocate that no child should die or become paralysed due to polio?
A lot of harm is being done by sensational news that comes sometimes on online platforms or regular media. I recall a time when mpox was an issue. I was with the editorial team of a newspaper, and I spent over one hour trying to convince them that mpox vaccination was not an attempt to reduce the population of certain people. If an editorial team seems to be so invested in pushing that narrative, then you can imagine a layman, what the attitude would be. So we need partnerships with the media to help us push the right narratives.
People cite many misconceptions, but in reality, there is no evidence that the polio vaccine has ever harmed anyone. And we need you to help us push this narrative so that parents will become more convinced. If they’re talking about sterilising children or sterilising people, should our population be increasing from 88 million to 250 million? So, when mothers and caregivers hear it, then we’ll get better vaccine outcomes, and we’ll protect the lives of our children.
We pledge to eradicate polio in Nigeria. We’re talking about keeping polio at zero. We are doing our best to make sure that we have zero polio in Nigeria.
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