Abuja, 28 March 2018 - The 35th Expert Review Committee for Polio Eradication and Routine Immunization (ERC) has expressed optimism that the Nigerian programme is on course to achieving polio eradication with ‘impressive progress’ recorded. 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.

The summary of the experts’ feedback was contained in a presentation by Dr Pascal Mkanda, Polio Eradication Programme Coordinator of the World Health Organization (WHO) Regional Office for Africa, after meeting with government officials, partners and other stakeholders in Abuja from 26-27 March, 2018 to review progress of the programme in Nigeria.
“With no wild polio virus reported for 18 months in accessible areas, there is a unique opportunity for Nigeria to get the job done within the lifetime of the current administration,” Dr Mkanda said.

Giving further highlights of the ERC’s findings, he noted that despite the insecurity in some parts of the Northeast, there was a one-third reduction in inaccessible population over a period of 6 months. This was possible through the implementation of several different strategies.

Last lap dependent on total access to children 
The ERC commended the unconventional efforts that the government has made towards increasing access to children trapped in areas with extant insecurity. However, there are communities still inaccessible and children unreached due to insurgency. 

The position of ERC is that “The conflict situation in Borno State is still very fragile; nevertheless the programme has innovative ways for reaching communities that were previously inaccessible such as Reaching Inaccessible Settlements (RES), Reaching Inaccessible Children (RIC) and transit vaccination strategies. More than 95% of the settlements planned for RES have been reached in Borno vaccinating about 272,000 children while RIC has reached over 52,000 children”. The innovative approaches resulted in the reduction of the estimated number of trapped children from over 600,000 in 2016 to about 104,000 by end of 2017.

Consequently, the members of the ERC recommended that the Federal Government and Borno State further accelerate the RIC strategy (RIC)  by June-August (before the start of rainy season which is the high polio transmission season) vaccination and surveillance in consultation with the military.

Maintaining cross-border focus on high-risk populations

The 35th ERC expressed concern that 178 Nigerian Islands in the Lake Chad Basin remain unreached with immunization and surveillance. Access to these islands, in collaboration with the neighboring countries in the basin needs to be intensified before the rainy season. 

Furthermore, the initiative to track nomads and mobile populations, as well as conduct synchronized activities at the borders was commended.
 

Sustaining high quality surveillance to reduce risk of undetected transmission

ERC Members posited that reliability of acute flaccid surveillance data is of critical importance hence the need to ensure a high quality case verification process. They also requested that the Nigeria programme carry out sensitivity analysis of each environmental surveillance site and ensure sewage sample collection is supervised/monitored by polio officers

Resources required to finish the job

Noting the dwindling global financial resources commitment towards the polio eradication initiative, ERC recommended the Federal Government increase its 2018-2020 financial commitment to sustain critical activities towards certification. 

Additionally, “Funds for Basic Health Care Provision should be appropriated by the National Assembly and assented to by the Presidency,” Dr Mkanda said. 

Sustain engagements for strengthening routine immunization and primary healthcare

Encouraged by launch of Community Health Influencers, Promoters and Services (CHIPS), the experts’ tasked government to map all community mobilization structures; determine a sustainable financing modality for the CHIPs; and sustain traditional and religious leaders’ engagement for routine immunization and Primary Healthcare system strengthening. 
The ERC further urged the Nigerian programme to fully implement a previous recommendation on the launch of an intensive advocacy and communication campaign, highlighting the devastating burden of under 5 deaths in Nigeria due to low vaccination coverage at all levels.
At the end of the 2-day meeting, the Chairman and ERC members debriefed Nigeria’s Minister of Health , Professor Isaac Adewole who reaffirmed present  government’s commitment to eradicating polio.
Support for immunization to the Government of Nigeria through WHO, is made possible by funding from the Bill & Melinda Gates Foundation, Department for International Development, European Union, Gavi, the Vaccine Alliance, Global Affairs Canada, Government of Germany, through KfW Bank, Japan International Cooperation Agency, Korea Foundation for International Healthcare, Measles and Rubella Initiative through United Nations Foundation, Rotary International, United States Agency for International Development, United States Centre for Disease Control and Prevention and  World Bank.

Technical Contact:

Dr Fiona Braka; Tel: +234 703 170 5252; Email:  brakaf [at] who.int (brakaf[at]who[dot]int)