US embassy cable - 04ABUJA731

UNCLAS SECTION 01 OF 02 ABUJA 000731 
 
SIPDIS 
 
DEPT FOR AF/W, USAID/W FOR AFR/AA, CONSTANCE NEWMAN, 
AFR/WA, MICHAEL KARBELING, GH/AA, ANN PETERSON, GH/CH 
SURVIVAL, HOPE SUKIN, OES/IHA 
LAGOS FOR ADMIN 
 
E.O. 12958: N/A 
TAGS: PGOV, SOCI, NI, SOCI, KHIV, AID 
SUBJECT: NIGERIA: STATUS OF POLIO ERADICATION 
INITIATIVE (PEI) 
 
REF:  03/25/04 POLIO ERADICATION INITIATIVE CABLE 
 
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SUMMARY 
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1. This cable provides an update on the current 
situation related to polio eradication in Nigeria, 
including actions in process and to be undertaken over 
the next two-week period. 
The Deputy Governor of Kano State told Chargi April 26 
that GON, UN and Kano were in agreement that polio 
vaccine would be procured from Indonesia under State 
supervision.  Once the procurement is accomplished a 
public education program would be launched to convince 
Kano residents that the vaccine was uncontaminated. 
Kano State leadership is now waiting for the GON to 
arrange the procurement trip to Indonesia. 
There has been no polio immunization activity in Kano 
since mid-2003, resulting in a rapid increase in new 
cases and a widening of the geographic area affected. 
In 2003, Nigeria recorded 355 of the 745 cases 
worldwide.  From January 1 to February 24, 2004, 63 
cases have been confirmed in 17 states  7 of the 
cases are in Kano and 14 in Kaduna. 
The second round of 2004 National Immunization Days 
(NIDs) has been concluded and debriefings held at the 
national level.  Currently round three (April 24-27) 
is under way in all states except Kano. 
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CURRENT ACTIVITIES 
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2.   Firm dates have been set for the remainder of the 
2004 rounds: May 22-25; October 9-12; and November 13- 
16.  Responsive mop-ups will be conducted between June 
and September.  Further, all rounds for 2004 will be 
full NIDs, as opposed to sNIDs (sub-National 
Immunization Days) that would target only infected 
states, in view of the fact that 24 of the 37 states 
are now infected with the wild poliovirus and all 37 
are considered 'at risk.' 
3. The Governor of Kano traveled to the United 
States and returned on April 15.  Prior to his 
departure, he met with the US Charge d'Affaires (ref 
cable #00553) and with Dr. (Mrs.) Awosika, Chief 
Executive of the National Program on Immunization 
(NPI).  In both meetings, Governor Shekarau indicated 
a willingness to resume implementation of the national 
immunization days (NIDs) as soon as certain conditions 
are met (i.e., assurance and provision of "clean" 
vaccines).  Kano Deputy Governor Abdullahi met with 
the Chargi April 26.  He affirmed that the GON, UN and 
Kano Governor had agreed that a Kano State delegation 
would accompany GON representatives to Indonesia to 
procure vaccine.  If the Kano delegation were 
convinced that the vaccine was uncontaminated, the 
State would permit reintroduction of the OPV.  The 
Deputy Governor noted that a public education campaign 
would be necessary to re-educate the public that 
originally rejected the vaccine. Kano is now waiting 
for the GON to schedule the procurement trip.  The 
Deputy Governor maintained that there is frequent 
contact with the GON about the vaccine procurement, 
but was unclear about a timeline. 
4.  Dr. (Mrs.) Awosika met, on Thursday, April 8, with 
Dr. Bichi, one of the Kano scientists who initiated 
the protest against the oral polio vaccine (OPV), the 
Commissioner of Health and the Primary Health Care 
Director of Kano State.  At that time, they echoed the 
sentiments of the Governor (above) and felt confident 
of full participation by Kano in the near future. 
5. The WHO Country Representative, Dr. Mohammed 
Belhocine, contacted the Minister of Health on April 
12 to obtain a status update.  The Minister said he 
would meet with the Governor as soon as possible and 
request that he make a public statement in order to 
adequately prepare for resumption of polio vaccination 
in Kano.  It remains now to wait for this public 
statement by the Governor, declaring his acceptance of 
the OPV available (most likely the batch from 
Indonesia) and his approval for Kano to fully 
participant in subsequent rounds.  The Minister 
further stated that an Inter-Agency Coordinating 
Committee (ICC) meeting would take place on Tuesday, 
April 20, the first ICC meeting since January.  During 
the course of that meeting there was, unfortunately, 
nothing new was reported on the status of Kano State's 
participation in the polio eradication initiative 
(PEI).  The April round is now underway, without Kano. 
 
6. It is now known that poliovirus from Nigeria has 
migrated as far away as Botswana, increasing the 
pressure on Nigeria to step up both coverage and 
quality of the NIDs nationwide.  Adding further to 
that pressure, it has been reported that a new 
outbreak of meningitis is now occurring in some areas 
in Kano State, and rejection of even that vaccine is 
taking place in many areas throughout the state. 
 
7. Advocacy efforts continue throughout the northern 
states by the National Program on Immunization (NPI) 
and other agencies, as appropriate. 
 
8. The USAID initiative in Kano (participatory 
learning and action for community ownership - PLACO) 
has now completed the groundwork in all 44 of the 
local government areas (LGAs) in Kano State.  What 
this means is that, once a green light is given to 
resume the PEI, mobilization and implementation can 
happen quickly. 
 
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 DONOR COMMITMENT 
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9.  Government and donors have reviewed the first two 
NIDs rounds of 2004 and have re-organized the strategy 
for the remainder of the year, based upon the 
debriefing reports from the field. 
10.  The Core Technical Group continues to meet a 
minimum of once weekly, except during the 
implementation of NIDs, at which time the participants 
are in the field monitoring. 
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  NEXT STEPS 
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11.  Debriefing of the April round will take place 
immediately following conclusion of the round (April 
27) and preparation will begin for the May round. 
12.   ICC approval of proposed national-level 
structure changes must be secured at the next ICC 
meeting, scheduled for Monday, May 10, and subsequent 
actions initiated to make the changes quickly 
functional (e.g., formation of new working groups to 
replace former committees for training and social 
mobilization and an operations center in Abuja). 
13. A state of readiness will be maintained in Kano 
State in order to quickly mobilize as soon as the way 
becomes clear to resume vaccination activities in the 
state. 
 
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 CONCLUSION 
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14. The problem with polio eradication in Kano now 
hinges on the GON to follow through on its commitment 
to acquire OPV from Indonesia with adequate oversight 
from Kano State.  Once safe Indonesian vaccine is 
acquired, the Kano Governor has committed to 
implementing the PEI. 
 
15. Post will continue to provide regular reports on 
progress in the effort to eradicate polio in Nigeria. 
ROBERTS 
 
 
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