US embassy cable - 04ABUJA734

UNCLAS SECTION 01 OF 02 ABUJA 000734 
 
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 Charg 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 - 17 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 Charg 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