US embassy cable - 04ABUJA1185

UNCLAS SECTION 01 OF 02 ABUJA 001185 
 
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 
 
E.O. 12958: N/A 
TAGS: PGOV, EAID, SOCI, NI 
SUBJECT: NIGERIA: STATUS OF POLIO ERADICATION INITIATIVE 
(PEI) 
 
REF: ABUJA 924 
 
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SUMMARY 
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1.  It is still anticipated that Kano will begin catch-up 
immunization programs this summer and rejoin the nationwide 
schedule when it resumes.  It is less clear now, however, 
what the schedule will be or when it will begin.  The 
Governor has now convened another panel to examine the latest 
test results brought forward by Dr. Bichi.  Workers sent to 
the state from the National Program on Immunization (NPI) to 
prepare for resumption of PEI were sent home and told to 
cease their activities for the present.  Solutions to the 
latest concerns are being sought by GON, Kano State and the 
donor community to enable resumption of PEI.  WHO is 
beginning travel advisories to cover the entire north of 
Nigeria. 
 
2.  Post renews its request for 2 million USD in ESF to move 
this program forward; only substantial additional resources 
will allow USAID work in Kano State to go forward.  Please 
see Embassy cable of July 6.  END SUMMARY 
 
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CURRENT ACTIVITIES 
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3.  Polio Situation:  There are now - as of June 23, 2004, 
259 confirmed polio cases in 30 Nigerian states recorded 
since January 1, 2004. This accounts for 77 percent of the 
total global wild poliovirus case count and 85 percent of the 
cases in Africa since the beginning of 2004.  As the virus 
enters the highest transmission period, post anticipates the 
Nigeria case count will increase significantly. The most 
recent country to be re-infected with poliovirus originating 
from Nigeria is Sudan, where a case has been identified in 
Darfur. 
 
4.  With the far-reaching and growing spread of this virus, 
the Director General of WHO has become personally involved in 
seeking solutions, resulting in phone conversations with the 
Governor of Kano State to offer support and convey concern of 
all UN Member States over the current status.  While the 
governor was cordial and receptive, he declined to offer a 
firm date for resumption of PEI. 
 
5.  WHO will be obliged, if the current situation continues 
unabated, to impose a travel ban to cover the entire north of 
Nigeria, for obvious epidemiological reasons (85.7% of total 
cases in Nigeria are in the northern region).  The ban will 
apply to both incoming and outgoing travelers. 
 
6.  USAID's Child Survival Project in Kano State flagged off 
Child Health Week on June 15 and ended the program a week 
later, on June 22.  All routine antigens were available and 
administered to Kano children during the week, with the 
exception of oral polio vaccine (OPV).  It was previously 
hoped that OPV could be reintroduced into Kano by this means 
(at fixed-post sites rather than door-to-door) to remove the 
onus that has gathered around the singular  intervention of 
polio.  Other child health components offered during the week 
were demonstrations of bed-net dipping, administration of 
vitamin A, nutrition demonstrations and counseling, and 
growth monitoring and promotion.  The turnout during the week 
was large, with many residents inquiring about OPV and 
requesting it.  A full report on Child Health Week will be 
available in July. 
 
7.  The GON is in close contact with the Governor of Kano 
State to find a solution to the recurrent stand-off.  Donors 
are also in touch to offer assistance as needed and 
requested, although WHO declined a request by Kano State to 
fund further international testing of OPV.  WHO responded by 
saying they see no need for further testing of vaccines from 
a certified and approved lab, and that sufficient testing had 
been done in the opinion of everyone else concerned. Dr. 
Lawan Bichi, a pharmacist who has been serving as the 
scientist for Kano State, has concluded more local testing of 
available Indonesian vaccines and found them still to have 
unacceptably (to them) high levels of both estradiol and 
progesterone. 
 
8.  It seems clear that Dr. Bichi does not speak for either 
the Governor of the state or for the majority of state 
officials, since the Kano State Governor has now sidelined 
Dr. Bichi and appointed a committee of eight (8) men to 
review the latest, locally-produced laboratory report and 
make recommendations.  Word on the decisions of this 
committee will be available during the week of July 5th.  The 
latest testing came as a surprise to all concerned, since the 
Governor was making reassurances about and preparations for 
the resumption of PEI in Kano State.  This has created a 
set-back, but sources in Kano tell us that at least five of 
the eight committee members are favorably inclined to the 
eradication initiative.  Meantime, until all issues are 
sorted out and laid to rest officially, all PEI personnel who 
had been sent to Kano State to begin preparations were sent 
away and ordered to cease their activities for the present. 
 
9.  Donors continue to meet to craft a unified strategy that 
all can support.  Heads of donor agencies met on Monday, July 
5th, with the Minister of Health to spell out their concerns 
and to enlist his support for a new way forward with PEI. The 
Minister  expressed his understanding of the major 
impediments to the PEI and asked for a collective donor 
position paper on immunization, to be submitted by the 26th 
of July with a follow-up meeting on the 29th to take 
decisions on a way forward.  The paper and follow-up meeting 
will include approaches to polio eradication in Nigeria as 
well as a review of the NPI decree of 1997 determining the 
mandate of this body. 
 
10.  A joint proposal is due from WHO and UNICEF to USAID by 
July 12th.  This proposal will fund the polio eradication 
activities detailed in the previous cable, dated May 28th 
2004.  USAID plans to begin operationalizing the activities 
in the proposal as soon as the requisite paperwork is 
concluded and ESF funds made available. 
 
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USG COMMITMENT AND NEED FOR ADDITIONAL RESOURCES 
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11.  USAID remains committed to devoting exclusive attention 
to Kano State for the duration of the present Child Survival 
contract with BASICS, which will terminate at the end of 
August 2004.  Our proposed grants to WHO and UNICEF will 
allow us to continue our activities in Kano State with no 
gaps in service including both routine and polio 
immunization.   It is our plan in the short term through this 
mechanism to facilitate the reinstatement of PEI in the 
state, and in the long term to continue immunization efforts 
through the newly approved USAID social service delivery 
project. 
 
12.  Post reiterates its request for $2 million USD in ESF to 
support proposed activities in Kano State for both short- and 
long-term assistance. 
 
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NEXT STEPS 
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13.  Post will continue to provide regular reports on 
progress in the effort to eradicate polio in Nigeria. 
CAMPBELL