US embassy cable - 04ABUJA1186

C O N F I D E N T I A L SECTION 01 OF 02 ABUJA 001186 
 
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: DECL: 07/06/2014 
TAGS: PREL, PGOV, EAID, SOCI, NI 
SUBJECT: NIGERIA:  NEXT STEPS:  POLITICAL ACTION TO RESTART 
THE POLIO ERADICATION INITIATIVE (PEI) 
 
REF: A. ABUJA 1132 
 
     B. ABUJA 971 AND PREVIOUS 
 
Classified By: AMBASSADOR JOHN CAMPBELL FOR REASONS 1.5 (B) AND (D) 
 
1.  (C) Summary.  As the World Health Organization (WHO) 
pressures Kano State to resume the polio vaccination 
campaign, the National Coordinator/Chief Executive of the 
National Program on Immunization has refused to make state 
and local governments stakeholders in the process, 
frustrating the international donor community.  While Kano 
State Governor Ibrahim Shekarau claims to be receptive to 
restarting the vaccination program, opposition to the vaccine 
has taken on its own political life.  See also USAID Abuja 
cable of July 6.  End Summary. 
 
------------ 
Developments 
------------ 
 
2.  (U) The WHO announced on Friday, July 2, that it was 
investigating a new outbreak of polio cases in Rogo, 
southwest Kano State.  After it issued a travel advisory for 
northern Nigeria, the WHO said that the Kano State government 
had agreed to restart the vaccination campaign "within days," 
using vaccines from Indonesia, a fellow Muslim country.  WHO 
also warned that its advisory could become a ban on travel 
both to and from northern Nigeria. 
 
3.  (U) Over the 4th of July weekend, UNICEF told Mission 
that it had seen a report by Dr. Lawan Bichi, a pharmacist 
who had been serving as the Kano State scientist, claiming 
that the Indonesian vaccine had excessively high levels of 
female hormones, feeding into rumors that the vaccination 
campaign was an attempt to reduce fertility among Muslims. 
 
4.  (C) Dr. Bichi himself told Poloff that the state 
government is awaiting a final report from its current 
scientific committee before presenting its findings publicly. 
 Commenting that he was no longer involved in the issue, 
Bichi said he supported resolution of the issue because "we 
are Muslims, and as leaders, it is our responsibility to find 
out the truth." 
 
5.  (C) On July 6, the Ambassador raised polio with National 
Security Advisor Aliyu Mohammed Gusau, who assured the 
Ambassador that he is engaged on this issue and believes that 
Shekarau is sincere in his efforts to begin vaccinations.  He 
promised to arrange a meeting between the governor and the 
Ambassador this week, when Shekarau will be in Abuja.  Gusau 
said he was deeply concerned about the impact on Nigeria's 
international image caused by the critical articles in the 
international press. 
 
-------- 
Analysis 
-------- 
 
6.  (C) At the center of the issue is the National 
Coordinator/Chief Executive of the National Program on 
Immunization (NPI) since 1998, Dr. (Mrs.) Dere Awosika.  Her 
reluctance to include state and local governments in the 
implementation of the program is proving to be an enormous 
obstacle.  Rumors of improper fiscal practices have plagued 
Awosika since she assumed the post.  Recently, a 63 million 
Euro deficit in the accounts of the NPI was traced to her 
doorstep.  Appointed at the insistence of First Lady Stella 
Obasanjo, Awosika has proven immune to efforts to ensure her 
cooperation or accountability.  USAID plans to work jointly 
with UNICEF and WHO to push immunization at the state and 
local government level, and other donors are considering 
decentralized efforts as well. 
 
7.  (C) Kano State Governor Ibrahim Shekarau was ready to 
restart the vaccination campaign several weeks ago, but 
Awosika jumped the gun by prematurely announcing his 
intentions.  Shekarau was forced to back off, isolated and 
embarrassed, but now says he is ready again.  Talks over the 
weekend with Poloff in Kano indicate that the state is ready 
to move, and is now merely preparing publication of the final 
report on the vaccine.  Shekarau's spokesman announced to BBC 
Hausa Service on July 4 that implementation of the program is 
only "days away." 
8.  (C) Still, political stumbling blocks remain in the way 
of the vaccination campaign.  Whether or not Shekarau was 
ever in control of the opposition to the vaccine, he is not 
now.  Bichi's report is an example of the public face of a 
northern faction lobbying for a new political issue.  Shari'a 
occupied a prominent place in Nigeria's politics from 1998 
until 2003, but is no longer on the front burner.  This 
group, whose political fortunes hinged on the issue, is 
looking for a new relevance.  Opposition to the vaccination 
program is a cynical attempt to gain political advantage by 
fanning the flames of paranoia about the USG's intentions 
toward the Muslim community. 
---------- 
Next Steps 
---------- 
9.  (C) Two things could assist Shekarau and the Federal 
Ministry of Health to break the impasse on the issue.  First, 
the USG needs to push strongly behind the scene for the 
decentralization of the vaccination program.  While Awosika 
seems recalcitrant, we recommend an immediate focus on 
Minister of Health Eyitayo Lambo.  USAID, in coordination 
with the other donors, will approach Lambo as soon as 
possible with a strong push to decentralize the vaccination 
program, an action that Lambo apparently supports.  A public 
reformation of the national program, devolving control to the 
local and state level, is desirable both from a logistical 
standpoint and from a political perspective. 
 
10.  (C) The second element of this strategy is for a 
political push on the Kano State Governor to make a public 
announcement and a strengthened political effort to implement 
the program.  The National Security Advisor assured the 
Ambassador that the GON is making this push, but action from 
the Minister of Health would give Shekarau some political 
room to maneuver.  Shekarau may be able to deliver, but he 
wants a politically acceptable way out.  This change to the 
national program should give him the space he needs to act. 
These two elements should be combined and coordinated to 
allow Lambo and Shekarau to both be seen solving the problem, 
jointly, if possible, or at least in a coordinated fashion. 
 
11.  (C) For now, public pressure on either the GON or the 
Kano state governor could prove counterproductive, and the 
possibility of a WHO travel ban could impede progress on both 
fronts.  It is critical that the USG engage on these issues 
immediately, as the news of additional outbreaks are yet to 
hit the Nigerian press.  Once new stories break, and WHO 
ratchets up the pressure on Shekarau and the GON, the 
Nigerian aversion to public criticism and arm-twisting could 
be strengthened, delaying implementation even further. 
CAMPBELL