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STUDY: What Nigeria Must Do To Stay Polio-Free
Date Posted: 15/Jan/2020
Polio is a viral disease, transmitted from person to person, mainly through a faecal-oral route, contaminated water or food. The virus multiplies inside the intestines and causes paralysis in children. There is no cure for polio, but it can be prevented through administration of an effective vaccine – the Oral Polio Vaccine that rapidly boosts immunity levels and protects children from paralysis.
 
To end outbreak activities in any country, national and regional disease surveillance and laboratory teams must confirm that no polio transmission is detected in samples collected from paralysed children, children in contact, and the environment for at least nine months. To be declared polio free, a country must go three years without a case of wild poliovirus (WPV) detected Polio is no longer endemic in Nigeria; the has attained and surpassed this stage and is on the verge of being declared polio free by the World Health Organisation. 
Polio
Remarkable progress towards this goal marks almost three years with no case of wild poliovirus (WPV) reported. The progress was made possible with increased vaccination and surveillance reach in inaccessible areas in the northeast. Innovative and impactful strategies and special interventions targeted at vaccinating more children have paid off. 
 
The innovative strategies resulted in more settlements being accessed and thus more children vaccinated in security-compromised areas in the northeast zone of the country. In December 2109, a team from the African Regional Certification Commission , ARCC, for the eradication of poliomyelitis, visited the Federal Capital Territory and six States – Abia, Delta, Ebonyi, Edo, Lagos and Oyo. Following a critical analysis and assessment of the status and integrity of certain parameters, the green light was given. Aspects such as routine immunisation, cold chain, surveillance activities, documentation, etc., health facilities at the primary, secondary and tertiary levels, were assessed as well as the polio eradication processes carried out at those levels. The ARCC team is expected to reconvene in March 2020 for a final verification visit to states in Northern Nigeria. 
 
Preparation for the second phase of the review is in high gear because the based on the recommendations, Nigeria may receive polio free status, while the African Region could be certified to have eradicated polio by June 2020. It is cheering to note that Nigeria has initiated a robust national action plan to ensure polio is eradicated once for all, however, specific steps need to be taken before this can come to pass. 
 
In the countdown to polio eradication, Nigeria must strengthen routine immunisation strategy under the Temporary Recommendations as required by the Emergency Committee of the International Health Regulations regarding the international spread of poliovirus under the World Health Organisation setup. In addition, Nigeria must continue to ensure that all children under the age of five are rountinely vaccinated. 
 
Nevertheless, the risk of international spread of poliovirus remains a Public Health Emergency of International Concern, PHEIC, and a recommendation for the extension of Temporary Recommendations was deemed necessary by the WHO. Based on the current situation regarding WPV1 and circulating vaccine-derived poliovirus, cVDPV, and the reports provided by affected countries, the WHO Director-General determined that the situation relating to poliovirus continues to constitute a PHEIC, with respect to WPV1 and cVDPV. 
 
The Director-General endorsed the recommendations for countries meeting the definition for countries still at risk one way or another. Already, Nigeria has officially declared at Federal and State government, level the interruption of WPV1 transmission as a National public health emergency and is maintaining the response as required. With the most recent detection of the circulating vaccine-derived poliovirus, cVDPV2, on the 9th of October 2019, Nigeria is also maintaining emergency status. 
 
Along with other countries, a high level state of preparedness is desired. The possibility of cVDPV2 importation remains a threat and appropriate response to such importations must be treated as a national public health emergency. What this means is that Nigeria should continue to ensure its polio surveillance mechanism can rapidly detect cVDPV2, with plans in place to respond rapidly with well planned and executed mOPV2 campaigns. 
 
In line with international coordination, more action is expected in support of cross border actions, such as sharing of surveillance and other data, synchronising campaigns and where possible ensure vaccination of international travelers.

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