On July 24, 2015, Nigeria passed an important milestone marking an entire year without a single new wild poliovirus case. This is a remarkable achievement in the global effort to eradicate polio.
This week, we detailed in a report with cautious optimism that polio will be gone not only in Nigeria but in all of Africa.
Only a few years ago, Nigeria was Africa’s last outpost of polio and seemed to be losing the battle against the disease. In 2012, Nigeria recorded 122 cases — more than half of all cases worldwide.
With dedication and hard work from the Nigerian government and Global Polio Eradication Initiative partners such as Rotary International, the Centers for Disease Control and Prevention, World Health Organization, UNICEF and the Bill and Melinda Gates Foundation, as well as tens of thousands of health workers, nearly every child in the country was vaccinated against polio. Special efforts were focused on hard-to-reach areas.
Last year, the payoff from these efforts became clear. Only six new cases were recorded in 2014 compared to 53 in 2013. And this year, the number has fallen to zero. In the next few weeks, intensive laboratory testing at CDC as part of the Global Polio Laboratory Network will help confirm whether polio is truly gone from Nigeria.
Getting to this point wasn’t easy. Emergency Operations Centers were set up in the capital, Abuja, and six other locations in northern Nigeria to coordinate polio elimination activities and increase countrywide collaboration. CDC supported more than 200 Nigerian doctors and other health experts to work in more than 150 of Nigeria’s riskiest areas to improve vaccine program performance.
Nigeria accepted a CDC and WHO recommendation to use Inactivated Polio Virus injections in addition to oral polio drops, an intervention that seems to have made a difference in northeastern states just in time. Soon after the vaccine drive, Boko Haram interfered with further public health, including vaccine efforts.
There was strong investment by the national government, including an increase in domestic polio funding almost every year since 2012, with $80 million earmarked for the program in 2015. Thousands of health camps were conducted in high-risk and underserved areas to help build trust among a wary public as well as deliver other health services alongside the polio vaccine.
It’s not yet certain that the country is polio-free, but in my visit a few weeks ago, I was impressed with Nigeria’s rigorous and robust efforts to find every possible case all over the country, including in the security-challenged northeast. If there is any sign of polio’s return, the country is poised to move quickly and decisively. Political support, program funding and high vaccination rates throughout the country must be maintained, even without any polio cases.
In the next few months, we anticipate that Nigeria will be taken off the list of countries with established polio cases once the absence of wild poliovirus is confirmed by laboratory results. Over the next two years, polio surveillance data must be assured to meet global standards, not only in Nigeria but also in other countries such as the Democratic Republic of Congo, which has large isolated population groups in which polio could be lurking. This is necessary to certify the entire African region polio-free.
Eradicating polio remains a priority for CDC. We have never been closer to this elusive goal than we are today, as new cases now occur in only two remaining countries: Afghanistan and Pakistan.
But closing the last gap is often the most difficult. That’s another reason Nigeria’s success is important. It provides a clear example of success despite difficulty. While we are on the verge of an important public health milestone in Africa, the job is not yet done.
To end polio forever, all countries must strengthen immunization service delivery, address gaps in disease surveillance and do more to reach children missed by vaccination programs. The U.S. Global Health Security Agenda will take the same systems we use to eradicate polio and use them to help protect America and the world from other disease threats.
Dr. Tom Frieden is the director of the Centers for Disease Control and Prevention. The opinions expressed in this commentary are solely those of the author.